Fill and Sign the Fillable Online Mampampampm Project Staffing Fax Email Print Form

1 Criminal Form 2 9/06 ORI No: _____________ Order No: _____________ NYSID No: _____________ CJTN No. ________________ ORDER OF PROTECTION Present: Hon Non-Family Offense – C.P.L. 530.13 1 ________________________________________ People of the State of New York ‘ Youthful Offender (check if applicable) -against-Part_____ Index/Docket No.________________ Indictment No., if any: ____________________ _________________________________________ Charges ________________________________ (Check one) ‘ Ex parte ‘ ------------------------------------------------------------------------------------------------------------------------------------------------------------- ‘ ‘ ‘ ‘ ‘ ‘ “ “ “ “ “ “ ‘ Refrain from communication or any other contact by mail, telephone, e-mail, voice-mail or other means with [specify protected person(s)]: ; ‘ Refrain from assault, stalking, harassment, aggravated harassment, menacing, reckless endangerment, disorderly conduct, intimidation, threats or any criminal offense or interference with the victim or victims of , or designated witnesses to, the alleged offense and such members of the family or household of such victim(s) or witness(es) as shall be specifically named [specify]:_______________________________________________________; ‘ Refrain from intentionally injuring or killing without justification the following companion animal (pet)[specify type/name]: ‘Surrender any and all handguns, pistols, revolvers, rifles, shotguns and other firearms owned or possessed, including, but not limited to, the following: ________________________________________and do not obtain any further guns or other firearms. Such surrender shall take place immediately, but no later than [specify date/time]:___________________________ at:__________________________________________________________________________________________________ ‘ Specify other conditions defendant must observe for the purposes of protection: ; IT IS FURTHER ORDERED that the above-named Defendant's license to carry, possess, repair , sell or otherwise dispose of a firearm or firearms, if any, pursuant to Penal Law §400.00, is hereby “ suspended or “ revoked (note: final order only), and/or “ the Defendant shall remain ineligible to receive a firearm license during the period of this order. (Check all applicable boxes). NOTE: If this paragraph is checked, a copy of this form must be sent to: New York State Police, Pistol Permit Section, State Campus Building #22, 1220 Washington Avenue, Albany, New York 12226-2252. IT IS FURTHER ORDERED that this order of protection shall remain in effect until [specify date]: _______________. DATED:________________ ________________________________________________ JUDGE / JUSTICE COURT (COURT SEAL) ‘ Defendant advised in Court of issuance and contents of Order. ‘ Order personally served on Defendant in Court ____________________________________________ (Defendant’s signature) ‘ Order to be served by other means [specify]:_ _____ ‘ Warrant issued for Defendant The Criminal Procedure Law provides that presentation of a copy of this order of protection to any police officer or peace officer acting pursuant to his or her special duties shall authorize, and in some situations may require, such officer to arrest a defendant who has violated its terms and to bring him or her before the Court to face penalties authorized by law. Federal law requires that this order must be honored and enforced by state and tribal courts, including courts of a state, the District of Columbia, a commonwealth, territory or possession of the United States, if the person against whom the order is sought is an intimate partner of the protected party and has been or will be afforded reasonable notice and opportunity to be heard in accordance with state law sufficient to protect that person's rights (18 U.S.C. §§2265, 2266). It is a federal offense to: cross state lines to violate an order of protection; cross state lines to engage in stalking, harassment or domestic violence; possess, purchase, ship, transfer or receive a handgun, rifle, shotgun or other firearm or ammunition following a conviction of a domestic violence misdemeanor involving the use or attempted use of physical force or a deadly weapon; or (except for military or law enforcement officers while on duty) possess, purchase, ship, transfer or receive a handgun, rifle, shotgun or other firearm or ammunition while an order of protection, issued after notice and an opportunity to be heard, that protects an intimate partner from assault, harassment, threatening and/or stalking, remains in effect (18 U.S.C. §§922(g)(8), 922(g)(9), 2261, 2261A, 2262).