Fill and Sign the State of Maine District Court Location Docket No Petitioner Form

Ord M od /T erm O rd er f o r P ro te ctio n ( O RM TS P) - P age 1 of 3WPF SA 7.030 (07/2017) – RCW 7.90.170 Court of Washington For _____________________________ ____________Petitioner (Protected Person) DOB vs._____________________________ ____________Respondent (Restrained Person) DOBNo.Ord er o n M otio n t o Mo dif y /T erm in ate S exu al A ssau lt Pr o te c tio n O rd er ( O RM TS P) ( J IS O rd er C od e: M PS) C le rk ’s a ctio n r e quir e d The Moving Party is: the respondent the petitioner (name): ____________________________, who filed the motion on behalf of the petitioner. The court received the moving party’s motion for an order to modify (change) or terminate the terms and conditions of the following order: Sexual Assault Protection Order filed on (date): . All provisions Provision 1: No contact Provision 2: Exclude from places Provision 3: Stay away Provision 4: Other (specify) ______________________________________________ . Provision 5: School transfer Prohibit Weapons and Order Surrender Order to Surrender Weapons filed on (date): . Hearing: Petitioner’s Motion: A hearing was held today. Respondent’s Motion: The court found adequate cause on (date) :_________________ and the court held a hearing today. Ord M od /T erm O rd er f o r P ro te ctio n ( O RM TS P) - P age 2 of 3WPF SA 7.030 (07/2017) – RCW 7.90.170The court considered the motion, any declarations of the other party, other documents in the court record, if any, and testimony, if any.Findings: This is the first Motion to Modify/Terminate a Sexual Assault Protection Order that the respondent has filed within the last 12 months in which the order has been in effect. By a preponderance of the evidence, the respondent did or not did approve, as indicated below, that there has been a material change in circumstances such that the respondent is not likely to engage in or attempt to engage in physical or nonphysical contact with the petitioner if the following order/s is/are modified (changed)/terminated: Sexual Assault Protection Order: Provisions:Did proveDid not prove All provisions Provision 1: No contact Provision 2: Exclude from places Provision 3: Stay away Provision 4: Other (specify) Provision 5: School transfer Prohibit Weapons and Order Surrender Order to Surrender Weapons. The Sexual Assault Protection Order should continue in effect but changed as indicated in the order, below. The Order to Surrender Weapons should continue in effect but changed as indicated in the order below. The Sexual Assault Protection Order should be terminated. The Order to Surrender Weapons should be terminated. Order: The motion is denied . The motion is granted . The Sexual Assault Protection Order expires on (date): The Order to Surrender Weapons expires on (date): The Sexual Assault Protection Order continues in effect but changed as follows: The Order to Surrender Weapons continues in effect but changed as follows: Ord M od /T erm O rd er f o r P ro te ctio n ( O RM TS P) - P age 3 of 3WPF SA 7.030 (07/2017) – RCW 7.90.170 The Sexual Assault Protection Order is terminated. The Order to Surrender Weapons is terminated. Other Orders: Petitioner is granted judgment against respondent as provided in the Judgment, form SA 8.030. Washington Crime Information Center (WACIC) Data Entry It is Further Ordered that the clerk of 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 court shall also forward a copy of this order on or before the next judicial day to: _______________________ County Sheriff’s Office _________________ Police Department Where the Other Party Lives which shall personally serve (name ): ____________________________________________ with a copy of this order and shall promptly complete and return to this court a Return of Service. The moving party shall make private arrangements for service of this order.The other party appeared and was served a copy of this order by the court; further service is not required. Dated: at a.m./p.m. Judge/Commissioner 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.I acknowledge receipt of a copy of this Order: I acknowledge receipt of a copy of this Order:Moving Party DateNon-moving party Date