IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR __________ COUNTY, FLORIDA
Case No.:
Division:
__________________ ,
Petitioner,
and
___________________ ,
Respondent.
TEMPORARY INJUNCTION FOR PROTECTION AGAINST
SEXUAL VIOLENCE
The Petition for Injunction for Protection Against Sexual Violence under Section
784.046, Florida Statutes, and other papers fled in this Court have been reviewed.
Under the laws of Florida, the Court has jurisdiction of the petitioner and the subject
matter and has jurisdiction of the respondent upon service of the temporary
injunction. The term Petitioner as used in this injunction includes the person on
whose behalf this injunction is entered.
It is intended that this protection order meet the requirements of 18
U.S.C. Section 2265 and therefore intended that it be accorded full faith
and credit by the court of another state or Indian tribe and enforced as if
it were the order of the enforcing state or of the Indian tribe.
SECTION I. NOTICE OF HEARING
Because this Temporary Injunction for Protection Against Sexual Violence has been
issued without notice to Respondent, the Petitioner and Respondent are instructed
that they are scheduled to appear and testify at a hearing regarding this matter on
{date} _____________________, at __________ a.m./p.m., when the Court will consider
whether to issue a Final Judgment of Injunction for Protection Against Sexual
Violence, which shall remain in efect until modifed or dissolved by the Court, and
whether other things should be ordered. The hearing will be before The Honorable
{name} ____________________________, at {room name/number, location, address,
city}
____________________________________________________________________________, Florida.
If Petitioner and/or Respondent do not appear, this temporary injunction may be
continued in force, extended, or dismissed, and/or additional orders may be
granted, including entry of a permanent injunction and the imposition of court costs.
Petitioner and Respondent will be bound by the terms of any injunction or order
issued at the fnal hearing. All witnesses and evidence, if any, must be presented at
Florida Supreme Court Approved Family Law Form 12.980(r), Temporary Injunction for
Protection Against Sexual Violence (03/15)
this time.
IF EITHER PETITIONER OR RESPONDENT DO NOT APPEAR AT THE FINAL
HEARING, HE OR SHE WILL BE BOUND BY THE TERMS OF ANY INJUNCTION
OR ORDER ISSUED IN THIS MATTER.
NOTICE: Because this is a civil case, there is no requirement that these proceedings
be transcribed at public expense.
YOU ARE ADVISED THAT IN THIS COURT:
a.____a court reporter is provided by the court.
b.____electronic recording only is provided by the court. A party may arrange in
advance for the services of and provide for a court reporter to prepare a written
transcript of the proceedings at that party’s expense.
c.____ neither electronic recording nor court reporting services are provided by the
court. A party may arrange in advance for the services of and provide for a court
reporter to prepare a written transcript of the proceedings at that party’s expense.
A RECORD, WHICH INCLUDES A TRANSCRIPT, MAY BE REQUIRED TO SUPPORT AN
APPEAL. THE PARTY SEEKING THE APPEAL IS RESPONSIBLE FOR HAVING THE
TRANSCRIPT PREPARED BY A COURT REPORTER. THE TRANSCRIPT MUST BE FILED
WITH THE REVIEWING COURT OR THE APPEAL MAY BE DENIED.
If you are a person with a disability who needs any accommodation in order
to participate in this proceeding, you are entitled, at no cost to you, to the
provision of certain assistance. Please contact__________________________
__________________________________________________________________
{identify applicable court personnel by name, address, and telephone number} at
least 7 days before your scheduled court appearance, or immediately upon
receiving this notification if the time before the scheduled appearance is less
than 7 days; if you are hearing or voice impaired, call 711.
SECTION II. FINDINGS
The statements made under oath by Petitioner make it appear that Section
784.046, Florida Statutes, applies to the parties, that Petitioner is a victim of sexual
violence by Respondent and meets the requirements for an injunction established
by law.
SECTION III. TEMPORARY INJUNCTION AND TERMS
This injunction shall be efective until the hearing set above and in no
Florida Supreme Court Approved Family Law Form 12.980(r), Temporary Injunction for
Protection Against Sexual Violence (03/15)
event for longer than 15 days, unless extended by court order or unless
the Respondent is incarcerated, and if incarcerated, shall be efective for
15 days following the date Respondent is released from incarceration. If a
final order of injunction is issued, the terms of this temporary injunction
will be extended until service of the final injunction is efected upon
Respondent. This injunction is valid and enforceable in all counties of the
State of Florida. The terms of this injunction may not be changed by either
party alone or by both parties together. Only the Court may modify the
terms of this injunction. Either party may ask the Court to change or end
this injunction.Willful violation of the terms of this injunction, such as refusing to vacate
the dwelling which the parties share, going to Petitioner's residence, place
of employment, school, or other place prohibited in this injunction,
telephoning, contacting or communicating with Petitioner, if prohibited by
this injunction, or committing an act of sexual violence against Petitioner
constitutes a misdemeanor of the first degree punishable by up to one
year in jail, as provided by Sections 775.082 and 775.083, Florida
Statutes.
Any party violating this injunction may be subject to civil or indirect
criminal contempt proceedings, including the imposition of a fine or
imprisonment and also may be charged with a crime punishable by a fine,
jail, or both, as provided by Florida Statutes.
ORDERED and ADJUDGED:
1. Violence Prohibited. Respondent shall not commit, or cause any other
person to commit, any acts of violence against Petitioner, including assault,
aggravated assault, battery, aggravated battery, sexual assault, sexual
battery, stalking, aggravated stalking, kidnapping, or false imprisonment, or
any criminal ofense resulting in physical injury or death. Respondent shall
not commit any other violation of the injunction through an intentional
unlawful threat, word, or act to do violence to Petitioner.
2. No Contact. Respondent shall have no contact with the Petitioner
unless otherwise provided in this section.
a. Unless otherwise provided herein, Respondent shall have no contact with
Petitioner. Respondent shall not directly or indirectly contact Petitioner in
person, by mail, e-mail, fax, telephone, through another person, or in any
other manner. Further, Respondent shall not contact or have any third party
contact anyone connected with Petitioner's employment or school to inquire
about Petitioner or to send any messages to Petitioner. Unless otherwise
provided herein, Respondent shall not go to, in, or within 500 feet of:
Petitioner’s current residence {list
address} _______________________________________________________
or any residence to which Petitioner may move; Petitioner’s current or any
subsequent place of employment {list address of current employment}
_____________________________________
________________________________ or place where Petitioner attends school {list
address of school} ___________________________________________________ ; or the
following other places (if requested by Petitioner) where Petitioner or
Petitioner’s minor child(ren) go often:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Florida Supreme Court Approved Family Law Form 12.980(r), Temporary Injunction for
Protection Against Sexual Violence (03/15)
{Initial if applies; write N/A if not applicable}
b. _____Respondent may not knowingly come within 100 feet of Petitioner’s
automobile at any time.
c._____ Other provisions regarding
contact:_________________________________________
________________________________________________________________________
________________________________________________________________________.
3. Firearms.
{Initial all that apply; write N/A if does not apply}
a.____Respondent shall not use or possess a frearm or ammunition.
b.____Respondent shall surrender any frearms and ammunition in
Respondent's possession to the ____________________County Sherif's
Department.
c. ____Other directives relating to frearms and
ammunition:_______________________
____________________________________________________________________________
____________________________________________________________________________.
4. Mailing Address or Designated E-Mail Address(es). Respondent shall
notify the Clerk of the Court of any change in either his or her mailing
address, or designated e-mail address(es), within 10 days of the change. All
further papers (excluding pleadings requiring personal service) shall be
served either by mail to Respondent’s last known mailing address or by e-
mail to Respondent’s designated e-mail address(es). Service by mail shall be
complete upon mailing or e-mailing.
5. Additional order(s) necessary to protect Petitioner from sexual
violence: ___________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________ .
SECTION IV. OTHER SPECIAL PROVISIONS
{This section to be used for inclusion of local provisions approved by the chief
judge as provided in
Florida Family Law Rule 12.610.}
_____________________________________________________________________________
__________________________________________________________________________
___________________________________________________________________________
SECTION V. DIRECTIONS TO LAW ENFORCEMENT OFFICER IN ENFORCING
Florida Supreme Court Approved Family Law Form 12.980(r), Temporary Injunction for
Protection Against Sexual Violence (03/15)
THIS INJUNCTION
{Unless ordered otherwise by the judge, all provisions in this injunction
are considered mandatory provisions and should be interpreted as part of
this injunction.}
1. The Sherif of ______________ County, or any other authorized ofcer, is
ordered to serve this temporary injunction upon Respondent as soon as
possible after its issuance.
2. This injunction is valid and enforceable in all counties of the State of
Florida. Violation of this injunction should be reported to the appropriate
law enforcement agency. Law enforcement ofcers of the jurisdiction in
which a violation of this injunction occurs shall enforce the provisions of this
injunction and are authorized to arrest without a warrant pursuant to section
901.15, Florida Statutes, for any violation of its provisions, which constitutes
a criminal act under Section 784.047, Florida Statutes.
3. Should any Florida law enforcement ofcer having jurisdiction have probable
cause to believe that Respondent has knowingly violated this injunction, the
ofcer may arrest Respondent, confne him/her in the county jail without bail,
and shall bring him/her before the Initial Appearance Judge on the next
regular court day so that Respondent can be dealt with according to law. The
arresting agent shall notify the State Attorney’s Ofce immediately after
arrest. THIS INJUNCTION IS ENFORCEABLE IN ALL COUNTIES OF FLORIDA AND
LAW ENFORCEMENT OFFICERS MAY EFFECT ARRESTS PURSUANT TO SECTION
901.15(6), FLORIDA STATUTES.
4. Reporting alleged violations. If Respondent violates the terms of this
injunction and there has not been an arrest, Petitioner may contact the Clerk
of the Circuit Court of the county in which the violation occurred and
complete an afdavit in support of the violation or Petitioner may contact the
State Attorney’s ofce for assistance in fling an action for indirect civil
contempt or indirect criminal contempt. Upon receiving such a report, the
State Attorney is hereby appointed to prosecute such violations by indirect
criminal contempt proceedings, or the State Attorney may decide to fle a
criminal charge, if warranted by the evidence.
DONE AND ORDERED in ________________________, Florida on
______________________.
__________________________________________
CIRCUIT JUDGE
Florida Supreme Court Approved Family Law Form 12.980(r), Temporary Injunction for
Protection Against Sexual Violence (03/15)
COPIES TO:
Sherif of ________ County
Petitioner : (or his or her attorney)
__ by U. S. Mail
__ by hand delivery in open court
____ by e-mail to designated e-mail address(es)
Respondent:
__ forwarded to sherif for service
____ State Attorney’s Ofce
__ Other: ________________________
I CERTIFY the foregoing is a true copy of the original Temporary Injunction for
Protection Against Sexual Violence as it appears on fle in the ofce of the Clerk
of the Circuit Court of ____ ___County, Florida, and that I have furnished
copies of this order as indicated above
CLERK OF THE CIRCUIT COURT
(SEAL)
By:
_________________________________________
Deputy Clerk or Judicial
Assistant
Florida Supreme Court Approved Family Law Form 12.980(r), Temporary Injunction for
Protection Against Sexual Violence (03/15)
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