PROTECTION ORDER(Protection from Abuse Act)
§ 30 -5- 1, et seq., Ala. Code 1975
Amended Order
For Cases Filed on or After January 1, 2016
State of Alabama Unified Judicial System Form C-3 (Page 1 of 3) Rev. 1/2016
Case No._____________________________________________ ________________
In the Circuit Court of ________________________________County, Alabama
PLAINTIFF (Victim)
Date of Birth (DOB) of Plaintiff (Victim)
and any minor(s) on whose behalf the Petition Other Protected Persons(s) [L ist Name(s) and DOB(s)]:
for Protection from Abuse was filed [List Name(s) and DOB(s)]:
V.
DEFENDANT
Last
Relationship to Victim:
Former-Spouse
Common-Law Marriage Former Common-Law Marriage
Child in Common
Current or Former Dating Relationship
Current or Former Household Member
Relative of Current o r Former Household Member:
Parent Stepparent
Child Stepchild
Defendant’s Home Address & Telephone #:
_________________________
__________________________________________________
CAUTION: WEAPONS INVOLVED:
Hands, Feet, Fist Other:___________________________ ________
Weapon Present on the Property
THE COURT HEREBY FINDS:
That it has jurisdiction over the parties and matter under the laws of the state and that reasonable notice and opportunity to be heard was given to
the person against whom the order is sought sufficient to protect the person’s right to due process. Additional findings of this Court follow on
succeeding pages.
THE COURT HEREBY ORDERS (Check all that apply):
That the above-named Defendant is enjoined from threatening to commit or committing acts of abuse as defined in the Protectio n
That the above-named Defendant is restrained from any contact with the
Plaintiff, and/or child(ren) .
Additional terms of this order follow on succeeding pages.
The terms of this order shall be effective until ; or
further order of the Court . THIS ORDER IS VALID AND ENFORCEABLE
IN ALL COUNTIES IN THE STATE OF ALABAMA. LAW ENFORCEMENT OFFICERS MAY USE THEIR ARREST POWERS PURSUANT TO SECTION 15-10-3 TO ENFORCE THE TERMS OF THE INJUNCTION.
NOTICE TO LAW ENFORCEMENT
This Order shall be enforced, even without registration, by courts and any law e nforcement officer of any state, the District of Columbia, any
U.S. territory, and may be enforced by Tribal lands (18 U.S.C.A. Section 2265).
WARNINGS TO DEFENDANT:
This Order shall be enforced, even without registration, by the courts and any law enforcement officer of any State, the District of Columbia, any U.S.
territo-ry, and may be enforced by Tribal lands (18 U.S.C.A. Section 2265). Crossing state, territorial, or tribal boundaries to violate this Order may result
in pen-alties, including federal imprisonment (18 U.S.C.A. Section 2262). Federal law provides penalties for possessing, transporting, shipping, or
receiving any firearm or ammunition while subject to a qualified protection order or after being convicted of a misdemeanor crime of domestic violence
[18 U.S.C.A. Sections 922(g)(8) and 922(g)(9)]. Section 13A- 11-72(a) provides that it is a Class C felony for a person convicted in the State of Alabama
or elsewhere of a misdemeanor offense of domestic violence or subject to a valid protection order for domestic abuse to own a firearm or have one in his
or her posses-sion or under his or her control. This Order is also enforceable on U.S. Department of Defense installations (10 U.S.C.A. Section 1561a). A
violation of this Order is a Class A misdemeanor. Section 13A-6-142, Ala. Code 1975.
ONLY THE COURT CAN CHANGE THIS ORDER
Original-Court Record Copy-Law Enforcement
Copy-Plaintiff Copy-Defendant
Judge's Initials:
That
the above-named Defendant is restrained from harassing, stalking, or threatening the Plaintiff, and/or child(ren); and/or any designated
person to wit:___________________________ or engaging in other conduct that would place the person(s) in reasonable fear of bodily injury.
from Abuse Act.
SEX
RACE DOB
HTWT
EYES HAIR DISTINGUISHING FEATURES
DRIVER’S LICENSE # STATE EXP. DATE
VEHICLE TAG#
PROTECTION ORDER(Protection from Abuse Act)
§ 30 -5- 1, et seq., Ala. Code 1975
Amended Order
State of Alabama Unified Judicial System Form C-3 (Page 2 of 3) Rev. 1/2016
Case No._____________________________________________ ________________
In the Circuit Court of __________________________________County, Alabama
FINDINGS OF THE COURT (Continued from Page One) (Check all that apply ):
child(ren) of the Plaintiff ; and/or
any designated family or household member, to wit: ______________________________________________.
THE COURT FURTHER ORDERS THAT (Check all that apply):
(1)
.
(2) The Defendant is restrained and enjoined from harassing, stalking, annoying, threatening or
engaging in conduct that would
place the following in reasonable fear of bodily inj ury, the: Plaintiff; and/or child(ren) of the Plaintiff ; and/or any designated per-
son, to-wit: _________________________________________ , o r from contacting the Plaintiff and/or children of the Plaintiff.
(3) The Defendant is restrained and enjoined from having physical or violent contact with: the Plaintiff or the Plantiff’s property; place of
employment; school; and/or the child(ren)’s: residence;
place of employment; school; and/or
any designated person’s , to-
wit:________________________________; residence; place of employment; school; and/or
ordered to stay away from any
specified place, as designated below which the court determines the Defendant has no legitimate reason to freq uent, frequented by: the Plain-
tiff ; and/or child(ren); and/or any designated person. Name(s) and location(s) of the other specified place(s):
______________________________. The Defendant is ordered to not go within _________ feet (minimum of 300 feet) of the Plaintiff’s residence
even if the residence is shared with the Plaintiff. The Defendant is ordered to not go within ________ feet (minimum of 300 feet) of the Plaintiff's
to-wit: __________________________________ ________________________ school and/or place of employment.
(4) Temporary custody of the child(ren) of the parties is hereby awarded to: _______________________________________________. (5) The Defendant is en joined from interfering with the Plaintiff’s efforts to remove any of the Plaintiff’s child(ren) or from removing any children from
(6) The Defendant is enjoined from removing any child(ren) from the individual, to wit: ____________________________________________,
having legal custody of the child(ren), except as subsequently authorized by a custody or visitation order issued by a court of competent jurisdiction.
(7) The possession and use of the automobile,________________________________________________________ , is awarded to ______________________________________________________________________________and other essential personal effects, (Description, year, make)
_______________________________________________________________________________________________________________
are awarded to ___________________________________________________________________________.
_______________________________________________(the appropriate law enforcement officer) is to accompany the Plaintiff to the residence
of the parties or to______________________________ as necessary to protect the Plaintiff or any child(ren) from abuse.
(8) The Defendant is removed and excluded from the residenc e of the Plaintiff, regardless of ownership of the residence.
(9) The Defendant is prohibited from: transferring; c oncealing; encumbering; or
otherwise disposing of specified property mutually
owned or leased by the parties, as follows: ____________ ___________________________________________________ _________________.
(10)
(Please specify)
Ori gina l-C ourt Record C opy-L aw Enforcement Copy-Plaintiff C opy-Defendant
Judge's Initials:
the jurisdiction of the court. I direct ______________________________________ school; and/or place of employment; and /or the child(ren)'s school; and/or place of employment; and/or any designated person's,
PROTECTION ORDER(Protection from Abuse Act)
§ 30 -5- 1, et seq., Ala. Code 1975
Amended Order
State of Alabama Unified Judicial System Form C-3 (Page 3of 3) Rev. 1/2016
Case No._____________________________________________ ________________
In the Circuit Court of __________________________________County, Alabama
(11) The Defendant is ordered to comply with the following visitati on arrangements of any child(ren) [These visitation arrangements
should be given on a basis that gives primary consideration to the s afety of the Plaintiff and/or child(ren), or both, and re quire super-
vision by a third party or denies visitation if necessary to protect the sa fety of the Plainti and/or child(ren)]: _________ ___________
___________________________________________________ _______________________________________________________.
(12) The Defendant is ordered to pay attorney’s fees in the amount of $ ____________________________and court costs.
(13) The Defendant is ordered to support the Plaintiff and/or child(re n) living in the residence or household when the Defendant i s the sole
owner or lessee. The Plaintiff is granted possession of the residence or h ousehold to the exclusion of the Defendant by evicting
the Defendant; restoring possession to the Plaintiff; or both; or by agreeing to allow the Defendant to pr ovide suitable
alternate housing.
(14) The Defendant is ordered to pay temporary reasonable support in the amount of $________________________ for the Plaintiff and /
or any child(ren) in the Plaintiff's custody, or both, when the De fendant has a legal obligation to support these persons. The
amount of temporary support awarded is in accordance with the Chil d Support Guidelines, Rule 32, Alabama Rules of Judicial Ad-
ministration, as calculated on Form CS- 42.
(15) The Defendant is ordered to provide temporary possession of the vehicle (description) _____________________ to the Plaintiff ,
since the Plaintiff has no other means of transportation of his or her own and the Defendant either has control of more than one
vehicle; or has alternate means of transportation.
(16) The following previous court orders are incorporate d (all or in-part) int o this Order. Custody Order
__________________ (case#) Visitation Order __________________ ___ (case#) Support Order ______________________ (case#).
(17) The Defendant is ordered to surrender all firearms to ___________ _______________________________________ (law enforcement
agency) by _____________________(date). Any law enforceme nt officer is hereby authorized to remove any weapons known to be
possessed by the Defendant if not timely surrendered.
(18) Any law enforcement officer is hereby directed to accompany the P laintiff to the: residence of the parties; and/or another loca-
tion, ______________________________________________ ________, as necessary to enforce any of the terms of this Order.
(19) Other (please specify): ___________________________________________________ ________________________________________________________
___________________________________________________ _______________________________________________________.
(Description of location)
Ori
gina l-C ourt Record C opy-L aw Enforcement Copy-Plaintiff C opy-Defendant
Date Judge
RETURN ON SERVICE
Return receipt of certified mail received in this office on _________ ________________________________________________________ .
I certify that I personally delivered a copy of the Protection Order to_____________________________________________________ in
_______________________________________ County, Alabam a on _________________________________________.
(Date)
(Date)
Date Server’s Signature
Type of Process Server Office Address of Server
Office Telephone Number of Server
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