Fill and Sign the Notice of Hearing Harassment Form

Temp. Protection Order/Nt of Hearing – Harassment (TMORAH) - Page 1 of 3 UH -03.0200 (07/2019 ) CR 65(b), - RCW 10.14.080 (1), (2), RCW 9.41.800 Court of Washington For Petitioner, vs. Respondent. No. Temporary Protection Order and Notice of Hearing – Harassment (TMORAH) (Clerk’s action required) Next Hearing Date and Time: _____________________________ At: ____________ __________________ Warning to the Respondent: Violation of the provisions of this order with actual notice of its terms is a criminal offense under chapter 10.14 RCW and will subject a violator to arrest . Willful disobedience of the terms of this order may also be contempt of court and subject you to penalties under chapter 7.21 RCW. Minors addressed in this order: Name (First, Middle Initial, Last) Age Race Sex Based upon the petition, testimony, and case record, the cour t finds that the respondent committed unlawful harassment as defined in RCW 10.14.080, and that great or irreparable injury to the protected person/s will result if this order is not granted. It is therefore ordered that : [ ] No -Contact : Respondent is restrained from making any attempts to contact petitioner and any minors named in the above table. Temp. Protection Order/Nt of Hearing – Harassment (TMORAH) - Page 2 of 3 UH -03.0200 (07/2019 ) CR 65(b), - RCW 10.14.080 (1), (2), RCW 9.41.800 [ ] Surveillance : Respondent is restrained from making any attempts to keep under surveillance petitioner and any minors named in the above table. [ ] Stay -Away : Respondent is restrained from entering or being within _______________ (distance) of petitioner’s [ ] residence [ ] place of employment [ ] other: [ ] The address is confidential [ ] Petitioner waives confidentiality of the address whi ch is: [ ] Other : ________________________________ ________________________________ ________________________________ ________________________________ ______ ________________________________ ________________________________ ______ ________________________________ ________________________________ _____ ________________________________ ________________________________ _____ ________________________________ ________________________________ _____ [ ] Surrender of Weapons Order The court finds that: [ ] Irreparable injury could result if the order to surrender weapons is not issued . [ ] Respondent’s possession of a firearm or other dangerous weapon presents a serious and imminent threat to public health or safety or the health or safety of any individual. The Respondent must comply with the Order to Surrender Weapons Issued Without Notice filed separately, which states: Respondent shall immediately surrend er all firearms , other dangerous weapons , and any concealed pistol license s. (Note: Also use for m number All Cases 02 -030 .) Washington Crime Information Center (WACIC) Data Entry It is ordered that the clerk of the court shall forward a copy of this ord er, and any order to surrender weapons, on or before the next judicial day to: _________________________________ [ ] County Sheriff’s Office [ ] Police Department where petitioner lives which shall enter it into WACIC. Service [ ] The clerk of the cou rt shall also electronically forward a copy of this order, and any order to surrender weapons, on or before the next judicial day to: ________________________________ ______ [ ] County Sheriff's Office [ ] Police Department where Respondent lives which shall personally serve the respondent with a copy of this order and shall promptly complete and return to this court proof of service. Or [ ] (Only if surrender of weapons not ordered) Petitioner shall make private arrangements for service of this order . Temp. Protection Order/Nt of Hearing – Harassment (TMORAH) - Page 3 of 3 UH -03.0200 (07/2019 ) CR 65(b), - RCW 10.14.080 (1), (2), RCW 9.41.800 The respondent is directed to appear and show cause why the court should not enter an order for protection effective for one year or more and order the relief requested by the petitioner or other relief the court deems proper, which may include payment of costs. Failure to appear at the hearing or to otherwise respond will result in the court issuing an order for protection pursuant to RCW 10.14 effective for a minimum of one year from the date of the hearing. The next hearing date and time is shown bel ow the caption on page one. A copy of this Temporary Protection Order and Notice of Hearing - Harassment has been filed with the clerk of the court. This Temporary Order for Protection is effective until the next hearing date and time shown below the capt ion on page one. Dated at ______ a.m./p.m. Judge/Court Commissioner I acknowledge receipt of a copy of this Order:  Signature of Respondent/Lawyer WSBA No. Print Name Date  Signature of Petitioner/Lawyer WSBA No. Print Name Date Petitioner or Petitioner’s Lawyer must complete a Law Enforcement Information Sheet (LEIS).