Maryland > Statewide > Circuit-District Court > Domestic Violence
Temporary Protective Order CC-DC-DV 2 - Maryland
| Temporary Protective Order Form. This is a Maryland form and can be used in Domestic Violence Circuit-District Court Statewide . |
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Judge Time Hours Minutes CIRCUIT COURT DISTRICT COURT OF MARYLAND FOR City/County Court Address Located at Telephone No. PETITIONER/PLAINTIFF MD Case No. TEMPORARY PROTECTIVE ORDER First Middle Last Date of Birth and any minor(s) or minor child(ren) on whose behalf the petition was filed. (List names and date(s) of birth.) Name Name Name DOB DOB DOB Name Name Name OTHER(S) TO BE PROTECTED: DOB DOB DOB VS. RESPONDENT/DEFENDANT SEX Relationship to Petitioner Spouse Vulnerable adult Former Spouse Children in Common Cohabitant Parent Other relationship Address City, State, Zip Telephone RESPONDENT IDENTIFIERS RACE DOB HT WT EYES HAIR DISTINGUISHING FEATURES DRIVER'S LICENSE # STATE EXPIRES CAUTION: Weapon Involved Type Access to Firearm(s) VEHICLE DESCRIPTION TAG NO. EMPLOYER THE COURT FINDS that under the laws of Maryland the issuing Court has jurisdiction over the parties and the subject matter. THE COURT ORDERS: That the above named Respondent SHALL NOT abuse, threaten to abuse, and/or harass the Protected Parties. That the above named Respondent SHALL NOT contact the Protected Parties by any means. Additional terms of the Order are as set forth in this document. The terms of this Order shall be effective until Only the Court can change this Order. Month/Day/Year NOTICE TO RESPONDENT: PENALTIES Violation of this Order may result in criminal prosecution, imprisonment and/or fine, and contempt of court. Law enforcement shall arrest a person whom the officer has probable cause to believe is in violation of this Order, as required by Maryland Code, Family Law Article, § 4-508 and Criminal Procedure § 2-204.1. This Protective Order shall be recognized and enforced by the courts of any state, the District of Columbia, any U.S. Territory, tribal lands (18 U.S.C. § 2265) or Department of Defense installations. (10 U.S.C. § 1561a) Crossing state, territorial or tribal boundaries to violate this Order may result in federal imprisonment. (18 U.S.C. § 2262) Federal law provides penalties of up to $250,000 fine and 10 years in prison for possessing, transporting, shipping, or receiving any firearm or ammunition while subject to a protective order or after being convicted of a misdemeanor crime of domestic violence (18 U.S.C. § 922(g)(8)) or knowingly transferring a firearm after a conviction of a misdemeanor crime of domestic violence (18 U.S.C. § 922(g)(9)). Questions regarding this notice should be directed to your attorney, law enforcement agency, or the Maryland State Police Firearms Enforcement Section at 410-290-0050. American LegalNet, Inc. www.FormsWorkFlow.com Page 1 of 5 CC-DC/DV 2 (Rev. 10/2010) Case No. After the appearance of the Petitioner Petitioner's Counsel Respondent consideration of the Petition and evidence, the Court makes the following findings: A. That Date Respondent's Counsel, and in , who is a Person(s) Eligible for Relief, is: The current spouse of the Respondent. A former spouse of the Respondent. A cohabitant with the Respondent. An individual related to the Respondent by blood, marriage, or adoption Relationship A parent, stepparent, child or stepchild of the Respondent or a Person Eligible for Relief who resides or resided with the Respondent or Person(s) Eligible for Relief for at least 90 days within one year before the filing of the Petition. A vulnerable adult. An individual who has a child(ren) in common with the Respondent. Number of Children and Ages B. That the Petitioner is: The person Eligible for Relief. In the case of a vulnerable adult or minor child: A State's Attorney A local department of social services A relative An adult residing in the home That the Respondent consents to the entry of a protective order without a finding of abuse. OR That there are reasonable grounds to believe that the Respondent committed the following abuse(s): Caused serious bodily harm Placed Person Eligible for Relief in fear of imminent serious bodily harm Assault in any degree Rape or a statutory sexual offense (or attempt) in any degree False Imprisonment Stalking Statutory abuse of a child ( Physical Sexual Mental) (Forward to DSS for investigation.) Statutory abuse of a vulnerable adult on Date C. at Time Description of Harm AND That there are reasonable grounds to believe that the above abuse(s) consisted of the use of a firearm, a threat to use a firearm by the Respondent, serious bodily harm, or a threat of serious bodily harm to person or persons eligible for relief. Weapon(s) involved, type . That the Respondent has access to firearm(s). D. E. That, in the case of a request for an order to vacate the home, the Respondent and Person(s) Eligible for Relief resided together at the time of abuse and: Are married, or Are not married, but The name of a Person Eligible for Relief is on the lease or deed. A Person Eligible for Relief has resided in the home with the Respondent for at least 90 days within the past year. In the case of abuse of a child or vulnerable adult, an adult other that the Respondent lives in the home. CC-DC/DV 2 (Rev. 10/2010) Page 2 of 5 American LegalNet, Inc. www.FormsWorkFlow.com Case No. Based on the foregoing, the Court hereby ORDERS: Date 1. That the Respondent SHALL NOT abuse, threaten to abuse, and/or harass 2. That the Respondent SHALL NOT contact (in person, by telephone, in writing, or by any other means) or attempt to contact 3. That the Respondent SHALL NOT enter the residence of at (Residence includes yard, grounds, outbuildings, and common areas surrounding the dwelling.) An undisclosed location for reasons of safety. 4. Respondent SHALL STAY AWAY from: (1) School: (2) School: (3) School: An undisclosed school for reasons of safety. (1) Childcare provider at while (2) Childcare provider at while An undisclosed childcare provider for reasons of safety. (1) Place of employment: (2) Place of employment: An undisclosed place of employment provider for reasons of safety. (1) Temporary residence of at (2) Temporary residence of at An undisclosed temporary residence for reasons of safety. (1) The home of another family member at (2) The home of another family member at An undisclosed home of another family member for reasons of safety. 5. That the Respondent SHALL VACATE the home immediately (home includes yard, grounds, outbuildings, and common areas surrounding the dwelling) at and remain away until the hearing provided for below. (Paragraph 7 and hearing date set on extension of order.) Temporary use and possession of the home is
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