Order Protection Notice

Temporary Order for Protection and Notice of Hearing

Court of Washington

Names of minors:

No minors involved

Respondent Identifiers

Respondent’s Distinguishing Features:

Access to weapons:

yes no unknown

The court finds:

The court has jurisdiction over the parties, the minors, and the subject matter. The respondent will be served notice of his or her opportunity to be heard at the scheduled hearing. RCW 26.50.070. For good cause shown, the court finds that an emergency exists and that a Temporary Protection Order should be issued without notice to the respondent to avoid irreparable harm or injury.

The court orders:

1. Respondent is restrained from causing petitioner physical harm, bodily injury, assault, including sexual assault, and from molesting, harassing, threatening, or stalking petitioner the minors named in the table above these minors only:

2. Respondent is restrained from harassing, following, keeping under physical or electronic surveillance, cyberstalking as defined in RCW 9.61.260, and using telephonic, audiovisual, or other electronic means to monitor the actions, locations, or wire or electronic communication of petitioner the minors named in the table above the minors listed below members of the victim’s household listed below the victim’s adult children listed below:

Additional no contact provisions are on the next page.

The terms of this order shall be effective until:

3. Respondent is restrained from coming near and from having any contact whatsoever, in person or through others, by phone, mail, or any means, directly or indirectly, except for mailing or service of process of court documents by a 3rd party or contact by respondent’s lawyer(s) with petitioner the minors named in the table above these minors only:

4. Respondent is restrained from going onto the grounds of or entering petitioner's residence workplace school the day care or school of the minors named in the table above these minors only:

other:

Petitioner's address is confidential. Petitioner waives confidentiality of the address which is:

5. Petitioner shall have exclusive right to the residence petitioner and respondent share. The respondent shall immediately vacate the residence. The respondent may take respondent's personal clothing and respondent's tools of trade from the residence while a law enforcement officer is present. This address is confidential. Petitioner waives confidentiality of this address which is:

6. Respondent is prohibited from knowingly coming within, or knowingly remaining within (distance) of: petitioner's residence workplace school the day care or school of the minors named in the table above these minors only:

other:

7. Petitioner shall have possession of essential personal belongings, including the following:

8. Petitioner is granted use of the following vehicle:

Year, Make & Model License No.

9. Other:

Protection for minors:

10. Petitioner is granted the temporary care, custody, and control of the minors named in the table above these minors only:

11. Respondent is restrained from interfering with petitioner's physical or legal custody of the minors named in the table above these minors only:

12. Respondent is restrained from removing from the state the minors named in the table above these minors only:

Surrender of Weapons Order filed separately

The respondent must comply with the Order to Surrender Weapons Issued Without Notice filed separately, which requires the respondent to surrender any firearms and other dangerous weapons.

The court finds that irreparable injury could result if the order to surrender weapons is not issued.

The respondent is directed to appear and show cause why this temporary order should not be made effective for one year or more and why the court should not order the relief requested by the petitioner or other relief which may include electronic monitoring, payment of costs, and treatment. Failure to Appear at the Hearing May Result in the Court Granting Such Relief. The Next Hearing Date is Shown on Page One.

Warnings to Respondent:

A violation of provisions 1 through 6 of this order with actual notice of its terms is a criminal offense under chapter 26.50 RCW and will subject you to arrest.

Pursuant to 18 U.S.C. § 2265, a court in any of the 50 states, the District of Columbia, Puerto Rico, any United States territory, and any tribal land within the United States shall accord full faith and credit to the order.

Warning: A person may be guilty of custodial interference in the second degree if they violate provisions 10, 11, or 12.

Washington Crime Information Center (WACIC) Date Entry

It is further ordered that the clerk of the court shall forward a copy of this order on or before the next judicial day to which shall enter it into WACIC.

Service

The clerk of the court shall also forward a copy of this order on or before the next judicial day to which shall personally serve the respondent with a copy of this order and shall promptly complete and return to this court proof of service.

Petitioner has made private arrangements for service of this order.

Law Enforcement Assistance

Law enforcement shall assist petitioner in obtaining:

Possession of petitioner's residence personal belongings located at: the shared residence respondent's residence other:

Custody of the above-named minors, including taking physical custody for delivery to petitioner (if applicable).

Other:

Dated: at

Presented by:

The petitioner or petitioner’s lawyer must complete a Law Enforcement Information Sheet (LEIS).