Fill and Sign the Department of Human Services Forensic Handbook Form

Or for Protection (Harassme nt) (ORAH) – Page 1 of 3 UH -04.0500 ( 07/2019 ) - RCW 10.14.080 (4), RCW 9.41.800 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 RCW 10.14 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 RCW 7.21. 1. Full Faith and Credit: 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 Based upon the petition, testimony, and case record, the court finds that the respondent committed unlawful harassment, as defined i n RCW 10.14.080, and was not acting pursuant to any statutory authority, and it is therefore ordered that : Or for Protection (Harassme nt) (ORAH) – Page 2 of 3 UH -04.0500 ( 07/2019 ) - RCW 10.14.080 (4), RCW 9.41.800 [ ] No -Contact : Respondent is restrained from making any attempts to contact Petitioner and any minors named in the table above. [ ] Surveillan ce : Respondent is restrained from making any attempts to keep under surveillance Petitioner and any minors named in the table above. [ ] Stay Away : Respondent is restrained from entering or being within ________ (distance) of Petitioner’s [ ] reside nce [ ] place of employment [ ] other: [ ] The address is confidential. [ ] Petitioner waives confidentiality of the address which is: [ ] Other : ________________________________________________________________ __________________________________ _____________________________________ _______________________________________________________________________ ______________________________________________________________________. [ ] Pay Fees and Costs : j udgment is granted against Respondent in favor of ______________________ in the amount of $ _______ for costs incurred in bringing the action and $ _________ for attorneys’ fees. Notice : Petitioner, you must fill out and file a completed form WPF UH 04.0700, Judgment Summary . The court has granted j udgment against the respondent in the amount of $ __________ for administrative court costs and service fees. A Judgment Summary, form WPF UH 04.0700, must be completed and filed. [ ] Prohibit Weapons and Order Surrender The Respondent must:  not acces s, possess or obtain any firearms, other dangerous weapons, or concealed pistol license s; and  comply with the Order to Surrender Weapons filed separately. (Note: Also use form All Cases 02.050 .) Findings – The court (check all that apply): [ ] must issue the orders referred to above because the court finds by clear and convincing evidence that the respondent: [ ] has used, displayed, or threatened to use a firearm or other dangerous weapon in a felony; or [ ] is ineligible to possess a firearm under RCW 9.41.040. [ ] may issue the orders referred to above because the court finds by a preponderance of evidence, the respondent : [ ] presents a serious and imminent threat to public health or safety, or the health or safety of any individual by possess ing a firearm or other dangerous weapon; or [ ] has used, displayed or threatened to use a firearm or other dangerous weapon in a felony; or [ ] is ineligible to possess a firearm under RCW 9.41.040. Or for Protection (Harassme nt) (ORAH) – Page 3 of 3 UH -04.0500 ( 07/2019 ) - RCW 10.14.080 (4), RCW 9.41.800 Washington Crime Information Center (WACIC) Data En try It is further ordered that the clerk of the court shall forward a copy of this order , and any order to surrender weapons, on or before the next judicial day to __________________________________________________ [ ] County Sheriff’s Office [ ] Poli ce Department, where Petitioner lives and shall enter it into WACIC. Service [ ] The clerk of the court shall also electronically forward a copy of this order , and any order to surrender weapons , on or before the next judicial 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. [ ] Respondent appeared and was informed of the order by the court; further service is not required. Or [ ] (Only if surrender of weapons not ordered ) Petitioner has made private arrangements for service of this order. Or [ ] Respondent did not appear. The restraint 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 Anti -harassment protection order expir es 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. Other: . Dated at ______________ _____ a.m./p.m. Judge/Court Commissioner I acknowledge re ceipt of a copy of this Order: Signature of Respondent/Lawyer WSBA No. Print Name Date Signature of Petitioner/Lawyer WSBA No. Print Name Date Petitioner : The law allows you to register for certain notifications regarding this protection ord er and its status. Visit www.RegisterVPO.com or call 1 -877 -242 -4055 for more information, or to sign up. If you feel that you are in danger, call 9 -1-1 immediately . Petitioner or Petitioner’s Lawyer must complete a Law Enforcement Information Sheet (LEIS).