New Mexico > Local District Court > 3rd Judicial District > Domestic Violence

Stipulated Order Of Protection (Against Petitioner) 4-971 - New Mexico

Stipulated Order Of Protection (Against Petitioner) Form. This is a New Mexico form and can be used in Domestic Violence 3rd Judicial District Local District Court .
 Fillable pdf Last Modified 1/13/2014
Get this form for FREE as a print-only pdf

District Court Civil Form (4-971) Order of Protection THIRD JUDICIAL DISTRICT DONA ANNA COUNTY, NEW MEXICO Amended Order Case No. __________________ PROTECTED PARTY ([ ] PETITIONER [ ] RESPONDENT) First Middle Last PROTECTED PARTY IDENTIFIERS Date of Birth of Protected Party Other Protected Persons/DOB ____________________________________________ ____________________________________________ And/or on behalf of minor family member(s): (list name and DOB) _____________________________________________________ _____________________________________________________ V. RESTRAINED PARTY RESTRAINED PARTY IDENTIFIERS SEX First Middle Last RACE HAIR DOB HT WT Relationship to Protected Party: ___________________________ ______________________________________________________ Restrained Party's Address ______________________________________________________ ______________________________________________________ SOCIAL SECURITY # Not used in New Mexico DRIVERS LICENSE # STATE EXP DATE EYES Distinguishing Features _______________________ CAUTION: Weapon Involved THE COURT HEREBY FINDS: That it has jurisdiction over the parties and subject matter, and the Restrained Party has been provided with reasonable notice and opportunity to be heard. Additional findings of this order follow on succeeding pages. THE COURT HEREBY ORDERS: That the above named Restrained Party be restrained from committing further acts of abuse or threats of abuse. That the above named Restrained Party be restrained from any contact with the Protected Party. Additional terms of this order are as set forth on succeeding pages. The terms of this order shall be effective until , . WARNINGS TO RESTRAINED PARTY: This order shall be enforced, even without registration, by the courts of any state, the District of Columbia, any U.S. Territory, and may be enforced by Tribal Lands under 18 U.S.C. Section 2265. Crossing state, territorial, or tribal boundaries to violate this order may result in federal imprisonment under 18 U.S.C. Section 2262. As a result of this order, it may be unlawful for you to possess or purchase ammunition or a firearm, including a rifle, pistol or revolver, under 18 U.S.C. Section 922(g)(8). If you have any questions whether federal law makes it illegal for you to possess or purchase a firearm, you should consult an attorney. ONLY THE COURT CAN CHANGE THIS ORDER. Page 1 of 7 Judge's signature on page 7 American LegalNet, Inc. www.FormsWorkFlow.com ADDITIONAL PAGES OF STIPULATED ORDER OF PROTECTION AGAINST PETITIONER The court further FINDS, CONCLUDES AND ORDERS: 1. NOTICE, APPEARANCE AND STATUS: This order was entered on stipulation of the parties. The relationship of the parties is that of an "intimate partner" as defined in 18 USC Section 921 (a)(32). (See 2 following) 2. EFFECT OF STIPULATION TO ORDER OF PROTECTION: Violation of this order can have serious consequences, including: A. If you violate the terms of this order, you maybe charged with a misdemeanor, which is punishable by imprisonment of up to three hundred sixty-four (364) days and a fine of up to one thousand dollars ($1,000) or both. You may be found in contempt of court. B. If you are the spouse or former spouse of the other party, an individual who cohabitates with or has cohabitated with the other party, or if you and the other party have had a child together, federal law prohibits you from possessing or transporting firearms or ammunition while this order is in effect. If you have a firearm or ammunition, you should immediately dispose of the firearm or ammunition. Violation of this law is a federal crime punishable by imprisonment for up to ten (10) years and a fine of up to two hundred fifty-thousand dollars ($250,000). C. If you are not a citizen of the United States, violation of this order may have a negative effect on your application for residency or citizenship. 3. DOMESTIC ABUSE PROHIBITED: The PETITIONER shall not abuse the Respondent or members of the Respondent's household. "Abuse" means any incident by Petitioner against the Respondent or Respondent's household member resulting in (1) physical harm; (2) severe emotional distress; (3) bodily injury or assault; (4) threat by Petitioner causing imminent fear of bodily injury to Respondent or Respondent's household members; (5) criminal trespass; (6) criminal damage to property; (7) repeatedly driving by Respondent's or Respondent's household member's residence or workplace; (8) telephone harassment; (9) stalking; (10) harassment; or (11) harm or threatened harm to children in any manner set forth above. ADDITIONAL PAGES OF STIPULATED ORDER OF PROTECTION D istrict C ourt C ivil Form (4-971) effective D ecem ber 15, 2008 AGAINST PETITIONER Page 2 of 7 American LegalNet, Inc. www.FormsWorkFlow.com PETITIONER shall not ask or cause other persons to abuse the Respondent or Respondent's household members. 4. CONTACT PROHIBITIONS: PETITIONER shall stay yards away from the Respondent and the Respondent's home and workplace at all times, unless at a public place, where the PETITIONER shall remain from the Respondent except as specifically permitted by this order. PETITIONER shall not telephone, talk to, visit or contact the Respondent in any way except as follows: The parties may contact each other by telephone regarding medical emergencies of minor children. yards away The parties may attend joint counseling sessions at the counselor's discretion. (Unless the court has sealed the protected party's address, include it below:) PROTECTED PARTY'S ADDRESSES (home address) (work address) (city) (tribe/pueblo) (State/zip) ADDITIONAL PAGES OF STIPULATED ORDER OF PROTECTION D istrict C ourt C ivil Form (4-971) effective D ecem ber 15, 2008 AGAINST PETITIONER Page 3 of 7 American LegalNet, Inc. www.FormsWorkFlow.com 5. COUNSELING: PETITIONER shall attend counseling at , contacting that office within five (5) days. The Petitioner shall participate in, attend and complete counseling as recommended by the named agency. RESPONDENT shall attend counseling at , contacting that office within five (5) days. The Respondent shall participate in, attend and complete counseling as recommended by the named agency. PETITIONER shall report to drug [and] alcohol screen by the results returned to this court. RESPONDENT shall report to a drug [and] alcohol screen by with the results returned to this court. Other counseling requirements: , for a (date) with , for (date) 6. CUSTODY: The court's orders regarding th
Link/Embed this Document
URL
Embed


Popular Searches

  1. eviction
  2. proof of service by mail
  3. dissolution of marriage
  4. dismissal
  5. writ of execution
  6. notice of hearing
  7. Ex Parte
  8. visitation
  9. SUBSTITUTION OF ATTORNEY
  10. financial affidavit

Bookmark and Share