For filing an ex parte Motion for Temporary Orders (CJD 400) when your child is in immediate danger. This template includes the Motion, a Sworn Affidavit, and a Proposed Order — all three documents you need to file.
This is your formal request to the court. Fill in your information above — the document below updates automatically. Print and file this with the clerk.
Probate and Family Court
Court: ______________________________
Docket No.: ______________________________
Case Name: ______________________________
MOTION FOR TEMPORARY ORDERS (Ex Parte)
I, ______________________, the Plaintiff in the above-captioned matter, hereby respectfully requests that the Court enter temporary orders on an ex parte basis pursuant to Probate and Family Court Rule 9, and in support thereof states as follows:
1. I am the Plaintiff in this matter. The minor child(ren) involved is/are: ______________________________.
2. The other parent is: ______________________________.
3. There is an emergency requiring immediate Court intervention. The facts supporting this request are as follows:
[Your emergency description will appear here as you type above.]
4. The relief I am requesting is as follows:
[Your requested relief will appear here.]
5. I am requesting ex parte review because providing notice to the other parent would create a risk of irreparable harm to the child(ren). The emergency cannot wait for the standard 10-day notice period required by Rule 9.
6. Attached in support of this Motion is my Sworn Affidavit and the following exhibits: ______________________________.
WHEREFORE, I respectfully request that this Court enter the temporary orders requested herein on an ex parte basis, and schedule a two-party hearing at the earliest opportunity.
Respectfully submitted,
______________________, Pro Se
Date: __________
This is your sworn statement. Do NOT sign at home — you must sign in front of a notary public. Most banks offer free notary services. Bring photo ID.
Probate and Family Court
Court: ______________________________
Docket No.: ______________________________
Case Name: ______________________________
Affidavit of: ______________________________
I, ______________________, being first duly sworn on this __________ day of __________, 20____, depose and state as follows:
1. I am the Plaintiff in the above-captioned matter. I reside at ______________________.
2. The following statements are based on my personal knowledge and are true and accurate to the best of my belief. If called as a witness in this matter, I could and would testify competently to the facts stated below.
3. The minor child(ren) involved is/are: ______________________________.
4. The other parent is: ______________________________.
5. The following facts constitute an emergency requiring immediate Court intervention. Without immediate Court action, the child(ren) face(s) a risk of irreparable harm:
[Your emergency description will appear here.]
6. The relief I am requesting is as follows:
[Your requested relief will appear here.]
7. I am requesting ex parte review because notice to the other parent would create a risk of irreparable harm to the child(ren).
I declare under the pains and penalties of perjury that the foregoing is true and accurate to the best of my knowledge.
Affiant Signature
Date: ____________________
NOTARY ACKNOWLEDGMENT
Commonwealth of Massachusetts, County of ____________ ss.
On this _____ day of ____________, 20____, before me, the undersigned notary public, personally appeared ______________________, proved to me through satisfactory evidence of identification, to be the person whose name is signed on the preceding document, and acknowledged to me that they signed it voluntarily for its stated purpose.
Notary Public Signature
My commission expires: ____________________
This is the order you want the judge to sign. Keep it clear and specific — the judge may sign it as-is or modify it.
Probate and Family Court
Court: ______________________________
Docket No.: ______________________________
Case Name: ______________________________
PROPOSED EX PARTE ORDER FOR TEMPORARY CUSTODY
This matter came before the Court on an ex parte basis upon the Motion for Temporary Orders filed by ______________________ (the "Plaintiff"), together with the Affidavit in support thereof. The Court having reviewed the Motion and Affidavit, and finding that there is a risk of irreparable harm to the minor child(ren) such that immediate Court intervention is necessary, hereby ORDERS:
1. Temporary sole physical and legal custody of the minor child(ren), ______________________________, is awarded to ______________________ pending further order of the Court.
2. The other parent, ______________________________, shall have no parenting time with the minor child(ren) pending the two-party hearing.
3. The other parent shall stay away from the child(ren)'s residence at __________________________ and the child(ren)'s school/daycare at __________________________.
4. A two-party hearing on this Motion is scheduled for __________ at ________ __M in the ________ County Probate and Family Court. Both parties shall appear.
5. This order shall remain in effect until modified or vacated by further order of the Court.
6. Other relief as requested: ______________________________________________________
Justice of the Probate and Family Court
Date: ____________________
DadHelp · Document Pack for Massachusetts · Not legal advice · dadcourthelp.com