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CV-406 , 05/16 Temporary Restraining Order and Notice of Injunction Hearing (TRO -Harassment) §813.125, W isconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 2 STATE OF WISCONSIN, CIRCUIT COURT, COUNTY Amended Temporary Restraining Order (Temporary Order of Protection) and Notice of Injunction Hearing (Harassment - 30711) Case No. PET ITIONER (PERSON TO BE PROTECTED ) Name of Petitioner (First, Middle, Last) Date of Birth of Petitioner -VS - RESPONDENT/DEFENDANT Respondent/Defendant has access to weapon(s). Type of weapon(s): Location of weapon(s): Weapon (s) were involved in an incident [past or present] involving petitioner . THE COURT FINDS: Findings are on the following page(s) of this temporary restraining order. THE COURT ORDERS: Orders are on the following page(s) of this temporary restraining ord er. THIS TEMPORARY RESTRAINING ORDER SHALL BE EFFECTIVE UNTIL Injunction Hearing Date - Not to exceed 14 days NOTIFICATIONS/WARNINGS TO RESPONDENT/DEFENDANT: This order shall be enforced, even without registration, and is entitled to full faith and credit in every civil or crimina l court of any state, the District of Columbia, any U.S. Territory, and may be enforced by Tribal Lands (18 U.S.C. Section 2265; W is. Stats. 813.128). Crossing state, territorial, or tribal boundaries to violate this order may result in federal imprisonmen t (18 U.S.C. Section 2262). Federal law provides penalties for, and you may be prohibited from possessing, transporting, shipping, receiving or purchasing a firearm, including, but not limited to, a rifle, shotgun, pistol, revolver, or ammunition, pursuant to 18 U.S.C. 922(g)(8). Additional notifications/warnings are on the following page of this temporary restraining order. Violation of this temporary restraining order shall result in immediate arrest and is punishable by imprisonment not to exceed 9 mo nths or a fine not to exceed $1 0,000, or both, payment of filing and service fees , and an order for GPS tracking. Only the court can change this order. Name of Respondent/Defendant (First, M iddle, Last) Respondent’s/Defendant’s Street Address, City, State, Zip Please specify Petitioner ’s relationship(s) to Respondent/Defendant: spouse cousin adoptive parent former spouse sibling grandparent person in dating relationship parent child (biological/adoptive/step) current or former live -in step parent relationship Other: [Be specific ] SEX RACE DOB HT WT HAIR COLOR EYE COLOR Respondent’s/Defendant’s Distinguishing Features (such as scars , marks or tattoos) None known. CAUTION: (Check all that apply) Temporary Restraining Order and Notice of Injunction Hearing (TRO -Har assment) Page 2 of 2 Case No. CV-406, 05/16 Temporary Restraining Order and Notice of Injunction Hearing (TRO -Harassment) §81 3.125, W isconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 2 THE COURT FINDS: 1. The petitioner or person on behalf of petitioner filed a petition alleging hara ssment under §813.125, W is. Stat s. 2. This court has personal and subject matter jurisdiction. 3. There are reasonable grounds to believe that the respondent has engaged in harassment with intent to harass or intimidate the petitioner as defined in §813.125, W is. St ats. 4. The court orders a temporary restraining order and sets a date for an injunction hearing. THE COURT ORDERS: 1. A he aring for an injunction be held on Date Time Location Circuit Court Judge/Circuit Court Commissioner 2. Service of this notice and order shall be made at least hours prior to the hearing. 3. The action may be commenced without payment of filing fees because the petition alleges conduct that is the same as or similar to conduct that is prohibited under §940.32 , Wis. Stats. ; or is intentional infliction of physical pain, physical injury or illness; or is an intentional impairment of physical condition; or is a §940.225(1), (2) or (3) , Wis. Stats. ; or is a violation of §943.01 , W is. Stats., involving property that belongs to the individual; or is a threat to engage in the above mentioned con duct. 4. The respondent cease or avoid the harassment of the petitioner. 5. The respondent avoid the petitioner’s residence and/or any premises temporarily occupied by the petitioner. 6. The responden t avoid contact that harasses or intimidates the petitioner. Contact includes: contact at petitioner’s home, work, school, public places, in person, by phone, in writing, by electronic communication or device, or in any other manner. 7. The respondent refrain from removing, hiding, damaging, harming, or mistreating, or disposing of, a household pet. 8. The respondent allow the petitioner or a family member or household member of the petitioner acting on his/her behalf to retrieve a household pet. 9. The respondent avoid contacting the petitioner or causing any person other than a party's attorney or law enforcement officer to contact the petitioner unless the pe titioner consents in writing. 10 . The sheriff to accompany the petitioner and assist in placing the petitioner in physical possession of his/her residence, if requested. 11 . Other : [May not be inconsistent with rem edies requested in the petition.] (Harassment is defined as: (a) Striking, shoving, kicking or otherwise subjecting the person to physical contact; or (b) Engages in an act that would constitute child abuse under §48.02(1); or (c) Sexual assault under §940.225; or (d) Stalking un der §940.32; or attempts or threatens to do same; or (e) Engages in a course of conduct or repeatedly commits acts which harass or intimidate the person and which serve no legitimate purpose.) FAILURE TO APPEAR could result in an injunction being issued d irecting you to  cease or avoid the harassment of the petitioner;  avoid the petitioner’s residence and/or any premises temporarily occupied by the petitioner;  avoid contact that harasses or intimidates the petitioner. Contact includes: contact at petitione r’s home, work, school, public places, in person, by phone, in writing, by electronic communication or device, or in any other manner ; AND  follow any other orders made by this court. VIOLATION OF AN INJUNCTION if issued at this hearing shall result in you r arrest and may result in the imposition of criminal penalties regardless of whether you have been served a copy of the injunction. Service of a copy of this notice of injunction hearing and the petition for the temporary restraining order and /or injunct ion is constructive knowledge of the existence of the injunction. THIS TEMPORARY RESTRAINING ORDER IS IN EFFECT UNTIL THE INJUNCTION HEARING. BY THE COURT: If you require reasonable accommodations to participate in the court process due to a disability, please call at least 10 working days prior to the scheduled court date. Please note that the court does not provide transportation. Circuit Court Ju dge/ Circuit Court Commissioner Title (Print or Type Name if not eSigned) Date DISTRIBUTION: 1. Court 2. Petitioner 3. Person filing on behalf of the petitioner 4. Respondent 5. Law Enforcement 6. Other: