Washington > Statewide > Domestic Violence
Order For Protection DV 3.015 - Washington
| Order For Protection Form. This is a Washington form and can be used in Domestic Violence Statewide . |
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Court of Washington For _________________________________ __________ Petitioner (First, Middle, Last Name) DOB v. _________________________________ __________ DOB Respondent (First, Middle, Last Name) Names of Minors: No Minors Involved Order for Protection No. Court Address Telephone Number:( ) (Clerk's Action Required) (ORPRT) Respondent Identifiers Sex Height Race Weight Hair Eyes First Middle Last Age _____________________________________ ________ _____________________________________ ________ _____________________________________ ________ _____________________________________ ________ Caution: Access to weapons: yes no unknown Respondent's Distinguishing Features: ______________________________________ The Court Finds Based Upon the Court Record: The court has jurisdiction over the parties, the minors, and the subject matter and respondent has been provided with reasonable notice and an opportunity to be heard. Notice of this hearing was served on the respondent by personal service service by mail pursuant to court order service by publication pursuant to court order other . This order is issued in accordance with the Full Faith and Credit provisions of VAWA: 18 U.S.C. § 2265. Respondent's relationship to the petitioner is: spouse or former spouse current or former dating relationship in-law parent or child parent of a common child stepparent or stepchild blood relation other than parent or child current or former cohabitant as intimate partner, current or former cohabitant as roommate including current or former registered domestic partner Respondent committed domestic violence as defined in RCW 26.50.010 and represents a credible threat to the physical safety of petitioner; the court concludes as a matter of law the relief below shall be granted. Court Order Summary: Respondent is restrained from committing acts of abuse as listed in restraint provisions 1 and 2, on page 2. No-contact provisions apply as set forth on the following pages. Additional provisions are listed on the following pages. The terms of this order shall be effective immediately and for one year from today's date, unless stated otherwise here (date): Order for Protection (ORPRT) - Page 1 of 5 WPF DV-3.015 Mandatory (06/2012) - RCW 26.50.060 American LegalNet, Inc. www.FormsWorkFlow.com It is Ordered: 1. Respondent is Restrained from causing physical harm, bodily injury, assault, including sexual petitioner the minors assault, and from molesting, harassing, threatening, or stalking these minors only: named in the table above (If the respondent's relationship to the petitioner is that of spouse or former spouse, parent of a common child, or former or current cohabitant as intimate partner, including current or former registered domestic partner, then effective immediately, and continuing as long as this protection order is in effect, the respondent may not possess a firearm or ammunition. 18 U.S.C. § 922(g)(8). A violation of this federal firearms law carries a maximum possible penalty of 10 years in prison and a $250,000 fine. An exception exists for law enforcement officers and military personnel when carrying department/government-issued firearms. 18 U.S.C. § 925(a)(1).) 2. Respondent is Restrained from harassing, following, keeping under physical or electronic surveillance, cyberstalking as defined in RCW 9.61.260, and using telephonic, audiovisual, or other electronic means to monitor the actions, locations, or wire or electronic communication of petitioner the minors named in the table above only the minors listed below members of the victim's household listed below the victim's adult children listed below: 3. Respondent is Restrained from coming near and from having any contact whatsoever, in person or through others, by phone, mail, or any means, directly or indirectly, except for mailing or service of process of court documents by a 3rd party or contact by Respondent's lawyer(s) petitioner the minors named in the table above these minors only: with If both parties are in the same location, respondent shall leave. 4. Respondent is Excluded from petitioner's residence workplace school; or school of the minors named in the table above these minors only: Other Petitioner's address is confidential. is: 5. Petitioner shall have exclusive right to the residence that petitioner and respondent share. The respondent shall immediately Vacate the residence. The respondent may take respondent's personal clothing and tools of trade from the residence while a law enforcement officer is present. This address is confidential. Petitioner waives confidentiality of this address which is: 6. Respondent is Prohibited from knowingly coming within, or knowingly remaining within ________________________ (distance) of: petitioner's residence workplace school; the day care or school of the minors named in the table on page one these minors only: Other: 7. Petitioner shall have possession of essential personal belongings, including the following: the day care Petitioner waives confidentiality of the address which Order for Protection (ORPRT) - Page 2 of 5 WPF DV-3.015 Mandatory (06/2012) - RCW 26.50.060 American LegalNet, Inc. www.FormsWorkFlow.com 8. Petitioner is granted use of the following vehicle: Year, Make & Model_____________________________________ License No. 9. Other: 10. Respondent shall participate in treatment and counseling as follows: domestic violence perpetrator treatment program approved under RCW 26.50.150 or counseling at: parenting classes at: drug/alcohol treatment at: other: 11. Petitioner is granted judgment against respondent as provided in the Judgment, WPF DV 3.030. 12. Parties shall return to court on _______________________, at __________ ___.m. for review. Complete only if the protection ordered involves pets: 13. Petitioner shall have exclusive custody and control of the following pet(s) owned, possessed, leased, kept, or held by petitioner, respondent, or a minor child residing with either the petitioner or the respondent. (Specify name of pet and type of animal.): ____________________________________________________________________________. 14. Respondent is Prohibited from interfering with the protected person's efforts to remove the pet(s) named above. 15. Respondent is Prohibited from knowingly coming within, or knowingly remaining within _______________ (distance) of the following locations where the pet(s) are regularly found: petitioner's residence (You have a right to keep your re
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