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Temporary Order Of Protection GF-5 - New York
| Temporary Order Of Protection Form. This is a New York form and can be used in General Family Court Statewide . |
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F.C.A. §§ 430, 550, 655, 828, 1029 ORI No: Order No: _______________ NYSID No: At a Term of the County of (address) PRESENT: Hon. General Form 5 8/2010 Court , State of New York TEM PORARY ORDER OF PROTECTION [Articles 4, 5, 6, 8 and 10] In the M atter of a Proceeding under Article of the Family Court Act Petitioner Date of Birth: Respondent Date of Birth: NOTICE: YOUR FAILURE TO OBEY THIS ORDER M AY SUBJECT YOU TO M ANDATORY ARREST AND CRIM INAL PROSECUTION, W HICH M AY RESULT IN YOUR INCARCERATION FOR UP TO SEVEN YEARS FOR CRIM INAL CONTEM PT, AND/OR M AY SUBJECT YOU TO FAM ILY COURT PROSECUTION AND INCARCERATION FOR UP TO SIX M ONTHS FOR CONTEM PT OF COURT. IF YOU FAIL TO APPEAR IN COURT W HEN YOU ARE REQUIRED TO SO, THIS ORDER M AY BE EXTENDED IN YOUR ABSENCE AND THEN CONTINUES IN EFFECT UNTIL A NEW DATE SET BY THE COURT. A petition under Article of the Family Court Act , sworn to on , having been filed in this Court in the above entitled proceeding, and good cause having been shown, the Respondent having been [check applicable box]: present in Court and advised of the issuance and contents of this Order not present in Court,, Now, therefore, it is hereby ordered that [specify first name, middle initial and last name] observe the following conditions of behavior: [Check Applicable Paragraphs and Subparagraphs]: [01] Stay away from [A] [name(s) of protected person(s)]: [B] home of , [C] school of [D] business of ,[E] place of employment of [F] other [specify location] Docket No. Family Unit No. (check one) Ex Parte Both Parties Present in Court and/or from the ; , [14] Refrain from communication or any other contact by mail, telephone, e-mail, voice-mail or other electronic or any other means with [specify protected persons(s)]: ; [02] Refrain from assault, stalking, harassment, aggravated harassment, menacing, reckless endangerment, strangulation, criminal obstruction of breathing or circulation, disorderly conduct, criminal mischief, sexual abuse, sexual misconduct, forcible touching, intimidation, threats or any criminal offense against [specify protected person(s) and/or members of protected person's family or household, and/or person(s) with custody of child(ren)]: ; [15] Refrain from intentionally injuring or killing without justification the following companion animal(s) (pet(s)) [specify type(s) and, if available, name(s)]: [11] Permit [specify individual]: with [specify law enforcement agency, if any]: litigation [ specify items]: to enter the residence at [specify]: _during [specify date/time]: to remove personal belongings not in issue in ; ; [04] Refrain from [indicate acts]: that create an unreasonable risk to the health, safety or welfare of [specify child(ren), family or household member(s)]: ; [05] Permit [specify individual]: separation or other written agreement, to visit with [specify child(ren)]: during the following periods of time [specify]: following terms and conditions [specify]: entitled by a court order or under the ; American LegalNet, Inc. www.FormsWorkFlow.com GF-5 [07] Temporary custody of [specify child(ren)] awarded to [specify individual] terms and conditions [specify]: Page 2 shall be under the following ; [12] Surrender any and all handguns, pistols, revolvers, rifles, shotguns and other firearms owned or possessed, including, but not limited to, the following: and do not obtain any further guns or other firearms. Such surrender shall take place immediately but in no event later than [specify date/time]: at [specify location]: ; Pay or provide access to health or medical insurance for necessary medical care and treatment arising from the incident or incidents forming the basis of the order [specify beneficiary of treatment and coverage] ; Arts. 5, 6&8 only Pay counsel fees and/or any costs associated with the order to [specify person and terms] ; Arts. 4,5&6 only Participate in an educational program (and pay the costs thereof)[(specify program] Art. 8 only ; Participate in a batterer's education program designed to help end violent behavior (and pay the costs thereof)[specify program] ; and Art. 8 only Pay to the petitioner/victim(s) restitution, as follows [specify terms] (amount up to $10,000); [99] Observe such other condition(s) as are necessary to further the purposes of protection [specify conditions]: It is further ordered that the above-named Respondent's license to carry, possess, repair, sell or otherwise dispose of a firearm or firearms, if any, pursuant to Penal Law '400.00, is [check applicable box(es)]: [13A] suspended, or [13B] revoked, (note: final order only) and/or [13C] the Respondent shall remain ineligible to receive a firearm license while this Order is in effect. It is further ordered that this temporary order of protection shall remain in force until and including [specify date]: but if you fail to appear in court on this date, the order may be extended and continue in effect until a new date set by the court. , The Family Court Act provides that presentation of a copy of this order of protection to any police officer or peace officer acting pursuant to his or her special duties authorizes, and sometimes requires, the officer to arrest a person who is alleged to have violated its terms and to bring him or her before the Court to face penalties authorized by law. Federal law requires that this order is effective outside, as well as inside, New York State. It must be honored and enforced by state and tribal courts, including courts of a state, the District of Columbia, a commonwealth, territory or possession of the United States, if the person restrained by the order is an intimate partner of the protected party and has or will be afforded reasonable notice and opportunity to be heard in accordance with state law sufficient to protect due process rights (18 U.S.C. §§ 2265, 2266). It is a federal crime to: · cross state lines to violate this order or to stalk, harass or commit domestic violence against an intimate partner or family member; · buy, possess or transfer a handgun, rifle, shotgun or other firearm or ammunition while this Order remains in effect (Note: there is a limited exception for military or law enforcement officers but only while they are on duty) ; and · buy, possess or transfer a handgun, rifle, shotgun or other firearm or ammunition after a conviction of a domestic violence-related crime involving the use or attempted use of physical force or a deadly weapon against an intimate partner or family m
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