IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR COUNTY, FLORIDA
Case No.:
Division:
_________________ ,
Petitioner,
and
_________________ ,
Respondent.
FINAL JUDGMENT OF INJUNCTION
FOR PROTECTION AGAINST DOMESTIC VIOLENCE
WITHOUT MINOR CHILD(REN) (AFTER NOTICE)
The Petition for Injunction for Protection Against Domestic Violence under Section
741.30, Florida Statutes, and other papers fled in this Court have been reviewed.
The Court has jurisdiction of the parties and the subject matter.
It is intended that this protection order meet the requirements of 18
U.S.C. Section 2265 and therefore intended that it be accorded full faith
and credit by the court of another state or Indian tribe and enforced as if
it were the order of the enforcing state or of the Indian tribe.
SECTION I. HEARING
This cause came before the Court for a hearing to determine whether an Injunction
for Protection Against Domestic Violence in this case should be:
_____ issued_____ modifed _____ extended.
The hearing was attended by:
_____ Petitioner
_____ Petitioner's Counsel
_____ Respondent
_____ Respondent’s Counsel
SECTION II. FINDINGS
On {date} , a notice of this hearing was served on Respondent
together with a copy of Petitioner’s petition to this Court and the temporary
injunction, if issued. Service was within the time required by Florida law, and
Respondent was aforded an opportunity to be heard.
After hearing the testimony of each party present and of any witnesses, or upon
Florida Supreme Court Approved Family Law Form 12.980(d)(2), Final Judgment of Injunction
for Protection Against Domestic Violence without Minor Child(ren) (After Notice) (03/15)
consent of Respondent, the Court fnds, based on the specifc facts of this case,
that Petitioner is a victim of domestic violence or has reasonable cause to believe
that he/she is in imminent danger of becoming a victim of domestic violence by
Respondent.
SECTION III. INJUNCTION AND TERMS
This injunction shall be in full force and efect until ____ further order of
the Court or ____ {date}___________________________. This injunction is valid
and enforceable in all counties of the State of Florida. The terms of this
injunction may not be changed by either party alone or by both parties
together. Only the Court may modify the terms of this injunction. Either
party may ask the Court to change or end this injunction at any time.
Any violation of this injunction, whether or not at the invitation of
Petitioner or anyone else, may subject Respondent to civil or indirect
criminal contempt proceedings, including the imposition of a fne or
imprisonment. Certain willful violations of the terms of this injunction,
such as: refusing to vacate the dwelling that the parties share; going to
or being within 500 feet of Petitioner's residence, going to Petitioner’s
place of employment, school, or other place prohibited in this injunction;
telephoning, contacting or communicating with Petitioner if prohibited by
this injunction; knowingly or intentionally coming within 100 feet of
Petitioner’s motor vehicle, whether or not it is occupied; defacing or
destroying Petitioner’s personal property; refusing to surrender frearms
or ammunition if ordered to do so by the court; or committing an act of
domestic violence against Petitioner constitutes a misdemeanor of the
frst degree punishable by up to one year in jail, as provided by sections
775.082 and 775.083, Florida Statutes. In addition, it is a federal criminal
felony ofense, punishable by up to life imprisonment, depending on the
nature of the violation, to cross state lines or enter Indian country for the
purpose of engaging in conduct that is prohibited in this injunction. 18
U.S.C. Section 2262.
ORDERED and ADJUDGED:
1. Violence Prohibited. Respondent shall not commit, or cause any other
person to commit, any acts of domestic violence against Petitioner. Domestic
violence includes: assault, aggravated assault, battery, aggravated battery,
sexual assault, sexual battery, stalking, aggravated stalking, kidnapping,
false imprisonment, or any other criminal ofense resulting in physical injury
or death to Petitioner or any of Petitioner's family or household members.
Respondent shall not commit any other violation of the injunction through an
intentional unlawful threat, word or act to do violence to the Petitioner.
2. No Contact. Respondent shall have no contact with the Petitioner
Florida Supreme Court Approved Family Law Form 12.980(d)(2), Final Judgment of Injunction
for Protection Against Domestic Violence without Minor Child(ren) (After Notice) (03/15)
unless otherwise provided in this section.
a. Unless otherwise provided herein, Respondent shall have no contact with
Petitioner. Respondent shall not directly or indirectly contact Petitioner in
person, by mail, e-mail, fax, telephone, through another person, or in any
other manner. Further, Respondent shall not contact or have any third party
contact anyone connected with Petitioner's employment or school to inquire
about Petitioner or to send any messages to Petitioner. Unless otherwise
provided herein, Respondent shall not go to, in, or within 500 feet of:
Petitioner’s current residence {list address}
or any residence to which Petitioner may move; Petitioner’s current or any
subsequent place of employment {list address of current employment}
or place where Petitioner attends school {list address of school} ;
or the following other places (if requested by Petitioner) where Petitioner or
Petitioner’s minor child(ren) go often:
.
Respondent may not knowingly come within 100 feet of Petitioner's
automobile at any time.
b. Other provisions regarding contact:
_______________________________________________
3. Firearms. Unless paragraph a. is initialed below, Respondent shall
not have in his or her care, custody, possession or control any
frearm or ammunition. It is a violation of Section 7t0.233, Florida
Statutes, and a frst degree misdemeanor, for the Respondent to
have in his or her care, custody, possession or control any frearm or
ammunition.
{Initial if applies; write N/A if not applicable}
a. ____Respondent is a state or local ofcer as defned in section 943.10(14),
Florida Statutes, who holds an active certifcation, who receives or
possesses a frearm or ammunition for use in performing ofcial duties on
behalf of the ofcer’s employing agency and is not prohibited by the court
from having in his or her care, custody, possession or control a frearm or
ammunition. The ofcer’s employing agency may prohibit the ofcer from
having in his or her care, custody, possession or control a frearm or
ammunition.
b.____Respondent shall surrender any frearms and ammunition in the
Respondent's possession to the County Sherif's
Department.
Florida Supreme Court Approved Family Law Form 12.980(d)(2), Final Judgment of Injunction
for Protection Against Domestic Violence without Minor Child(ren) (After Notice) (03/15)
c. ____Other directives relating to frearms and ammunition:
NOTE: RESPONDENT IS ADVISED THAT IT IS A FEDERAL CRIMINAL
FELONY OFFENSE TO SHIP OR TRANSPORT IN INTERSTATE OR
FOREIGN COMMERCE, OR POSSESS IN OR AFFECTING COMMERCE,
ANY FIREARM OR AMMUNITION; OR TO RECEIVE ANY FIREARM OR
AMMUNITION WHICH HAS BEEN SHIPPED OR TRANSPORTED IN
INTERSTATE OR FOREIGN COMMERCE WHILE SUBJECT TO SUCH AN
INJUNCTION. 18 U.S.C. SECTION t22(g)(8).
4. Evaluation/Counseling.
{Initial all that apply; write N/A if does not apply}
a. The Court fnds that Respondent has:
i. ____willfully violated the ex parte injunction;
ii. ____been convicted of, had adjudication withheld on, or pled nolo
contendere to a crime involving violence or a threat of violence; and/or
iii. ____in this state or any other state, had at any time a prior
injunction for protection entered against the respondent after a
hearing with notice.
Note: If Respondent meets any of the above enumerated criteria, the Court
must order the Respondent to attend a batterers' intervention program
unless it makes written factual fndings stating why such a program would
not be appropriate. See Section 741.30(6)(e), Florida Statutes.
b. Within ____10 days ____ days, (but no more than 10 days) of the date of
this injunction, Respondent shall enroll in and thereafter without delay
complete the following, and Respondent shall provide proof of such
enrollment to the Clerk of Circuit Court within
____ 30 days _____ days, (but no more than 30 days) of the date of this
injunction:
i. ____A certifed batterers’ intervention program from a list of
programs to be provided by the Court or any entity designated by the
Court. Respondent shall also successfully complete any substance
abuse or mental health evaluation that the assessing program
counselor deems necessary as a predicate to completion of the
batterers’ intervention program.
ii. ____A substance abuse evaluation at:
or a similarly qualifed facility and any substance abuse treatment
Florida Supreme Court Approved Family Law Form 12.980(d)(2), Final Judgment of Injunction
for Protection Against Domestic Violence without Minor Child(ren) (After Notice) (03/15)
recommended by that evaluation.
iii. ____A mental health evaluation by a licensed mental health
professional at:
_______________________or any other similarly qualifed facility and any
mental health treatment recommended by that evaluation.
iv. ____Other:
c. ____Although Respondent meets the statutory mandate of attendance at a
batterers’ intervention program, the Court makes the following written
fndings as to why the condition of batterers’ intervention program would be
inappropriate:
d. ____Petitioner is referred to a certifed domestic violence center and is
provided with a list of certifed domestic violence centers in this circuit, which
Petitioner may contact.
5. Mailing Address or Designated E-Mail Address(es). Respondent shall
notify the Clerk of the Court of any change in either his or her mailing
address, or designated e-mail address(es), within 10 days of the change. All
further papers (excluding pleadings requiring personal service) shall be
served either by mail to Respondent’s last known mailing address or by e-
mail to Respondent’s designated e-mail address(es). Service shall be
complete upon mailing or emailing.
6. Other provisions necessary to protect Petitioner from domestic
violence:
TEMPORARY EXCLUSIVE USE AND POSSESSION OF HOME
[Initial if applies; write N/A if not applicable]
7. ____ Possession of the Home. ____ Petitioner ____ Respondent shall have
temporary exclusive use and possession of the dwelling located at:
.
Florida Supreme Court Approved Family Law Form 12.980(d)(2), Final Judgment of Injunction
for Protection Against Domestic Violence without Minor Child(ren) (After Notice) (03/15)
8. ____ Transfer of Possession of the Home. A law enforcement ofcer with
jurisdiction over the home shall accompany ____ Petitioner ____ Respondent
to the home, and shall place ____ Petitioner ____Respondent in possession
of the home.
9.____ Personal Items. ____ Petitioner ____ Respondent, in the presence of a law
enforcement officer , may return to the premises described above ____
on ________________________ , at ______a.m./p.m., or ____ at a time
arranged with the law enforcement department with jurisdiction over the
home, accompanied by a law enforcement ofcer only, for the purpose of
obtaining his or her clothing and items of personal health and hygiene and
tools of the trade. A law enforcement ofcer with jurisdiction over the
premises shall go with ____ Petitioner ____Respondent to the home and stand
by to insure that he/she vacates the premises with only his/her personal
clothing, toiletries, tools of the trade, and any items listed in paragraph 10
below. The law enforcement agency shall not be responsible for storing or
transporting any property. IF THE RESPONDENT IS NOT AWARDED
POSSESSION OF THE HOME AND GOES TO THE HOME WITHOUT A
LAW ENFORCEMENT OFFICER, IT IS A VIOLATION OF THIS
INJUNCTION.
10. ____The following other personal possessions may also be removed from the
premises at this time:
.
11. ____Other:______________________________________________________________________
__
.
TEMPORARY SUPPORT
12. Temporary Alimony.
{nitial all that apply; write N/A if does not apply}
a. ____The court fnds that there is a need for temporary alimony and that
____ Petitioner ____Respondent (hereinafter Obligor) has the present ability
to pay alimony and shall pay temporary alimony to ____ Petitioner ____
Respondent (hereinafter Obligee) in the amount of
per month, payable ____ in accordance with Obligor’s employer’s payroll
cycle, and in any event, at least once a month ____ other {explain}
beginning {date} _____________ . This alimony shall continue until
modifed by court order, until a fnal judgment of dissolution of marriage is
Florida Supreme Court Approved Family Law Form 12.980(d)(2), Final Judgment of Injunction
for Protection Against Domestic Violence without Minor Child(ren) (After Notice) (03/15)
entered, until Obligee dies, until this injunction expires, or until {date}
___ , whichever occurs frst.
b. ____The _____ Petitioner _____ Respondent shall be required to maintain
health insurance coverage for the other party. Any uncovered medical costs
for the party awarded alimony shall be assessed as follows:
.
c. ____Other provisions relating to alimony:
_____________________________
___________.
13. Method of Payment.
[Initial one only]
a. ____Obligor shall pay any temporary court-ordered alimony through income
deduction, and such support shall be paid to either the State Disbursement
Unit or the central depository. Obligor is individually responsible for paying
this support obligation in the event that all or any portion of said support is
not deducted from Obligor’s income. Obligor shall also pay any service
charge required by statute. Until alimony payments are deducted from
Obligor’s paycheck pursuant to the Income Deduction Order, Obligor is
responsible for making timely payments directly to either the State
Disbursement Unit or the central depository.
b. ____Temporary alimony shall be paid through either the State Disbursement
Unit or the central depository. Obligor shall also pay any applicable service
charge required by statute.
c. ____Other provisions relating to method of payment:
_________________________________
.
SECTION IV. OTHER SPECIAL PROVISIONS
{This section to be used for inclusion of local provisions approved by the chief judge
as provided in Florida Family Law Rule 12.610.}
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________.
SECTION V. DIRECTIONS TO LAW ENFORCEMENT OFFICER IN ENFORCING
THIS INJUNCTION
{Unless ordered otherwise by the judge, all provisions in this injunction
are considered mandatory provisions and should be interpreted as part of
Florida Supreme Court Approved Family Law Form 12.980(d)(2), Final Judgment of Injunction
for Protection Against Domestic Violence without Minor Child(ren) (After Notice) (03/15)
this injunction.}
1. This injunction is valid in all counties of the State of Florida. Violation
of this injunction should be reported to the appropriate law enforcement
agency. Law enforcement ofcers of the jurisdiction in which a violation of
this injunction occurs shall enforce the provisions of this injunction and are
authorized to arrest without warrant pursuant to section 901.15, Florida
Statutes, for any violation of its provisions, except those regarding child
support and/or alimony, which constitutes a criminal act under section
741.31, Florida Statutes. When inconsistent with this order, any
subsequent court order issued under Chapter 61, Florida Statutes,
shall take precedence over this order on all matters relating to
property division, alimony, child custody, or child support.
2. THIS INJUNCTION IS ENFORCEABLE IN ALL COUNTIES OF FLORIDA, AND LAW
ENFORCEMENT OFFICERS MAY EFFECT ARRESTS PURSUANT TO SECTION
901.15(6), FLORIDA STATUTES. The arresting agent shall notify the State
Attorney's Ofce immediately after arrest.
3. Reporting alleged violations. If Respondent violates the terms of this
injunction and there has not been an arrest, Petitioner may contact the Clerk
of the Circuit Court of the county in which the violation occurred and
complete an afdavit in support of the violation, or Petitioner may contact the
State Attorney’s ofce for assistance in fling an action for indirect civil
contempt or indirect criminal contempt. Upon receiving such a report, the
State Attorney is hereby appointed to prosecute such violations by indirect
criminal contempt proceedings, or the State Attorney may decide to fle a
criminal charge, if warranted by the evidence.
4. Respondent, upon service of this injunction, shall be deemed to have
knowledge of and to be bound by all matters occurring at the hearing and on
the face of this injunction.
5. The temporary injunction, if any, entered in this case is extended until such
time as service of this injunction is efected upon Respondent.
DONE AND ORDERED in ______________________________, Florida on
_____________ .
CIRCUIT JUDGE
Florida Supreme Court Approved Family Law Form 12.980(d)(2), Final Judgment of Injunction
for Protection Against Domestic Violence without Minor Child(ren) (After Notice) (03/15)
I CERTIFY that a copy of the original Final Judgment of Injunction for Protection
Against Domestic Violence without Minor Child(ren) was ( ) mailed ( )
faxed and mailed ( ) e-mailed ( ) hand-delivered to the parties and any entities
listed below on {date} ________________.
CLERK OF THE CIRCUIT COURT
(SEAL)
By:
Deputy Clerk or Judicial Assistant
Sherif of County
Petitioner (or his or her attorney):
____ by U. S. Mail
____ by hand delivery in open court (Petitioner must acknowledge receipt in writing
on the face of the original order--see below.)
Respondent (or his or her attorney):
___ _ forwarded to sherif for service
____ by hand delivery in open court (Respondent must acknowledge receipt in
writing on the face of the original order--see below.)
____ by certifed mail (may only be used when Respondent is present at the hearing
and Respondent fails or refuses to acknowledge the receipt of a certifed copy of
this injunction.)
____ State Attorney’s Ofce
____ Batterer’s intervention program (if ordered)
___ _ State Disbursement Unit (if ordered)
____Central Depository (if ordered)
____ Department of Revenue
____ Other __________________________________________________
ACKNOWLEDGMENT
I, {Name of Petitioner} , acknowledge receipt of a
certifed copy of this Injunction for Protection.
__________________________________
Petitioner
ACKNOWLEDGMENT
I, {Name of Respondent} , acknowledge receipt of a
certifed copy of this Injunction for Protection.
____________________________________
Respondent