Fill and Sign the Cv 429 Form

CV-429, 05/16 Temporary Restraining Order and Notice of Injunction He aring (TRO-Individual at Risk) §813.123, W isconsin Statutes This form shall not be modified. It may be supplemented with additional mat erial. Page 1 of 3 STATE OF WISCONSIN, CIRCUIT COURT, COUNTY Amended Temporary Restraining Order (Temporary Order of Protection) and Notice of Injunction Hearing (Individual at Risk - 30713) Case No. PETITIONER (INDIVIDUAL AT RISK) Name of Petitioner (First, Middle, Last) Date of Birth of Individual at Risk -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 the individual at risk. 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 order. 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 credi t in every civil or criminal court of any state, the District of Columbia, any U.S. Territory, and may be enforced by Triba l Lands (18 U.S.C. Section 2265; W is. Stats. 813.128). Crossing state, territorial, or tribal boundaries to violate this order ma y result in federal imprisonment (18 U.S.C. Section 2262). Federal law provides penalties for, and you may be prohibited from possessing, transpo rting, 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 restr aining order. Violation of this temporary restraining order shall result in immediate arrest and is punishable by imprisonment not to exceed 9 months or a fine not to exceed $1,000, or both, and payment of filing and service fees. Only the court can change this order. Name of Respondent/Defenda nt (First, Middle, Last) Respondent’s/Defendant’s Street Address, City, State, Zip Please specify Individual at Risk’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 - Individual at Risk) Page 2 of 3 Case No. CV-429 , 05/16 Temporary Restraining Order and Notice of Injunction Hearing ( TRO-Individual at Risk) §813.123, W isconsin Statutes This form shall not be modified. It may be supplemented with additional mat erial. Page 2 of 3 THE COURT FINDS: 1. The individual at risk or person/agency on behalf of the individual at risk fi led a petition alleging the elements under §813.123, Wis. Stats . 2. This court has personal and subject matter jurisdiction. 3. There are reasonable grounds to believe that the respondent has interfered with, engaged in or based on prior conduct of the respondent, may engage in abuse as defined in §813.123, Wis. Stats., as stated in t he court record. 4. Neither the individual at risk, guardian [if any], or the guardian ad litem [if any] consented in writing to have contact with the respondent, and the court agrees it is not in the best interests of the individual at risk to have contact with the respondent. 5. The court orders a temporary restraining order and sets a date for an injunction hearing. THE COURT ORDERS: 1. A hearing for an injunction be held on Date Time Location Circuit Court Judge 2. Service of this notice and order shall be made at least hours prior to the hearing. 3. The respondent avoid interference with an investigation of the individual at r isk, the delivery of protective services to the individual at risk, or a protective placement of the individual at risk, o r the delivery of services to the elder adult at risk. 4. The respondent cease engaging in or threatening to engage in physical abuse, e motional abuse, sexual abuse, treatment without consent, unreasonable confinement or restraint, financial exploitat ion, neglect, harassment, stalking of the individual at risk, or mistreatment of an animal. 5. The respondent avoid the residence of the individual at risk and/or any other location temporarily occupied by the individual at risk. 6. The respondent avoid contacting the individual at risk or cau sing any person other than a party’s attorney or a law enforcement officer to contact the individual at risk. Contact includes: contact at individual at risk’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 petitione r acting on his/her behalf to retrieve a household pet. 9. The respondent shall not intentionally prevent a representative or employee of the c ounty protective services agency from meeting, communicating, or being in visual or audio contact with the adult at risk, except as ordered here: 10. If a person/agency filed this petition on behalf of the individual at risk, a guardian ad litem be appointed for the individual at risk. The court appoints [Guardian ad litem’s name ] . 11. Other: [May not be inconsistent with remedies requested in the pe tition.] Temporary Restraining Order and Notice of Injunction Hearing (TRO - Individual at Risk) Page 3 of 3 Case No. CV-429 , 05/16 Temporary Restraining Order and Notice of Injunction Hearing ( TRO-Individual at Risk) §813.123, W isconsin Statutes This form shall not be modified. It may be supplemented with additional mat erial. Page 3 of 3 FAILURE TO APPEAR could result in a injunction being issued directing you to  avoid interference with an investigation of the individual at risk;  avoid interference with the delivery of protective services to the individual at risk, or a protective placement of the individual at risk;  avoid interference with the delivery of services to the elder adult at risk;  avoid contacting the individual at risk or causing any person other than a party’s attorney or a law enforcement officer to contact the individual at risk . Contact includes: contact at individual at risk’s home, work, school, public places, in person, by phone, in writing, by electronic communication or device, or in any other manner;  engaging in or threatening to engage in physical abuse, emotional abuse, sexual abuse, treatment without consent, unreasonable confinement or restraint, financ ial exploitation, neglect, harassm ent, stalking of the individual at risk, or mistreatment of an animal; AND  follow any other appropriate orders not inconsistent with the remedies requested in the pe tition. VIOLATION OF AN INJUNCTION if issued at this hearing shall result in your arrest and may result in the impositi on 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 injuncti on 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 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 Judge/Circuit Court Commissioner Title (Print or Type Name if not eSigned) Date DISTRIBUTION: 1. Court 2. Petitioner(Individual at Risk) 3. Person/Agency acting on behalf of Individual at Risk 4. Respondent 5. Guardian ad Litem, if appointed 6. Law Enforcement 7. Other: