Sa 2015 temporary sexual assault protection order and notice of hearing washington form
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Court of Washington
For No .
_________________________ ____________
Petitioner (Protected Person) DOB
vs.
_________________________ ____________
Respondent (Restrained Person) DOB Temporary Sexual Assault Protection
Order and Notice of Hearing
( TMORSXP ) (JIS Order Code : TSX)
Clerk's Action Required
Next Hearing Date/Time : _________________
At : ____________________________________
_______________________________________
1. The court finds by a preponderance of the evidence that Petitioner is a victim of
nonconsensual sexual conduct or nonconsensual sexual penetration as defined in
RCW 7.90.010 by the respondent; Chapter 26.50 RCW does not apply; and:
Petitioner is 16 years of age or older.
Petitioner is a minor child, age _________, on whose behalf the petition is brought.
Petitioner’s parent(s) or legal guardian(s) are bringing this action and are appointed as
the petitioner’s guardian ad litem for this proceeding.
Petitioner is a vulnerable adult as defined in RCW 74.34.020 or 74.34.021; or other adult
who, because of age, disability, health, or inaccessibility, cannot file the petition.
2. Respondent is under 16 years of age. The court will determine at the next hearing
whether Respondent’s parent or guardian or an attorney should be appointed as
guardian ad litem to represent the respondent in this proceeding.
The court further finds that there is good cause to grant each remedy, regardless of the lack
of prior service of process or of notice upon the respondent, because the harm which each
remedy is intended to prevent or the irreparable injury which the surrender of weapons is
intended to prevent would be likely to occur if the respondent were given any prior notice, or
greater notice than was actually given, of the petitioner’s efforts to obtain judicial relief. It is
therefore ordered :
1. No Contact: Respondent is restrained from having any contact with the petitioner,
including but not limited to telephone calls, mail, written notes, e-mail, texting, and
social media (such as Facebook and Twitter), directly, indirectly, or through third parties
regardless of whether those third parties know of the order.
Temp Sexual Assault Prot Ord/Nt of Hrg (TMORSXP) - Page 1 of 3
WPF SA-2.015 Mandatory (06/2018) – RCW 7.90.090, .110, .120, .130. RCW 9.41.800
2 . Exclude from place: Respondent is excluded from the following places:
Petitioner’s residence
Petitioner’s workplace
Petitioner’s school
Petitioner’s day care
Other:
3. Stay Away: Respondent is prohibited from knowingly coming within, or knowingly
remaining within __________________ (distance) of:
Petitioner’s residence
Petitioner’s workplace
Petitioner’s school
Petitioner’s day care
Other:
4. Other :
Surrender of Weapons Order filed separately
Respondent must comply with the Order to Surrender Weapons Issued Without Notice filed
separately, which requires the respondent to surrender any firearm and other dangerous
weapons.
The court finds that irreparable injury could result if the order to surrender weapons is
not issued.
The respondent may file a Respondent’s Petition to Reopen Temporary Sexual Assault
Protection Order , form SA 6.050, if the respondent did not receive actual prior notice of the
hearing and if the respondent alleges that he or she had a meritorious defense to the order or
that the order or its remedy is not authorized by chapter 7.90 RCW.
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 ___________________________________ County Sheriff's
Office Police Department where Petitioner lives which shall enter it into WACIC.
Service
The clerk of the court shall also forward a copy of the summons, petition, and order 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 the summons, petition and order and
shall promptly complete and return to this court proof of service.
The clerk of the court shall also forward a copy of the summons, petition and order on or
Temp Sexual Assault Prot Ord/Nt of Hrg (TMORSXP) - Page 2 of 3
WPF SA-2.015 Mandatory (06/2018) – RCW 7.90.090, .110, .120, .130. RCW 9.41.800
before the next judicial day to ______________________________________ County
Sheriff's Office Police Department for service of the summons, petition and order
upon __________________________________________________(Respondent’s
Parent(s) or Legal Guardian(s)) at:
___________________________________________________________________
and shall promptly complete and return to this court a Return of Service.
Petitioner has made private arrangements for service of the summons, petition, and
order. (A Return of Service shall be filed with the court at or before the next hearing.)
Respondent appeared in person before the court and was served a copy of the
summons, petition, and order by the court; further service is not required under RCW
7.90.140(6).
The respondent is directed to appear and show cause why this temporary sexual
assault protection order should not be made effective for up to two years and why the
court should not order the relief requested by the petitioner. If Respondent is under 16
years of age then his or her parent(s) or legal guardian(s) shall also appear.
Failure to appear at the hearing may result in the court granting all of the relief
requested in the petition .
Warnings to the Respondent : A knowing violation of this sexual assault protection order
is a criminal offense under chapter 26.50 RCW and will subject a violator to arrest . You can
be arrested even if any person protected by the order invites or allows you to violate the
order’s prohibitions. You have the sole responsibility to avoid or refrain from violating the
order’s provisions. Only the court can change the order.
This temporary sexual assault protection order is effective until the next hearing date
shown on page one .
Dated: at a.m./p.m. _
Judge/Commissioner
Presented by:
Signature of Petitioner/Lawyer WSBA No. Print Name
Signature of Person Filing on Behalf of Petitioner Print Name
Temp Sexual Assault Prot Ord/Nt of Hrg (TMORSXP) - Page 3 of 3
WPF SA-2.015 Mandatory (06/2018) – RCW 7.90.090, .110, .120, .130. RCW 9.41.800 The petitioner or the petitioner’s lawyer must complete a Law
Enforcement Information Sheet (LEIS).
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