Fill and Sign the Injunction Child Abuse Wisconsin Form

STATE OF WISCONSIN, CIRCUIT COURT,       COUNTY For Official Use Injunction (Child Abuse)Petitioner:       Address: (Optional)             -VS- Respondent:       Address:             Case No.       Respondent’s Date of Birth       Sex       Race       Height       Weight       Hair color       Eye color       THE COURT FINDS: 1. The petitioner has filed a petition alleging child abuse. 2. The petitioner has served upon the respondent a copy of the petition and notice of the time for a hearing on the issuance of the injunction; or the respondent has served upon the petitioner notice of the time for a hearing on the issuance of the injunction. The respondent had an opportunity to be heard. This court has personal and subject matter jurisdiction. 3. The child is       , whose birth date is       . 4. Based on the hearing held on the petition, there are reasonable grounds to believe that the respondent has engaged in, or based on prior conduct of the child and the respondent may engage in, abuse of the child. THE COURT ORDERS: 1. The respondent avoid the child's residence and/or any premises temporarily occupied by the child now and in the future. 2. The respondent avoid contacting or causing any person other than a party's attorney to contact the child unless petitioner consents in writing and the court agrees the contact is in the best interest of the child. Contact means knowingly touching, meeting, communicating or being in visual or audio contact with the child. 3. If requested, the sheriff shall serve and assist in executing this injunction; other:       4. Other:       THE COURT FURTHER ORDERS the respondent is prohibited from possessing a firearm until the expiration of this injunction. Possession of a firearm is a Class G Felony punishable by a fine not to exceed $25,000 or imprisonment not to exceed 10 years, or both. A respondent may retain a firearm only if the respondent is a peace officer and only to the extent required by the peace officer's employer. The respondent shall immediately surrender any firearm(s) that he or she owns or has in his or her possession to: the sheriff of this county. the sheriff of the county in which the respondent resides:       . another person:       . Name and Address THIS INJUNCTION SHALL BE EFFECTIVE UNTIL       . Violation of this order shall result in immediate arrest and is punishable by imprisonment not to exceed 9 months or a fine not to exceed $1,000, or both, and payment of filing and service fees. This injunction is entitled to full faith and credit in every civil or criminal court of the United States or any other state, or Indian tribal courts (to the extent such tribal courts have personal jurisdiction over non tribal members). CV-414 , 10/05 Injunction (Child Abuse) §813.122, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Injunction (Child Abuse) Page 2 of 2 Case No. The respondent was present in DISTRIBUTION: court and personally served with 1. Original - Court a copy of this order. 2. Petitioner 3. Respondent 4. Law Enforcement BY THE COURT: Circuit Court Judge       Name Printed or Typed       Date CV-414 , 10/05 Injunction (Child Abuse) §813.122, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 2