Fill and Sign the Harassment Restraining Orders Minnesota Judicial Branch Form

- 1 - STATE OF MINNESOTA DISTRICT COURT COUNTY OF JUDICIAL DISTRICT FAMILY COURT DIVISION In Re the Marriage of: Court File No. , Petitioner, RESTRAINING ORDER AND , Respondent, The a b ove-e n title d m atte r c am e o n f o r h earin g b efo re , J u dge o f t h e F am ily C ourt D iv is io n, __ _____ _______ o n _ ____ _________, b ase d o n a m otio n b y t h e P etitio ner f o r t h e r e lie f s p ecif ie d in t h e N otic e o f M otio n h ere in . __ _____ _______ , E sq uir e , a p peare d a s c o unse l f o r a n d o n b eh alf o f P etitio ner._ _ _____ _______ , E sq uir e , a p peare d a s c o unse l f o r a n d o n b eh alf o f R esp onden t. N ow , t h ere fo re , b ase d u pon t h e e v id en ce a d duced , t h e a rg um en t o f c o unse l, a n d a ll o f t h e fil e s, r e c o rd s a n d p ro ceed in gs h ere in , t h e c o urt f in ds:1 . That t h e n am e a n d a d dre ss o f t h e P etitio ner's e m plo yer i s _ _____________, w ith in co m e o f _ _____________ .2. That t h e n am e a n d a d dre ss o f t h e R esp onden t's e m plo yer i s _ _____________, w ith inco m e o f _ _____________ .3. That t h e P etitio ner's d ate o f b ir th i s , a n d S ocia l S ecu rity a cco unt n um ber i s __ _____ _______ .4. That t h e R esp onden t's d ate o f b ir th i s , a n d S ocia l S ecu rity a cco unt n um ber i s __ _____ _______ . - 2 - IT I S O RD ER ED :1. That t h e R esp onden t i s r e str a in ed a n d e n jo in ed f ro m c o m mittin g a cts o f d om estic ab use a g ain st P etitio ner. T his s p ecif ic ally i n clu des i m min en t p hysic al h arm , b odily i n ju ry , a ssa u lt, or t h e i n flic tio n o f f e ar o f i m min en t p hysic al h arm , b odily i n ju ry o r a ssa u lt. 2 . That t h e R esp onden t i s e x clu ded f ro m t h e P etitio ner's r e sid en ce a t _ _____________.3 . That t h e t e m pora ry c u sto dy o f t h e m in or c h ild re n .4 . That t h e R esp onden t s h all p ay , a s a n d f o r t h e t e m pora ry s u pport o f t h e m in or ch ild re n o f t h e p artie s, t h e s u m o f . 5 . That t h e R esp onden t s h all p ay , a s a n d f o r t h e t e m pora ry m ain te n an ce o f t h e Pe titio ner, t h e s u m o f .6 . That s a id c h ild s u pport a n d/o r s p ousa l m ain te n an ce p ay m en ts a s o rd ere d h ere in s h all be d ed ucte d b y t h e R esp ond en t's p re se n t e m plo yer, o r a n y s u bse q uen t e m plo yer, o r o th er p ay or o f fu nds, f r o m R esp onden t's i n co m e, r e g ard le ss o f s o urc e, a n d f o rw ard ed t o t h e _ _____________ Co unty S upport a n d C olle ctio ns S erv ic es, _ _____________________, __ _____ _______________ _ , _ _____________, M in neso ta .7 . That u ntil t h e a u to m atic i n co m e w ith hold in g o rd ere d h ere in i s i m ple m en te d , t h e re sp onden t s h all b e r e sp onsib le t o m ak e t h e p ay m en ts o rd ere d h ere in d ir e ctly t o t h e __ _____ _______ C ounty S upport a n d C olle ctio ns S erv ic e, _ _____________________, __ _____ _______________ , _ _____________, M in neso ta .8 . The a tta ch ed A ppen dix A i s i n co rp ora te d b y r e fe re n ce h ere in .9. That t h e D is tr ic t C ourt A dm in is tr a to r m ail a c o py o f t h is o rd er t o t h e __ _____ _______ C ounty S herif f a n d t h e _ ___________ __ P olic e D ep artm en t w ho a re t o a ssis t t h e Pe titio ner i n t h e e x ecu tio n o f t h is o rd er, u sin g t h e f u ll f o rc e o f t h e C ounty , a n d t h e M unic ip ality i f ne cessa ry . T his o rd er s h all b e e n fo rc ed b y a n y o th er l a w e n fo rc em en t a g en cy w ith in t h e S ta te o f Min neso ta .1 0. That v io la tio n o f t h is o rd er s h all b e a m is d em ean or a n d m ay s u bje ct t h e r e sp onden t - 3 - to a rre st a n d t o i m pris o nm en t f o r u p t o n in ety ( 9 0) d ay s o r a f in e o f n ot m ore t h an $ 700.0 0, o r b oth . In t h e a lte rn ativ e, v io la tio n o f t h is o rd er c o uld r e su lt i n C onte m pt o f C ourt a n d b e p unis h ed acco rd in gly . 11. That t h is o rd er f o r p ro te ctio n e x pir e s o ne y ear f ro m d ate o f t h is o rd er. T his o rd er ma y b e v acate d o nly b y s u b se q uen t o rd er o f t h is c o urt a n d s h all r e m ain i n f u ll f o rc e a n d e ffe ct a n d sh all b e e n fo rc ed u ntil s u ch o rd er i s su es, o r u ntil e x pir a tio n d ate .T H E R ESP O NDEN T I S F O RBID DEN T O E N TER O R S T A Y A T T H E PETIT IO NER 'S R ESID EN CE O R F U TU RE R ESID EN CE F O R V IS IT A TIO N O R A NY OTH ER P U RPO SE E V EN I F I N VIT ED T O D O S O B Y T H E P E TIT IO NER O R A NY OTH ER P E R SO N; I N N O E V EN T I S T H IS O RDER F O R P R O TEC TIO N V O ID ED I F TH IS H APPE N S.A P E A C E O FFIC ER M UST A RREST W IT H OUT A W ARRANT A ND T A K E I N TO CUST O DY A P E R SO N W HOM T H E P E A CE O FFIC ER H AS P R O BA BLE C AUSE T O BELIE V E H AS V IO LA TED T H IS O RDER F O R P R O TEC TIO N R EST R AIN IN G T H E RESP O NDEN T O R E X C LU DIN G T H E R ESP O NDEN T F R O M A R ESID EN CE.R ESP O NDEN T I S F O RBID DEN T O E N TE R O R S T A Y A T T H E P E TIT IO NER 'S RE SID EN CE F O R V IS IT A TIO N. APPR O VED A S T O F O RM A ND C O NTEN T Date d : ( N am e o f A tto rn ey ) Atto rn ey f o r _ _____________________ (A ddre ss)(A ddre ss) (C ity , S ta te , Z ip )(T ele p hone N um ber) D ate d : _ ______ _______ BY T H E C O URT: _ _____________ _________________________Ju dge