Fill and Sign the Fapa Restraining Order Form

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF __________________ ) ___________________________________ ) No. Petitioner (Your name) ) ) (D.O.B. _) ) NOTICE TO RESPONDENT (Family Abuse Prevention Act) ) vs. ) ) ___________________________________ ) Respondent (Person to be restrained) ) ) (D.O.B. ) ) THIS FORM MUST BE ATTACHED TO SERVICE COPY OF THE RESTRAINING ORDER TO RESPONDENT: A TEMPORARY RESTRAINING ORDER HAS BEEN ISSUED BY THE COURT, WHICH AFFECTS YOUR RIGHTS AND IS NOW IN EFFECT. THIS ORDER BECOMES EFFECTIVE IMMEDIATELY. IF YOU WISH TO CONTEST THE Notice to Respondent (Family Abuse Prevention Act) 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 CONTINUATION OF THIS ORDER, YOU MUST COMPLETE THIS FORM AND MAIL IT TO: or deliver it to: REQUESTS FOR HEARING MUST BE MADE WITHIN 30 DAYS AFTER YOU RECEIVE THE ORDER. YOU MUST INCLUDE YOUR ADDRESS AND TELEPHONE NUMBER WITH YOUR REQUEST FOR A HEARING. THE HEARING WILL BE HELD WITHIN 21 DAYS, OR WITHIN FIVE DAYS IF YOU ARE CONTESTING A CUSTODY PROVISION (NOT PARENTING TIME). AT THE HEARING, A JUDGE WILL DECIDE WHETHER THE ORDER SHOULD BE CANCELED OR CHANGED. THE ONLY PURPOSE OF THIS HEARING WILL BE TO DETERMINE IF THE TERMS OF THE COURT’S TEMPORARY ORDER SHOULD BE CANCELED, CHANGED OR EXTENDED. Keep in mind that this order remains in effect until the court that issued the order modifies or dismisses it. It may also be renewed upon a finding that a person in petitioner’s situation would reasonably fear further acts of abuse by you if the order is not renewed. If you are arrested for violating this order, the security amount (bail) is $5,000.00, unless a different amount is ordered by the court. Violation of this order constitutes contempt of court and is punishable by a fine of up to $500.00 or 1 percent of your annual gross income, whichever is greater, a jail term of up to six months, or both. Other sanctions may be imposed. Under federal law, you may be prohibited from purchasing or possessing a firearm if the order remains in effect after the hearing. Notice to Respondent (Family Abuse Prevention Act) 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 REQUEST FOR HEARING I am the Respondent in the above-referenced action and I request a hearing to contest all or part of the order as follows (mark one or more): _____ The order restraining me from contacting or attempting to contact the petitioner. _____ The order granting child custody to the petitioner. _____ The terms of the parenting time order. _____ Other ____________________________________________________________ _________________________________________________________________ I (will) (will not) be represented by an attorney at the hearing. Notice of the time and place of the hearing can be mailed to me at the address below. Date: _____________________ ___________________________________ Print or Type Name of Respondent ___________________________________ ___________________________________ Signature of Respondent Address or Contact Address ___________________________________ City State Zip ___________________________________ Telephone or Contact Telephone Number(s) Notice to Respondent (Family Abuse Prevention Act) 3