Municipal Court County Court District Court Denver Juvenile Denver
Probate
_________________________________________ County, Colorado
Court Address:
Petitioner: ___________________________________
Address: _________________________________________
_________________________________________
v.
Respondent: ___________________________________
Address: _________________________________________
_________________________________________ COURT USE ONLY
Case Number:
16 Character #:
_______________________
Division Courtroom
PERMANENT CIVIL PROTECTION ORDER ISSUED PURSUANT TO §13-14-106, C.R.S.
Full Name of Restrained Person
Protected Person alleges Weapon
Involved Date of
Birth Sex Race Weight Height Hair
Color Eye
Color
M
F
Full Name of Protected
Person Date of
Birth Sex
Race Full Name of Protected
Person Date of
Birth Sex Race
The Court finds that it has jurisdiction over the parties and the subject matter; that the Restrained Person was
personally served and given reasonable notice and opportunity to be heard; that the Restrained Person
constitutes a credible threat to the life and health of Protected Persons named in this action; and sufficient cause
exists for the issuance of a Civil Protection Order.
The Court finds that the Restrained Person is is not governed by the Brady Handgun Violence Prevention
Act, 18 U.S.C. §922 (d)(8) and (g)(8).
This Protection Order DOES NOT EXPIRE and only the Court can change this Order.
A violation of a Protection Order is a crime and may be prosecuted as a misdemeanor, municipal ordinance violation,
or a delinquent act (if committed by a juvenile) pursuant to §18-6-803.5, C.R.S., and municipal ordinance.
The Court Orders that you, the Restrained Person, shall not contact, harass, stalk, injure, intimidate, threaten,
touch, sexually assault, abuse, or molest the Protected Persons named in this action, or harm, take, transfer,
conceal, or dispose of or threaten harm to an animal owned, possessed, leased, kept or held by any protected
party, a minor child of any other party, or otherwise violate this Order. You shall not use, attempt to use, or
threaten to use physical force against the Protected Persons that would reasonably be expected to cause bodily
injury. You shall not engage in any conduct that would place the Protected Persons in reasonable fear of bodily
injury.
1. Contact.
It is ordered that you, the Restrained Person, shall have no contact of any kind with the Protected Persons and you
shall not attempt to contact said Protected Persons through any third person, except your attorney,
except as follows:
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Case Name _____________________ v. ______________________ Case Number: ___________________
2. Exclusion from places.
You must keep a distance of at least _______ yards from the Protected Persons, where ever they may be
found.
It is ordered that you be excluded from the following places and shall stay at least ______ yards away from the
following places: (Please specify the address(es) where the Protected Persons reside, work or attend school.)
The Protected Person has requested that the address be omitted from the written order of the Court, including
the Register of Actions.
Home: ________________________________________________________________________________
Work: Name: __________________________ Address: ________________________________________
School: Name: __________________________ Address: ________________________________________
Other: _________________________________________________________________________________
Exceptions:
3. Care and Control Provisions.
It is in the best interest of the minor children that care and control of these children be awarded to:
_______________________________ (name of person).
This temporary care and control order and all other issues concerning the children, including Parenting Time and
Interim Decision-Making Responsibilities expires on _________________________ (date) not to exceed one
year from this Order. All other provisions of this Order remain in full force and effect permanently.
This Order governs any other Orders concerning the care and control of said children. However, provisions in
another Order concerning the children that do not conflict with this Order must be followed.
4. Issues Concerning Children. (Parenting Time and Decision-Making Responsibilities)
Parenting Time is granted, expires on _______________________ (date) and shall be as follows:
Interim Decision-Making Responsibilities expires on ______________________ (date) and shall be as follows:
__________________________ (name of person) shall have sole Decision-Making Responsibilities.
The parties shall jointly share Decision-Making Responsibilities.
Other as set forth in the “Other Provisions” section.
Parenting Time and Decision-Making Responsibilities shall be as previously ordered by the _______________
District Court, Case #______________
5. Other Provisions.
A Temporary Injunction is hereby entered by this Court and is in effect until ___________________ (date) not
to exceed one year after the issuance of this Order. This injunction restrains the Restrained Person from ceasing
to make payments for mortgage or rent, insurance, utilities or related services, transportation, medical care, or
child care when the Restrained Person has a prior existing duty or legal obligation to make such payments or from
transferring, encumbering, concealing, or in any way disposing of personal effects or real property, except in
Case Name _____________________ v. ______________________ Case Number: ___________________
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the usual course of business or for the necessities of life and requires the Restrained Person to account to the
court for all extraordinary expenditures made after the injunction is entered.
The Restrained Person shall not possess and/or purchase a firearm, ammunition, or other weapon.
The Court waives all fees and no fees for service should be assessed pursuant to §13-14-109, C.R.S.
Fees shall be paid by the Petitioner Respondent.
Arrangements for possession and care of an animal are as follows:
The Restrained Person shall not interfere with the protected person at the person’s place of employment or
place of education and shall not engage in conduct that impairs the protected person’s employment, educational
relationships, or environment.
6. Mandatory For Domestic Abuse Protection Orders which qualifies as an order described in 18 U.S.C.
§922 (d)(8) or (g)(8):
The Restrained Person shall not possess and/or purchase a firearm, ammunition AND, shall relinquish any
firearm within _____(hours) (24 or up to 72), and shall relinquish ammunition within_____(24 hours or up to 5
days). If the restrained person is in custody and cannot relinquish firearms and ammunition, the court orders you
to do so within 24 hours of your release from custody. The Restrained Person shall file proof of the relinquishment
with the court, within 3 business days of the relinquishment, as required by statute.
It is further ordered that:
This Permanent Protection Order is identical to the Temporary Protection Order and does not require service
on the Restrained Person.
This Permanent Protection Order is different from the Temporary Protection Order and requires service on the
Restrained Person before its provisions become effective.
Served Restrained Person in open court on __________________ (date).
By signing, I acknowledge receipt of this Order or Restrained Person is not present in courtroom.
____________________________________ ___________________________________________
Petitioner Date Judge Magistrate Date
___________________________________________
Print Name of Judicial Officer
____________________________________
Respondent Date
I certify that this is a true and complete copy of the original order.
Date: ___________________________ ___________________________________________
Clerk
Law Enforcement shall use all reasonable means to enforce this Protection Order.
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IMPORTANT INFORMATION ABOUT PROTECTION ORDERS
GENERAL INFORMATION
This Order or injunction shall be accorded full faith and credit and be enforced in every civil or criminal court
of the United States, Indian Tribe or United States Territory pursuant to 18 U.S.C. §2265. This Court has
jurisdiction over the parties and the subject matter.
Pursuant to 18 U.S.C. §922(g)(8), it is unlawful for any person to possess or transfer a firearm who is subject
to a court order that restrains such person from harassing, stalking or threatening an intimate partner of such
person or a child of such intimate partner or person, or engaging in other conduct that would place an intimate
partner in reasonable fear of bodily injury to the partner or child.
NOTICE TO RESTRAINED PERSON
A violation of a protection order may be a misdemeanor, municipal ordinance violation or a delinquent act (if
committed by a juvenile) and is a deportable offense. Anyone over the age of eighteen who violates this
Order may be subject to fines of up to $5000.00 and up to 18 months in jail. Violation of this Order may
constitute contempt of court. Anyone under the age of 18 who violates this Order may be subject to
commitment to the Department of Human Services for up to two years.
You may be arrested or taken into custody without notice if a law enforcement officer has probable cause to
believe that you have violated this Order.
If you violate this Order thinking that the other party or anyone else has given you permission, you are
wrong , and can be arrested and prosecuted. The terms of this Order cannot be changed by agreement of
the parties. Only the Court can change this Order.
Possession of a firearm while this Permanent Protection Order is in effect, may constitute a Felony under
Federal Law, 18 U.S.C. §922(g)(8).
You may apply to the Court for a modification or dismissal of a protection order after two years from the date
of issuance of the Permanent Protection Order, per §13-14-108(2)(b) , C.R.S.
Firearm and ammunition relinquishment must be in accordance with §13-14-105.5(2)(c), C.R.S. Failure to
comply with the order to relinquish may result in an arrest warrant.
NOTICE TO PROTECTED PERSON
You are hereby informed that if this Order is violated you may call law enforcement.
You may initiate contempt proceedings against the Restrained Person if the Order is issued in a civil
action or request the prosecuting attorney to initiate contempt proceedings if the order is issued in a
criminal action.
You cannot give the Restrained Person permission to change or ignore this Order in any way. Only the Court
can change this Order.
You may apply to the Court for a modification or dismissal of a Protection Order at any time, per §13-14-
108(2)(a), C.R.S.
NOTICE TO LAW ENFORCEMENT OFFICERS
If the Order has not been personally served, the law enforcement officer responding to a call of assistance
shall serve a copy of said Order on the person named/Restrained Person therein and shall write the time,
date, and manner of service on the Protected Persons’ copy of such Order and shall sign such statement.
The officer shall provide the Court with a completed return of service form. (§13-14-107(2 – 3) , C.R.S.)
You shall use every reasonable means to enforce this Protection Order.
You shall arrest or take into custody, or if an arrest would be impractical under the circumstances, seek a
warrant for the arrest of the Restrained Person when you have information amounting to probable cause that
the Restrained Person has violated or attempted to violate any provision of this Order subject to criminal
sanctions pursuant to §18-6-803.5, C.R.S. or municipal ordinance and the Restrained Person has been
properly served with a copy of this Order or the Restrained Person has received actual notice of the existence
and substance of such Order.
You shall enforce this Order even if there is no record of it in the Protection Order Central Registry.
You shall take the Restrained Person to the nearest jail or detention facility.
You are authorized to use every reasonable effort to protect the Protected Persons to prevent further
violence.
You may transport, or arrange transportation to a shelter for the Protected Persons.
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