Maryland > Statewide > Circuit-District Court > Domestic Violence
Petition To Modify Rescind Protective Order CC-DC-DV 6 - Maryland
| Petition To Modify Rescind Protective Order Form. This is a Maryland form and can be used in Domestic Violence Circuit-District Court Statewide . |
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CIRCUIT COURT DISTRICT COURT OF MARYLAND FOR City/County Located at Name of Petitioner on Original Court Order Street Address, Apt. No. City, State, Zip Code Court Address Case No. vs. Name of Respondent on Original Court Order Home: Work: Telephone Street Address, Apt. No. City, State, Zip Code Home: Work: Telephone PETITION TO MODIFY/RESCIND PROTECTIVE ORDER I, , the Respondent, in the above entitled case, ask this Court to: modify the Protective Order in this case dated Petitioner, Person Eligible for Relief as follows: rescind the Protective Order in this case dated My reasons are: extend the Protective Order due to a subsequent act of abuse. I want relief for myself minor child vulnerable adult, from abuse by . Name The Respondent committed the following acts of abuse against Name on or about, (check all that apply) by: kicking punching Date choking/strangling slapping shooting rape or other sexual offense (or attempt) hitting with object stabbing shoving threats of violence mental injury of child detaining against will stalking other . The details of what happened are: (Describe injuries. State when and where these acts occurred. Be as specific as you can.): Date Street Address (unless confidential) City, State, Zip Code Signature Home: Work: Telephone CERTIFICATE OF SERVICE I hereby certify that on the day of Month Name and Address Name and Address , Year , I mailed a copy of this Petition to: Date Signature CC-DC/DV 6 (Rev. 10/2010) Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Case No. ----------------------------------------------------------------------------------- Date ----------------------------------------------------- ORDER OF COURT It is this --------------- day of ------------------------------------------------------ , Month ----------------- , ORDERED that: Year this matter be scheduled for a hearing. the Petition is Denied because ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- Judge CC-DC/DV 6 (Rev. 10/2010) Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com
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