Fill and Sign the Court of Washington Forpetitioner Dob Vs Form

ORD FOR PROTECTION (HARASSMENT) (ORAH) – Page 1 of 2 UH -04.0500 (6/2002) - RCW 10.14.080 (4) COURT OF WASHINGTON FOR ______________________________________________ Petitioner (DOB) vs. ______________________________________________ Respondent (DOB) NO. ORDER FOR PROTECTION - HARASSMENT (ORAH) Court Address______________________ ___ ____________________________________ _ Telephone Number: ( ) (Clerk’s action required) WARNING TO THE RESPONDENT: Violation of the provisions of this order with actual notice of its terms is a criminal offense under chapter 10.14 RCW and will subject a violator to arrest . Willful disobedience of the terms of this order may also be contempt of court and subject you to penalties under chapter 7.21 RCW. 1. Full Faith and Credit: This order is issued to prevent violent or threatening acts of hara ssment. The court has jurisdiction over the parties, the minors and the subject matter. This order is issued in accordance with the Full Faith and Credit provisions of VAWA. 18 U.S.C. § 2265. 2. Notice of this hearing was served on the respondent by personal service service by publication pursuant to court order other . 3. Minors addressed in this order: Name (First, Middle Initial, Last) Age Race Sex ORD FOR PROTECTION (HARASSMENT) (ORAH) – Page 2 of 2 UH -04.0500 (6/2002) - RCW 10.14.080 (4) Based upon the petition, testimony, and case record, the court finds that the respondent committed unlawful harassment, as defined in RCW 10.14.080, and was not acting pursuant to any statutory authority, and IT IS THEREFORE ORDERED THAT : Respondent is RESTRAINED from making any attempts to keep under surveillance petitioner and any minors named in paragraph 2 above. Respondent is RESTRAINED from making any attempts to contact petitioner and any minors named in paragraph 2 above. Respondent is RESTRAINED from entering or being within ______________ (distance) of petitioner’s residence place of employment other: The address is confidential Petitioner waives confidentiality of the address which is: Judgment is granted against respondent for fees and costs in the amount of $____________. Other:______________________________________________________________________ ________________________________________________________________________________________________________________________________________________________ IT IS FURTHER ORDERED that the clerk of court shall forward a copy of this order on or before the next judicial day to: ________________________________________________________ County Sheriff’s Office _________________________________________________________ Police Department, WHERE PETITIONER LIVES and shall enter it in a computer-based criminal intelligence system available in this state used by law enforcement to list outstanding warrants. The clerk of court petitioner shall forward a copy of this order on or before the next ju dicial day to: __________________________________________________ County Sheriff’s Office, ______________________________________________________ Police Department, WHERE RESPONDENT LIVES which shall personally serve the respondent with a copy of this order and shall promptly complete and return to this court proof of service. OR Petitioner has made private arrangements for service of this order. OR Respondent appeared; further service is not required. OR Respondent did not appear. The res traint provisions in this order are the same as those in the temporary order. The court is satisfied that the respondent was personally served with the temporary order. Further service is not required. THIS ANTIHARASSMENT ORDER EXPIRES ON . If the duration of this order exceeds one year, the court finds that respondent is likely to resume unlawful harassment of the petitioner when the order expires. DATED _________________ at _______ a.m./p.m. JUDGE/COURT COMMISSIONER I acknowledge receipt of a copy of this Order: I acknowledge receipt of a copy of this Order: ______________________________________ Petitioner Date Respondent Date