Instructions for Florida Supreme Court Approved Family Law Form 12.980(q),
Petition for Injunction for Protection Against Sexual Violence (11/15)INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED
FAMILY LAW FORM 12.980(q)
PETITION FOR INJUNCTION FOR PROTECTION AGAINST
SEXUAL VIOLENCE (11/15)
When should this form be used?
If you are a victim of sexual violence or the parent or legal guardian of a minor
child who is living at home and is a victim of sexual violence, you can use this form
to ask the court for a protective order prohibiting sexual violence. Sexual violence
means any one incident of:
sexual battery, as defned in Chapter 794, Florida Statutes;
a lewd or lascivious act, as defned in Chapter 800, Florida Statutes,
committed upon or in the presence of a person younger than 16 years of
age;
luring or enticing a child, as described in Chapter 787, Florida Statutes;
sexual performance by a child, as described in Chapter 827, Florida
Statutes; or
any other forcible felony wherein a sexual act is committed or attempted
In order to get an injunction you must have reported the sexual violence to a law
enforcement agency and be cooperating in the criminal proceeding if there is one. It
does not matter whether criminal charges based on the sexual violence have been
fled, reduced, or dismissed by the state attorneyss ofce. Yoou may also seek an
injunction for protection against sexual violence if the respondent was sent to
prison for committing one of the sexual violence crimes listed above against you or
your minor child living at home and respondent is out of prison or is getting out of
prison within 90 days of your petition. Attach the notice of inmate release to your
petition.
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 seeking an injunction for protection against sexual violence
on behalf of a minor child who is living at home, the parent or legal guardian must
have been an eyewitness to, or have direct physical evidence or affidavits from
eyewitnesses of, the specifc facts and circumstances that form the basis of the
petition. 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.
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 is 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.
Instructions for Florida Supreme Court Approved Family Law Form 12.980(q),
Petition for Injunction for Protection Against Sexual Violence (11/15)This form should be typed or printed in black ink. Yoou 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 . Yoou should keep a copy for your records. If
you 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 an immediate and
present danger of violence exists, the judge will sign a Temporary Injunction for
Protection Against Sexual Violence , Florida Supreme Court Approved Family
Law Form 12.980(r). A temporary injunction is issued without notice to the
respondent. The clerk will give your petition , the temporary injunction, and any
other papers fled 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 frst, unless the
respondent is incarcerated, and in such instance the temporary injunction is
efective for 15 days following the date the respondent is released from
incarceration. 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--YoOU. Section I of the
temporary injunction gives a date that you should appear in court for a hearing. Yoou
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
Sexual Violence (After Notice) , Florida Supreme Court Approved Family Law
Form 12.980(s), which will remain in efect for a specifc time period or until
modifed 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 final 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 fnal injunction, the clerk will provide you with
the necessary copies.
Make sure that you keep one certified copy of the injunction with you at
all times !
Instructions for Florida Supreme Court Approved Family Law Form 12.980(q),
Petition for Injunction for Protection Against Sexual Violence (11/15)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 sexual violence exists, the court will set a full
hearing on your petition. The respondent will be notifed by personal service of
your petition and the hearing. If your petition is denied, you may: amend your
petition by fling 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?
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 defned in
that section. The clerk of the circuit court or family law intake staff will provide
you with necessary forms. For further information, see section 784.046, Florida
Statutes.
IMPORTANT INFORMATION REGARDING E-FILING
The Florida Rules of Judicial Administration now require that all petitions, pleadings,
and documents be fled electronically except in certain circumstances. Self-
represented litigants may file petitions or other pleadings or documents
electronically; however, they are not required to do so. If you choose to fle
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 fle. 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 certifed 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. Yoou may fnd 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
Instructions for Florida Supreme Court Approved Family Law Form 12.980(q),
Petition for Injunction for Protection Against Sexual Violence (11/15)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: Certificate 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.
Special Notes . . .
If you fear that disclosing your address would put you in danger, you should
complete a Request for Confidential Filing of Address, Florida Supreme Court
Approved Family Law Form 12.980(h), and fle it with the clerk of the circuit court
and write confdential in the space provided for your address on the petition.
IN THE CIRCUIT COURT OF THE _______________________ JUDICIAL CIRCUIT,
IN AND FOR ________________________ COUNTYo, FLORIDA
Case No.: ___________________________
___
Division: __________________________________________________________________________________
________
_______________________ _ __________,
Petitioner,
and
_______________________ _ __________,
Respondent,
PETITION FOR INJUNCTION FOR PROTECTION
AGAINST SEXUAL 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; however, if you fear that
disclosing your address to the respondent would put you in danger, you
should complete and fle a Request for Confdential Filing of Address, Florida
Supreme Court Approved Family Law Form 12.980(h), and write confdential in the
space provided on this form for your address.)
1. Petitioner currently lives at the following address: {address, city, state, zip
code}
Date of Birth of Petitioner: .
[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.)
Florida Supreme Court Approved Family Law Form 12.980(q), Petition for Injunction for
Protection Against Sexual Violence (11/15)
1. Respondent currently lives at the following address: {address, city, state, and
zip code} _______
______________________________________________________________________________
Respondentss Driverss License number is: {if known}
____________________________________
Florida Supreme Court Approved Family Law Form 12.980(q), Petition for Injunction for
Protection Against Sexual Violence (11/15)
2. Respondent's last known place of employment:
_______________________________________
Employment address:
____________________________________________________________
Working hours:
_________________________________________________________________
3. 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:
__________________
4. Other names Respondent goes by (aliases or nicknames):
_______________________________
______________________________________________________________________________
5. Respondent's attorneyss 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.")
6. If Respondent is a minor, the address of Respondentss parent or legal
guardian is:
______________________________________________________________________________
______________________________________________________________________________
SECTION III. CASE HISTORY AND REASON FOR SEEKING
PETITION
(This section must be completed.)
1. Petitioner has sufered sexual violence as shown by the fact that the
Respondent has: {describe the acts of violence}
_____________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
_________________________________________________________________________ _____
______________________________________________________________________________
______________________________________________________________________________
Florida Supreme Court Approved Family Law Form 12.980(q), Petition for Injunction for
Protection Against Sexual Violence (11/15)
______________________________________________________________________________
______________________________________________________________________________
_____________________________________________________________________________
_____ ______ Please indicate here if you are attaching additional pages to
continue these facts.
Florida Supreme Court Approved Family Law Form 12.980(q), Petition for Injunction for
Protection Against Sexual Violence (11/15)
{Indicate all that apply}
a. _____ Petitioner reported the sexual violence to law enforcement and is
cooperating in any
criminal proceeding. The incident report number by law enforcement is:
________________
{If there is a criminal case, include case number, if known}
_____ .
b. _____ Respondent was sent to prison for committing sexual violence
against Petitioner or Petitionerss minor child living at home and
Respondent is out of prison or is getting out of prison within 90 days. The
notice of inmate release is attached.
2. Has Petitioner ever received or tried to get an injunction for protection
against domestic violence, dating violence, repeat violence, or sexual
violence against Respondent in this or any other court?
_____ Yoes _____ No If yes, what happened in that case? {Include case
number, if known}
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
3. Has Respondent ever received or tried to get an injunction for protection
against domestic violence, dating violence, repeat violence, or sexual
violence against Petitioner in this or any other court?
_____ Yoes _____ No If yes, what happened in that case? {Include case
number, if known}
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
4. 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} :
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Additional Information
{Indicate all that apply}
a. Respondent owns, has, and/or is known to have guns or other weapons.
Florida Supreme Court Approved Family Law Form 12.980(q), Petition for Injunction for
Protection Against Sexual Violence (11/15)
Describe
weapon(s):_________________________________________________________
b. _____ This or prior acts of violence have been previously reported to:
{person or agency}
_________________________________________________________________________
Florida Supreme Court Approved Family Law Form 12.980(q), Petition for Injunction for
Protection Against Sexual Violence (11/15)
SECTION IV. INJUNCTION
(This section must be completed.)
1. Petitioner asks the Court to enter a TEMPORARYo INJUNCTION for protection
against sexual violence that will be in place from now until the scheduled
hearing in this matter.
2. Petitioner asks the Court to enter an 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 Petitionerss
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;
d. ordering Respondent not to use or possess any guns or frearms;
{Indicate all that apply}
e. prohibiting Respondent from going to or within 500 feet of the following
place(s) Petitioner or Petitionerss immediate family must go to
often:_________________________________
__________________________________________________________________________
__________________________________________________________________________
f. _____ prohibiting Respondent from knowingly and intentionally going to or
within 100 feet of Petitionerss motor vehicle; AND any other terms the
Court deems necessary for the safety of Petitioner and Petitionerss
immediate family.
Florida Supreme Court Approved Family Law Form 12.980(q), Petition for Injunction for
Protection Against Sexual 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 OF 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
COUNTYo OF
Sworn to or afrmed and signed before me on by
NOTARYo PUBLIC or DEPUTYo CLERK
{Print, type, or stamp commissioned
name of notary or clerk.}
_ Personally known
_ Produced identifcation
Type of identifcation produced
Florida Supreme Court Approved Family Law Form 12.980(q), Petition for Injunction for
Protection Against Sexual Violence (11/15)