Order of Protection Against Petitioner

Order of Protection

PROTECTED PARTY ([ ] PETITIONER [ ] RESPONDENT)

V.

RESTRAINED PARTY

CAUTION:

Weapon Involved

THE COURT HEREBY FINDS:

That it has jurisdiction over the parties and subject matter, and the Restrained Party has been provided with reasonable notice and opportunity to be heard.

Additional findings of this order follow on succeeding pages.

THE COURT HEREBY ORDERS:

That the above named Restrained Party be restrained from committing further acts of abuse or threats of abuse.

That the above named Restrained Party be restrained from any contact with the Protected Party.

Additional terms of this order as set forth on succeeding pages.

The terms of this order shall be effective until , .

WARNINGS TO RESTRAINED PARTY:

This order shall be enforced, even without registration, by the courts of any state, the District of Columbia, any U.S. Territory, and may be enforced by Tribal Lands under 18 U.S.C. Section 2265. Crossing state, territorial, or tribal boundaries to violate this order may result in federal imprisonment under 18 U.S.C. Section 2262.

As a result of this order, it may be unlawful for you to possess or purchase a firearm or ammunition, including a rifle, pistol or revolver, under 18 U.S.C. Section 922(g)(8). If you have any questions whether federal law makes it illegal for you to possess or purchase a firearm, you should consult an attorney.

Only the court can change this order.

Additional Pages

1. NOTICE, APPEARANCES AND STATUS

This order was entered on stipulation of the parties.

The relationship of the parties is that of an "intimate partner" as defined in 18 USC Section 921(a)(32). (See 2 below)

2. EFFECT OF STIPULATION TO ORDER OF PROTECTION

Violation of this order can have serious consequences, including:

A. If you violate the terms of this order, you may be charged with a misdemeanor, which is punishable by imprisonment of up to three hundred sixty-four (364) days and a fine of up to one thousand dollars ($1,000) or both. You may be found to be in contempt of court.

B. If you are the spouse or former spouse of the other party, an individual who cohabitates with or has cohabitated with the other party, or if you and the other party have had a child together, federal law prohibits you from possessing or transporting firearms or ammunition while this order is in effect.

C. If you are not a citizen of the United States, violation of this order may have a negative effect on your application for residency or citizenship.

3. DOMESTIC ABUSE PROHIBITED

The petitioner shall not abuse the respondent or members of the respondent's household.

Petitioner shall not ask or cause other persons to abuse the respondent or respondent's household members.

4. CONTACT PROHIBITIONS

Petitioner shall stay yards away from the respondent and the respondent's home and workplace at all times, unless at a public place, where the petitioner shall remain yards away from the respondent except as specifically permitted by this order.

Petitioner shall not telephone, talk to, visit or contact respondent in any way except as follows:

The parties may contact each other by telephone regarding medical emergencies of minor children;

The parties may attend joint counseling sessions at the counselor's discretion.

Protected party’s addresses

5. COUNSELING

Petitioner shall attend and complete counseling at , contacting that office within five (5) days.

Respondent shall attend and complete counseling at , contacting that office within five (5) days.

Petitioner shall report to for a drug [and] alcohol screen by with the results returned to this court.

Respondent shall report to for a drug [and] alcohol screen by with the results returned to this court.

Other counseling requirements:

6. CUSTODY

The court's orders regarding the minor child/children of the parties are found in the Custody, Support and Division of Property Attachment of this order of protection.

7. PROVISIONS RELATING TO SUPPORT

The court's orders regarding support issues for the parties are found in the Custody, Support and Division of Property Attachment of this order of protection.

8. PROPERTY, DEBTS, PAYMENTS OF MONEY

The court's orders regarding property, debts and payment of money are addressed in the Custody, Support and Division of Property Attachment of this order of protection.

9. ADDITIONAL ORDERS

Review hearing. The parties are ordered to appear for a review hearing on the day of , , at (a.m.) (p.m.).

IT IS FURTHER ORDERED:

10. RESPONDENT SHALL NOT CAUSE VIOLATION

While this order of protection is in effect, the respondent should refrain from any act that would cause the petitioner to violate this order.

11. NOTICE TO LAW ENFORCEMENT AGENCIES

ANY LAW ENFORCEMENT OFFICER SHALL USE ANY LAWFUL MEANS TO ENFORCE THIS ORDER.

Petitioner is ordered to surrender all keys to the residence to law enforcement officers.

Law enforcement officers or shall be present during any property exchange.

This order supersedes prior orders in County, State of , Cause No. to the extent that there are contradictory provisions.

12. NOTICE TO PETITIONER AND RESPONDENT

This order does not serve as a divorce and does not permanently resolve child custody or support issues.

13. AGREEMENT OF PARTIES

Without admitting that domestic abuse has occurred, the parties stipulate to the entry of this order and affirm that they have read and do understand the effects of this order as stated in Paragraph 2.

14. RECOMMENDATIONS

reviewed the pleading for order of protection;

prepared this order as my recommendation to the district court judge regarding disposition of requests for order of protection.

Domestic Violence Commissioner

Court's telephone number:

SO ORDERED.

A copy of this order was faxed mailed to respondent respondent's counsel on .

A copy of this order was faxed mailed to petitioner petitioner's counsel on .