Fill and Sign the Name of Child If Different Than Petitioner Form

CONFIDENTIAL COURT RECORD CV-413, 05/16 Temporary Restraining Order and Notice of Injunction Hearing (TRO -Child Abuse) §813.122, W isconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 2 STATE OF WISCONSIN, CIRCUIT COURT, COUNTY Amended Temporary Restraining Order (Temporary Order of Protection) and Notice of Injunction Hearing (Child Abuse - 30710) Case No. PET ITIONER /CHILD Name of Petitioner (First, Middle, Last ) Name of Child (if different than Petitioner) Date of Birth of Child -VS. - RESPONDENT/DEF ENDANT Respondent/Defendant has access to weapon(s). Type of weapon(s): Location of weapon(s): Weapon (s) were involved in an incident [past or present] involving the child. THE COURT FINDS: Findings are on the following page(s) of this temporary restraining order. THE COURT ORDERS: Orders are on the following page(s) of this temporary restraining orde r. THIS TEMPORARY RESTRAINING ORDER SHALL BE EFFECTIVE UNTIL Injunction Hearing Date - Not to exceed 14 days NOTIFICATIONS/WARNINGS TO RESPONDENT/DEFENDANT: This order shall be enforced, even without registration, and is entitled to full faith and credit in every civil or crim inal court of any state, the District of Columbia, any U.S. Territory, and may be enforced by Tribal Lands (18 U.S.C. Section 2265; W is. Stats. 813.128). Crossing state, territorial, or tribal boundaries to violate this order may result in federal imprison ment (18 U.S.C. Section 2262). Federal law provides penalties for, and you may be prohibited from possessing, transporting, shipping, receiving or purchasing a firearm, including, but not limited to, a rifle, shotgun, pistol, revolver, or ammunition, pursu ant to 18 U.S.C. 922(g)(8). Additional notifications/warnings are on the following page of this temporary restraining order. Violation of this temporary restraining 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. Only the court can change this order. Name of Respondent/Defendant (First, Middle, Last ) Respondent’s/Defendant’s Street Address, City, State, Zip Please specify Child’s relationship(s) to Respondent/Defendant: spouse cousin adoptive parent former spouse sibling grandparent person in dating relationship parent child (biological/adoptive/step) current or former live -in step parent relationship Other: [Be specific ] SEX RACE DOB HT WT HAIR COLOR EYE COLOR Respondent’s/Defendant’s Distinguishing Features (such as scars , marks or tattoos) None known. CAUTION: (Check all that apply) Temporary Restraining Order and Notice of Injunction Hearing (TRO - Child Abuse) Page 2 of 2 Case No. CONFIDENTIAL COURT RECORD CV-413 , 05/16 Temporary Restraining Order and Notice of Injunction Hearing (TRO -Child Abuse) §813.122, W isconsin Statu tes This form shall not be modified. It may be supplemented with additional material. Page 2 of 2 THE COURT FINDS: 1. The child or petitioner on behalf of the child filed a petition alleging child abuse under §813. 122, W is. Stat s. 2. This court has personal and subject matter jurisdiction. 3. There are reasonable grounds to believe that the respondent has engaged in, or based upon prior conduct of the child and the respondent, may engage in abuse of the child as defined in §813.122, Wi s. Stats . 4. Neither the child , guardian [if any ], or the guardian ad litem [if any ] consented in writing to have contact with the respondent, and the court agrees it is not in the best interests of the child to have contact with the respondent. 5. The c ourt orders a temporary restraining order and sets a date for an injunction hearing. THE COURT ORDERS: 1. A hearing for an injunction be held on Date Time Location Circuit Court Judge /Circuit Court Commissioner 2. Service of this notice and order shall be made at least hours prior to the hearing. 3. The respondent a void the child's residence and/or any premises temporarily occupie d by the child. 4. The respondent a void contacting the child or causing any person other than a party's attorney to contact the child, unless the child /petitioner consents in writing, and the court agrees the contact is in the best inter ests of the child. Contact includes: contact at child’s home, work, school, public places, in person, by phone, in writing, by electronic communication or device, or in any other manner. 5. The respondent refrain from removing, hiding, d amaging , harming, or mistreating, or disposing of, a household pet. 6. The respondent allow the petitioner or a family member or household member of the petitioner acting on his/her beha lf to retrieve a household pet. 7. Name: is appointed guardian ad litem for the child. [A guardian ad litem is mandatory if the respo ndent is a parent of the child.] 8. If the respondent is the parent or legal guardian of the child or has court -ordered visitation wit h the child, the petitioner must complete the Uniform Child Custody Jurisdiction and Enforcement Act Affidavit (GF -150), which the clerk shall keep confidential and not disclose to the respondent. 9. Other: [May not be inconsistent with remedies requested in the petition .] FAILURE TO APPEAR could result in an injunction being issued directing you to  avoid the child's residence and/or any other premises temporarily occupied by the child;  avoid contacting or causing a ny other person to contact the child, unless the petitioner consents in writing and the court agrees that the contact is in the child’s best interest. Contact includes: contact at child’s home, work, school, public places, in person, by phone, in writing, by electronic communication or device, or in any other manner , AND  follow any other orders made by this court. VIOLATION OF AN INJUNCTION if issued at this hearing shall result in your arrest and may result in the imposition of criminal penalties regardl ess of whether you have been served a copy of the injunction. Service of a copy of this notice of injunction hearing and the petition for the temporary restraining order and/or injunction is constructive knowledge of the existence of the injunction. THI S TEMPORARY RESTRAINING ORDER IS IN EFFECT UNTIL THE INJUNCTION HEARING. BY THE COURT: If you require reasonable accommodations to participate in the court process due to a disability, please call at least 10 working days prior to the scheduled court date. Please note that the court does not provide transportation. Circuit Cour t Judge/ Circuit Court Commissioner Title (Print or Type Name if not eSigned) Date DISTRIBUTION: 1. Court 2. Petitioner (child) 3. Person filing on behalf of child 4. Respondent 5. Guardian Ad Litem (if any) 6. Law Enforcement 7. Other: