Fill and Sign the Protective Order with Form

STATE OF MINNESOTA DISTRICT COURT COUNTY OF JUDICIAL DISTRICT FAMILY COURT DIVISION In Re the Marriage of: Court File No. , Petitioner, RESTRAINING ORDER AND , Respondent, The above-entitled matter came on for hearing before , Judge of the Family Court Division, ______________ on ______________ , based on a motion by the Petitioner for the relief specified in the Notice of Motion herein. ______________ , Esquire, appeared as counsel for and on behalf of Petitioner. ______________ , Esquire, appeared as counsel for and on behalf of Respondent. Now, therefore, based upon the evidence adduced, the argument of counsel, and all of the files, records and proceedings herein, the court finds: 1 . That the name and address of the Petitioner's employer is ______________ , with income of ______________ . 2 . That the name and address of the Respondent's employer is - 1 - ______________ , with income of ______________ . 3 . That the Petitioner's date of birth is , and Social Security account number is ______________ . 4 . That the Respondent's date of birth is , and Social Security account number is ______________ . IT IS ORDERED: 1. That the Respondent is restrained and enjoined from committing acts of domestic abuse against Petitioner. This specifically includes imminent physical harm, bodily injury, assault, or the infliction of fear of imminent physical harm, bodily injury or assault. 2. That the Respondent is excluded from the Petitioner's residence at ______________ . 3. That the temporary custody of the minor children . 4. That the Respondent shall pay, as and for the temporary support of the minor children of the parties, the sum of - 2 - . 5. That the Respondent shall pay, as and for the temporary maintenance of the Petitioner, the sum of . 6. That said child support and/or spousal maintenance payments as ordered herein shall be deducted by the Respondent's present employer, or any subsequent employer, or other payor of funds, from Respondent's income, regardless of source, and forwarded to the ______________ County Support and Collections Services, ______________________ , _______________________ , ______________ , Minnesota . 7. That until the automatic income withholding ordered herein is implemented, the respondent shall be responsible to make the payments ordered herein directly to the ______________ County Support and Collections Service, ______________________ , ______________________ , ______________ , Minnesota . 8. The attached Appendix A is incorporated by reference herein. 9. That the District Court Administrator mail a copy of this order to the ______________ County Sheriff and the ______________ Police Department who are to assist the Petitioner in the execution of this order, using the full force of the County, and the Municipality if necessary. This order shall be enforced by any other law enforcement agency within the State of Minnesota. 10. That violation of this order shall be a misdemeanor and may subject the respondent to arrest and to imprisonment for up to ninety (90) days or a fine of not more than $700.00, or both. In the alternative, violation of this order could result in Contempt of Court and be punished accordingly. 11. That this order for protection expires one year from date of this order. This order may be vacated only by subsequent order of this court and shall remain in full force and effect and - 3 - shall be enforced until such order issues, or until expiration date. THE RESPONDENT IS FORBIDDEN TO ENTER OR STAY AT THE PETITIONER'S RESIDENCE OR FUTURE RESIDENCE FOR VISITATION OR ANY OTHER PURPOSE EVEN IF INVITED TO DO SO BY THE PETITIONER OR ANY OTHER PERSON; IN NO EVENT IS THIS ORDER FOR PROTECTION VOIDED IF THIS HAPPENS. A PEACE OFFICER MUST ARREST WITHOUT A WARRANT AND TAKE INTO CUSTODY A PERSON WHOM THE PEACE OFFICER HAS PROBABLE CAUSE TO BELIEVE HAS VIOLATED THIS ORDER FOR PROTECTION RESTRAINING THE RESPONDENT OR EXCLUDING THE RESPONDENT FROM A RESIDENCE. RESPONDENT IS FORBIDDEN TO ENTER OR STAY AT THE PETITIONER'S RESIDENCE FOR VISITATION. APPROVED AS TO FORM AND CONTENT Dated: (Name of Attorney) Attorney for ______________________ (Address) (Address) (City, State, Zip) (Telephone Number) Dated: ______________ BY THE COURT: ______________ _________________________ Judge - 4 -