Utah > Statewide > Protective Orders And Civil Stalking
Request For Civil Stalking Injunction - Utah
| Request For Civil Stalking Injunction Form. This is a Utah form and can be used in Protective Orders And Civil Stalking Statewide . |
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This is a private record. Request for Civil Stalking Injunction Case Number: ________________ District:_____ County: _______________________ State: Utah Judge: _________________________________ 1 Petitioner (person needing protection): First Middle Last Address and phone # (to keep private, leave blank): Street City State Zip Phone #: To keep contact information private, check here and ask for " Law Enforcement Service" form. Fill it out, and attach it. Name and phone number of Petitioner's attorney (if any): 2 First Respondent (person you need to be protected from): Middle Last Other names used: Address: Street City State Zip A judge can grant a stalking injunction only if the Respondent did these 3 things: (1) The Respondent stalked you specifically, two or more times. "Stalked" means the Respondent stayed physically or visually close to you, made verbal or written threats to you, or did something that was threatening. (2) The Respondent knew or should have known that the stalking would cause you to fear that you or a family member could be physically hurt or emotionally distressed, or that a reasonable person would be afraid of being physically hurt or emotionally distressed, and (3) The Respondent's stalking actually made you or an immediate family member emotionally distressed or fearful that you would be hurt. An "immediate family member" means your spouse, child, sibling, or any other person who lives with you now, or who lived with you within the past 6 months. Note! In addition to your own statements in this Request, you must provide some other evidence of stalking, like police reports, sworn statements from witnesses, audiotapes, photos, letters, etc. 3a-101- 103. For a complete definition of stalking, see Utah Code §§ 76-5-106.5 and 77- 3 Provide as much information as you can about the Respondent. If you don't know, write "unknown." Respondent's Employer (Name and address): Request for Civil Stalking Injunction 1 of 5 Approved by Board of District Court Judges, June 2006 Revised: April 2012 American LegalNet, Inc. www.FormsWorkFlow.com Best place and time to find the Respondent: (Place): Other addresses (hangouts): Describe the Respondent's vehicle: Make: If more than one vehicle, describe here: Make: Year: Year: Color: Color: No No (Time): License Plates: License Plates: Don't know Don't know Has the Respondent used weapons or been violent in the past? Yes Is the Respondent a law enforcement officer, government investigator, or licensed private investigator? Yes 4 Describe the stalking below: a. When and where did the stalking events happen? (Attach additional pages if necessary.) 1P stalking event: P st When: Where: 2Pnd stalking event: P When: Where: b. Who did you report the stalking to (if anyone)? c. List names of all people who witnessed the stalking: d. List any evidence you have of the stalking, like transcripts, audiotape, police reports, photos, sworn statements from witnesses (affidavits), etc. You must attach at least one of these to this form. Request for Civil Stalking Injunction 2 of 5 Approved by Board of District Court Judges, June 2006 Revised: January 2007 American LegalNet, Inc. www.FormsWorkFlow.com e. Describe what the stalker did and why it made you or your family member feel emotionally distressed or afraid of being physically harmed, and why it would have made a reasonable person feel emotionally distressed or afraid of being physically harmed: Check here if you need more space. Ask the clerk for the "Describe Stalking" form. Fill it out and attach it to this form. f. Other facts: 5 Other Court Cases a. Are there other Court orders to the Respondent about stalking? (If Yes, fill out below and attach a copy of the court order.) Yes No b. Have you or the Respondent ever been involved in any other court case involving either of you? Yes No (If yes, list ALL court cases below): Type of Case County and State Court Case # (NOT the police report #) Person involved You You You You Respondent Respondent Respondent Respondent Did the judge make an order? Yes No Yes Yes Yes No No No Request for Civil Stalking Injunction 3 of 5 Approved by Board of District Court Judges, June 2006 Revised: January 2007 American LegalNet, Inc. www.FormsWorkFlow.com Please, Judge, I am asking you to: Make the orders I have checked below, 6 7 Personal Conduct Order the Respondent not to stalk me. No Contact Order the Respondent not to contact, phone, mail, email, or communicate with me in any way, either directly or indirectly, or any person listed below: Other people the Respondent must not contact: Name Relationship to Petitioner Address 8 Stay Away Order the Respondent to stay away from: a. My current or future: Vehicle addresses are listed below): Home address: Work address: School address: Describe vehicle: b. Other (specify): Job School Home, premises and property (My current 9 Other Assistance Needed (List below any other orders needed to protect you and other protected people listed on page 1 of this form): ______________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Request for Civil Stalking Injunction 4 of 5 Approved by Board of District Court Judges, June 2006 Revised: January 2007 American LegalNet, Inc. www.FormsWorkFlow.com The Petitioner must read and sign below: I swear that: · I am the Petitioner and I have read this Request for Civil Stalking Injunction, · I am a victim of stalking and believe the Respondent is the stalker, and · I live in this county or the Respondent lives in this county, or the stalking took place in this county. Date: ____________________________ Petitioner's signature: If the Petitioner is a minor, then parent or guardian must sign below. I swear that: · I am Petitioner's parent or guardian and I have read this Request for Civil Stalking Injunction, · Petitioner is a victim of stalking and I believe the Respondent is the stalker, and · The petitioner lives in this county or the Respondent lives in this county, or
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