Burlington, WA · Skagit County

No notary required

Protected Person’s Motion to Modify or Rescind Domestic Violence No-Contact Order and Notice of Hearing

Protected people or their parents or guardians use this form to ask the court to modify or rescind a domestic violence no-contact order.

What this form is

This form lets a protected person, or that person’s parent or guardian, ask the court to modify or rescind a domestic violence no-contact order. It asks for case and defendant information, the date of the existing order, reasons for the request, any requested changes, and the signer’s certification. The form also includes a notice of hearing for the motion.

Who needs it

A protected person, or the protected person’s parent or guardian, can use this form to request a change to or rescission of the order.

How to submit it

Submit it to the city department named on the form; check the city website for current contact details.

About notarization

This document is signed without a notary; the protected person or parent or guardian signs and dates a certification under penalty of perjury.

How to submit this form

  1. 1

    Download The Form

    Download the motion and notice of hearing PDF.

  2. 2

    Complete The Request

    Enter the case and defendant information, identify the existing order, explain why you seek a change, and state any requested terms.

  3. 3

    Sign And Date

    Sign and print your name, then complete the city and state and date fields for the certification under penalty of perjury.

  4. 4

    Submit To The City

    Submit the form to the city department named on it; check the city website for current contact details.

Frequently asked questions

What does this form request?
A protected person, or their parent or guardian, uses it to ask the court to modify or rescind a domestic violence no-contact order.
What information does the motion ask for?
It asks for case and defendant information, the date of the existing order, reasons for the request, requested changes, and a signed certification.
Do I need a notary for this motion?
No. The signer signs and dates a certification under penalty of perjury; the document does not require a notary.
How do I submit this motion?
Submit it to the city department named on the form; check the city website for current contact details.

Need something notarized?

This Protected Person’s Motion to Modify or Rescind Domestic Violence No-Contact Order and Notice of Hearing doesn’t need a notary — but if you have another Burlington form that does, a commissioned online notary can help.