Instructions for Florida Supreme Court Approved Family Law Form 12.980(f),
Petition for Injunction for Protection (11/15)
Against Repeat Violence (11/15)INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED
FAMILY LAW FORM 12.980(f)
PETITION FOR INJUNCTION FOR
PROTECTION AGAINST REPEAT VIOLENCE (11/15)
When should this form be used?
If you or a member of your immediate family are a victim of repeat violence , you
can use this form to ask the court for a protective order prohibiting repeat
violence. Repeat violence means that two incidents of violence have been
committed against you or a member of your immediate family by another person,
one of which must have been within 6 months of fling this petition.
Repeat violence includes assault, aggravated assault, battery, aggravated battery,
sexual assault, sexual battery, stalking, aggravated stalking, kidnapping, or false
imprisonment, or any criminal ofense resulting in physical injury or death.
Because you are making a request to the court, you are called the petitioner .
The person whom you are asking the court to protect you from is called the
respondent . If you are under the age of eighteen and have never been married
or had the disabilities of nonage removed by a court, one of your parents or your
legal guardian must sign this petition on your behalf.
The parent or legal guardian of any minor child who is living at home may seek an
injunction for protection against repeat violence on behalf of the minor child. With
respect to a minor child who is living at home, the parent or legal guardian must
have been an eye-witness to, or have direct physical evidence or affidavits from
eye-witnesses of, the specific facts and circumstances that form the basis of the
petition.
If the respondent is your spouse , former spouse, related to you by blood or
marriage, living with you now or has lived with you in the past (if you are or were
living as a family), or the other parent of your child(ren), whether or not you have
ever been married or ever lived together, you should use Petition for Injunction
for Protection Against Domestic Violence , Florida Supreme Court Approved
Family Law Form 12.980(a), rather than this form.
This form should be typed or printed in black ink. You should complete this form
(giving as much detail as possible) and sign it the presence of a notary or in front
of the clerk of the circuit court in the county where you live. The clerk will take
your completed petition to a judge . You should keep a copy for your records. If
have any questions or need assistance completing this form, the clerk or family
law intake staff will help you.
What should I do if the judge grants my petition?
If the facts contained in your petition convince the judge that you or a member of
Instructions for Florida Supreme Court Approved Family Law Form 12.980(f),
Petition for Injunction for Protection (11/15)
Against Repeat Violence (11/15)your immediate family are a victim of repeat violence and that an immediate and
present danger of repeat violence to you or that family exists, the judge will
sign a Temporary Injunction for Protection Against Repeat Violence,
Instructions for Florida Supreme Court Approved Family Law Form 12.980(f),
Petition for Injunction for Protection (11/15)
Against Repeat Violence (11/15)Florida Supreme Court Approved Family Law Form 12.980(k). A temporary
injunction is issued without notice to the respondent. The clerk will give your
petition , the temporary injunction, and any other papers filed with your petition to
the sherif or other law enforcement ofcer for personal service on the
respondent. The temporary injunction will take efect immediately after the
respondent is served with a copy of it. It lasts until a full hearing can be held or
for a period of 15 days, whichever comes first. The court may extend the
temporary injunction beyond 15 days for a good reason, which may include failure
to obtain service on the respondent.
The temporary injunction is issued ex parte . This means that the judge has
considered only the information presented by one side--YOU. Section I of the
temporary injunction gives a date that you should appear in court for a hearing.
You will be expected to testify about the facts in your petition. The respondent will
be given the opportunity to testify at this hearing, also. At the hearing, the judge
will decide whether to issue a Final Judgment of Injunction for Protection
Against Repeat Violence (After Notice) , Florida Supreme Court Approved
Family Law Form 12.980(l), which will remain in efect for a specific time period or
until modified or dissolved by the court. If you and/or the respondent do not
appear, the temporary injunction may be continued in force, extended, or
dismissed, and/or additional orders may be granted, including entry of a
permanent injunction and the imposition of court costs. You and
respondent will be bound by the terms of any injunction or order issued
at the fnal hearing.
IF EITHER YOU OR RESPONDENT DO NOT APPEAR AT THE FINAL HEARING,
YOU WILL BOTH BE BOUND BY THE TERMS OF ANY INJUNCTION OR ORDER
ISSUED IN THIS MATTER.
If the judge signs a temporary or final injunction, the clerk will provide you with
the necessary copies.
Make sure that you keep one certifed copy of the injunction with you at
all times !
What can I do if the judge denies my petition?
If your petition is denied on the grounds that it appears to the court that no
immediate and present danger of repeat violence exists, the court will set a full
hearing on your petition. The respondent will be notified by personal service of
your petition and the hearing. If your petition is denied, you may: amend your
petition by filing a Supplemental Affidavit in Support of Petition for
Injunction for Protection , Florida Supreme Court Approved Family Law Form
12.980(g); attend the hearing and present facts that support your petition; and/or
dismiss your petition.
Where can I look for more information?
Instructions for Florida Supreme Court Approved Family Law Form 12.980(f),
Petition for Injunction for Protection (11/15)
Against Repeat Violence (11/15)Before proceeding, you should read General Information for Self-
Represented Litigants found at the beginning of these forms. The words
that are in bold underline are defined in that section. The clerk of the circuit
court or family law intake staff will help you complete any necessary forms. For
further information, see Section 784.046, Florida Statutes, and Rule 12.610, Florida
Family Law Rules of Procedure.
Instructions for Florida Supreme Court Approved Family Law Form 12.980(f),
Petition for Injunction for Protection (11/15)
Against Repeat Violence (11/15)IMPORTANT INFORMATION REGARDING E-FILING
The Florida Rules of Judicial Administration now require that all petitions,
pleadings, and documents be filed electronically except in certain circumstances.
Self-represented litigants may fle petitions or other pleadings or
documents electronically; however, they are not required to do so. If you
choose to file your pleadings or other documents electronically, you must do so in
accordance with Florida Rule of Judicial Administration 2.525, and you must follow
the procedures of the judicial circuit in which you file. The rules and procedures
should be carefully read and followed.
IMPORTANT INFORMATION REGARDING E-SERVICE ELECTION
After the initial service of process of the petition or supplemental petition by the
Sherif or certified process server, the Florida Rules of Judicial Administration now
require that all documents required or permitted to be served on the other party
must be served by electronic mail (e-mail) except in certain circumstances. You
must strictly comply with the format requirements set forth in the Rules
of Judicial Administration. If you elect to participate in electronic service, which
means serving or receiving pleadings by electronic mail (e-mail), or through the
Florida Courts E-Filing Portal, you must review Florida Rule of Judicial
Administration 2.516. You may find this rule at www.flcourts.org through the link to
the Rules of Judicial Administration provided under either Family Law Forms:
Getting Started, or Rules of Court in the A-Z Topical Index.
SELF-REPRESENTED LITIGANTS MAY SERVE DOCUMENTS BY E-MAIL;
HOWEVER, THEY ARE NOT REQUIRED TO DO SO. If a self-represented litigant
elects to serve and receive documents by e-mail, the procedures must always be
followed once the initial election is made.
To serve and receive documents by e-mail, you must designate your e-mail
addresses by using the Designation of Current Mailing and E-mail Address ,
Florida Supreme Court Approved Family Law Form 12.915, and you must provide
your e-mail address on each form on which your signature appears. Please
CAREFULLY read the rules and instructions for: Certifcate of Service
(General), Florida Supreme Court Approved Family Law Form 12.914;
Designation of Current Mailing and E-mail Address , Florida Supreme Court
Approved Family Law Form 12.915; and Florida Rule of Judicial Administration
2.516.
IN THE CIRCUIT COURT OF THE _______________________ JUDICIAL CIRCUIT,
IN AND FOR ________________________ COUNTY, FLORIDA
Case No.: ___________________________
___
Division: __________________________________________________________________________________
________
_______________________ _ __________,
Petitioner,
and
_______________________ _ __________,
Respondent,
PETITION FOR INJUNCTION FOR PROTECTION
AGAINST REPEAT VIOLENCE
I, {full legal name} , being sworn, certify
that the following statements are true:
SECTION I. PETITIONER
(This section is about you. It must be completed.)
1. Petitioner currently lives at the following address: {address, city, state, zip
code}
[Indicate if applicable]
_____ Petitioner seeks an injunction for protection on behalf of a
minor child . Petitioner is the parent or legal guardian of {full legal name}
, a minor child who is living at home.
2. Petitioner's attorney's name, address, and telephone number is:
(If you do not have an attorney, write "none.")
SECTION II. RESPONDENT
(This section is about the person you want to be protected from. It must be
completed.)
1. Respondent currently lives at the following address: {address, city, state,
and zip code} _______
Respondent’s Driver’s License number is: {if known}
____________________________________
Family Supreme Court Approved Law Form 12.980(f), Petition for Injunction for
Protection Against Repeat Violence (11/15)
2. Petitioner has known Respondent since: {date}
________________________________________
3. Respondent's last known place of employment:
_______________________________________
Employment address:
____________________________________________________________
Working hours:
_________________________________________________________________
4. Physical description of Respondent:
Race: _____ Sex: _____ Male _____ Female _____ Date of Birth:
_________________________
Height: _____ Weight: _____ Eye Color: _____ Hair Color:
_______________________________
Distinguishing marks and/or scars: ____________________________________
_____________
Vehicle: (make/model) ________________ Color: ________ Tag Number:
__________________
5. Other names Respondent goes by (aliases or nicknames):
_______________________________
______________________________________________________________________________
6. Respondent's attorney’s name, address, and telephone number is:
________________________
______________________________________________________________________________
(If you do not know whether Respondent has an attorney, write "unknown." If
Respondent does not have an attorney, write "none.")
SECTION III. CASE HISTORY AND REASON FOR SEEKING PETITION (This
section must be completed.)
1. Has Petitioner ever received or tried to get an injunction for protection
against domestic violence, repeat violence, dating violence, or sexual
violence against Respondent in this or any other court?
_____ Yes _____ No If yes, what happened in that case? {include case
number, if known}
________________________________________________________________________
_______________________________________________________________________
2. Has Respondent ever received or tried to get an injunction for
protection against domestic violence, repeat violence, dating violence,
or sexual violence against Petitioner in this or any other court?
_____ Yes _____ No If yes, what happened in that case? {include case
number, if known}
________________________________________________________________________
_______________________________________________________________________
Family Supreme Court Approved Law Form 12.980(f), Petition for Injunction for
Protection Against Repeat Violence (11/15)
3. Describe any other court case that is either going on now or that
happened in the past between Petitioner and Respondent {include
case number, if known}:
________________________________________________________________________
________________________________________________________________________
4. Respondent has directed at least two incidents of violence, meaning
assault, aggravated assault, battery, aggravated battery, sexual
assault, sexual battery, stalking, aggravated stalking, kidnapping, or
false imprisonment, or any criminal ofense resulting in physical injury
or death against Petitioner or a member of Petitioner’s immediate
family. One of these two incidents of violence has occurred within 6
months of the date of filing of this petition. The most recent incident
(including date and location) is described below.
On {date} , at {location}
_____________________________________ _ ,
Respondent:
____________________________________________________________________
______________________________________________________________
________________
________________________________________________________________
______________
________________________________________________________________
______________
______________________________________________________________
________________
___________________________________________________________________
___________
________________________________________________________________
______________
__________________________________________________________________
____________
__________________________________________________________________
____________
__________________________________________________________________
____________
______________________________________________________________________________
_______ Please indicate here if you are attaching additional pages to continue
these facts.
Family Supreme Court Approved Law Form 12.980(f), Petition for Injunction for
Protection Against Repeat Violence (11/15)
5. Other prior incidents (including dates and location) are described below:
On {date} , at {location}
_____________________________________ _ ,
Respondent:
____________________________________________________________________
______________________________________________________________
________________
________________________________________________________________
______________
________________________________________________________________
______________
______________________________________________________________
________________
___________________________________________________________________
___________
________________________________________________________________
______________
__________________________________________________________________
____________
__________________________________________________________________
____________
__________________________________________________________________
____________
______________________________________________________________________________
_______ Please indicate here if you are attaching additional pages to continue
these facts.
6. Petitioner genuinely fears repeat violence by Respondent. Explain:
______________________
______________________________________________________________
________________
________________________________________________________________
______________
________________________________________________________________
______________
______________________________________________________________
________________
___________________________________________________________________
Family Supreme Court Approved Law Form 12.980(f), Petition for Injunction for
Protection Against Repeat Violence (11/15)
___________
________________________________________________________________
______________
__________________________________________________________________
____________
__________________________________________________________________
____________
__________________________________________________________________
____________
7. Additional Information
[Choose all that apply]
a. _____ Respondent owns, has, and/or is known to have guns or other
weapons.
Describe weapon(s):
_____________________________________________________________
______________________________________________________________
________________
b. _____ This or prior acts of repeat violence have been previously reported
to: {person or agency}
SECTION IV. INJUNCTION (This section must be completed.)
1. Petitioner asks the Court to enter a TEMPORARY INJUNCTION for
protection against repeat violence that will be in place from now until the
scheduled hearing in this matter.
2. Petitioner asks the Court to enter, after a hearing has been held on
this petition, a final judgment of injunction prohibiting Respondent from
committing any acts of violence against Petitioner and :
a. prohibiting Respondent from going to or within 500 feet of any place
Petitioner lives;
b. prohibiting Respondent from going to or within 500 feet of Petitioner’s
place(s) of employment or the school that Petitioner attends; the address
of Petitioner's place(s) of employment and/or school is:
__________________________________________________
___________________________________________________________________________
;
c. prohibiting Respondent from contacting Petitioner by telephone, mail, by
e-mail, in writing, through another person, or in any other manner;
Family Supreme Court Approved Law Form 12.980(f), Petition for Injunction for
Protection Against Repeat Violence (11/15)
d. ordering Respondent not to use or possess any guns or firearms;
[Indicate all that apply]
e. _____ prohibiting Respondent from going to or within 500 feet of the
following place(s) Petitioner or Petitioner’s immediate family must go to
often: _________________________
___________________________________________________________________________
f. _____ prohibiting Respondent from knowingly and intentionally going to or
within 100 feet of Petitioner’s motor vehicle; and any other terms the
Court deems necessary for the safety of Petitioner and Petitioner’s
immediate family.
Family Supreme Court Approved Law Form 12.980(f), Petition for Injunction for
Protection Against Repeat Violence (11/15)
I UNDERSTAND THAT BY FILING THIS PETITION, I AM ASKING THE COURT
TO HOLD A HEARING ON THIS PETITION, THAT BOTH THE RESPONDENT
AND I WILL BE NOTIFIED OF THE HEARING, AND THAT I MUST APPEAR AT
THE HEARING. I UNDERSTAND THAT IF EITHER RESPONDENT OR I FAIL TO
APPEAR AT THE FINAL HEARING, WE WILL BE BOUND BY THE TERMS OF
ANY INJUNCTION OR ORDER ISSUED AT THAT HEARING.
I UNDERSTAND THAT I AM SWEARING OR AFFIRMING UNDER OATH TO
THE TRUTHFULNESS OF THE CLAIMS MADE IN THIS PETITION AND THAT
THE PUNISHMENT FOR KNOWINGLY MAKING A FALSE STATEMENT
INCLUDES FINES AND/OR IMPRISONMENT.
Dated:
Signature of Petitioner
STATE OF FLORIDA
COUNTY OF
Sworn to or afrmed and signed before me on by
NOTARY PUBLIC or DEPUTY CLERK
{Print, type, or stamp commissioned
name of notary or clerk.}
_ Personally known
_ Produced identification
Type of identification produced
Family Supreme Court Approved Law Form 12.980(f), Petition for Injunction for
Protection Against Repeat Violence (11/15)