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FM-1193 (The Superior Court of California, County of Santa Clara)

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FM-1193
FM-1193 5/26/2020
For Mandatory Use
STIPULATION AND WAIVER OF HEARING ON REQUEST FOR ORDER
Page 1 of 2
ATTORNEY OR PARTY WITHOUT AN ATTORNEY (NAME AND ADDRESS): TELEPHONE NO.:
FOR COURT USE ONLY
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA
STREET ADDRESS:
201 North First Street, San José, CA 95113
MAILING ADDRESS:
191 North First Street
CITY AND ZIP CODE:
San José, California 95113
BRANCH NAME:
Family Justice Center
PLAINTIFF/PETITIONER:
DEFENDANT/RESPONDENT:
OTHER PARTY:
STIPULATION AND WAIVER OF HEARING ON
REQUEST FOR ORDER
CASE NUMBER:
APJ:
THIS STIPULATION MAY NOT BE USED TO WAIVE A HEARING
ON A REQUEST FOR A DOMESTIC VIOLENCE RESTRAINING ORDER
In light of the ongoing public health emergency and its effect on the Court’s ability to conduct hearings on all but the
most urgent matters, the parties to the above-captioned matter hereby STIPULATE and AGREE to all of the following:
1. The Court may issue a decision on the Request for Order re: _____________________________ (the “RFO”), filed
by ________________________ (name of party) on ___________________ (date filed) based solely on the
pleadings and without conducting a hearing.
2. The following pleadings have been filed, and should be considered by the Court, in rendering its decision (identify
all relevant pleadings by date, party, and title of document):
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
3. The pleadings listed above were timely and properly served, and/or any defects in notice or service are hereby
waived.
4. All objections to the authenticity and admissibility of evidence included in the foregoing pleadings are waived unless
submitted in writing and attached to this stipulation.
5. The Court may consider the additional materials which have not yet been filed but are described below and
attached to this stipulation (no more than 5 pages per side, including exhibits):
________________________________________________________________________________________
________________________________________________________________________________________
6. Upon the filing of this completed stipulation, the Clerk will vacate any hearing on the RFO and instead place the
RFO on the Court’s calendar for tracking purposes only. The Court will issue a written decision on the RFO and
send a copy to the parties.
FM-1193
FM-1193 5/26/2020
For Mandatory Use
STIPULATION AND WAIVER OF HEARING ON REQUEST FOR ORDER
Page 2 of 2
7. For any RFO seeking an order regarding child custody and/or visitation, the parties understand they must
participate in confidential mediation pursuant to Family Code section 3170 and Local Family Rule 2. The Court will
order the parties to complete Parent Orientation and Mediation unless the file shows the process has been
completed. The Court may also issue temporary child custody and/or visitation orders pending the completion of
mediation.
8. Each party consents to receive notices from the Court concerning the RFO at the following e-mail address and
telephone number:
Petitioner’s e-mail: ___________________________ Telephone: _______________________________
Respondent’s e-mail: _________________________ Telephone: _______________________________
Other Party’s e-mail: __________________________ Telephone: _______________________________
9. The parties understand their statutory right to present live testimony that is relevant and within the scope of a
hearing on the RFO. The parties also understand their right to cross-examine any adverse witnesses.
10. Each party represented by counsel has consulted with his/her/their attorney of record regarding these rights and the
consequences of giving them up. Each self-represented party has considered these rights and the consequences
of giving them up.
11. If one or both parties required the assistance of an interpreter to read and understand this stipulation, the interpreter
shall sign below. The interpreter can be a friend or family member who assisted in translating this form.
12. The parties are entering into this stipulation freely and voluntarily, and not due to coercion, duress or threats of any
kind.
13. The parties understand the court may determine a hearing is necessary despite this stipulation, and will notify the
parties if the RFO is re-scheduled for a hearing.
Dated:
(Signature of Petitioner)
Dated:
(Signature of Attorney for Petitioner)
Dated:
(Signature of Respondent)
Dated:
(Signature of Attorney for Respondent)
Dated:
(Signature of Other Party)
Dated:
(Signature of Attorney for Other Party)
_______________________________________ _____________________________________ ___________________________________
(Interpreter for Petitioner) (Interpreter for Respondent) (Interpreter for Other Party)
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FM-1193 (The Superior Court of California, County of Santa Clara)

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Completed 29 June 2021

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