Maryland > Statewide > District Court > Peace Orders
Petition For Peace Order DC-PO 1 - Maryland
| Petition For Peace Order Form. This is a Maryland form and can be used in Peace Orders District Court Statewide . |
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COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Court Address Index No. DISTRICT COURT OF MARYLAND FOR ....................................................................................................... City/County Located at ............................................................................................. Case No. ............................................................................ : Calendar No. .................................................................................................... Petitioner .................................................................................................... .................................................................................................... Street Address, Apt. No. VS. Plaintiff(s) : Respondent JUDICIAL SUBPOENA Home: Work: Telephone Number(s) -againstHome: Work: .................................................................................................... Street Address, Apt. No. : .................................................................................................... City, State, Zip Code Telephone Number(s) .................................................................................................... City, State, Zip Code (NOTE: Fill in the following, checking the appropriate boxes. If you need additional paper, ask the clerk.) : PETITION FOR PEACE ORDER : Defendant(s) 1. I want protection from ................................................................................................................................................................... : The Respondent committed the following acts against ....................................................................................................................., within the past 30 days on the dates stated below. (check all that apply) o kicking o punching o choking o slapping Victim . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Respondent ... o shooting PEOPLE OF THE STATE OF NEW YORKhitting with object o stabbing o shoving o threats of violence o rape or other sexual offense (or attempt) o THE o harassment o stalking o detaining against will o trespass o malicious destruction of property o other TO ............................................................................................................................................................................................................ The details of what happened are: (Describe injuries. State the date(s) and place(s) where these acts occurred. Be as specific as you can.): GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , Court located at County of Court Kind of Case Year Filed Results or Status (if you know) in room , on the day of , 20 , at o'clock in the noon, and at any recessed .................................. or adjourned date,......................................... to testify and give evidence ........................... action on the part of the as a witness in this .................................................................................. .................................. ......................................... ........................... .................................................................................. the Honorable at the 2. I know of the following court cases involving the Respondent and me: 3. Describe all other harm the Respondent has caused you and give date(s), if known Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. 4. I want the Respondent to be ordered: Witness, Honorable , one of the Justices of the รพ NOT to commit or threaten to commit any of the acts listed in paragraph 1 against ................................................... Name Court in County, day of , 20 ............................................................................................................................................................................................. o NOT to contact, attempt to contact, or harass ............................................................................................................... Name o NOT to go to the residence(s) at ................................................................................................................................... (Attorney must sign above and type name below) Address o NOT to go to the school(s) at ........................................................................................................................................ ....................................................................................................................................................................................... Attorney(s) for o NOT to go to the work place(s) at ................................................................................................................................ Name of school and address o To go to counseling o To go to mediation o To pay the filing fees and court costs o Other specific relief: ...................................................................................................................................................... I solemnly affirm under the penalties of perjury that the contents of this Petition are true to the best of my knowledge, information, Office and P.O. Address and belief. Petitioner Telephone No.: NOTICE TO PETITIONER Facsimile No.: Any individual who knowingly provides false information in a Petition for Peace Order is guilty of a misdemeanor and on E-Mail Address: conviction is subject to a fine not exceeding $1,000 or imprisonment not exceeding 90 days or both. Mobile Tel. No.: Date .................................................................................................... .................................................................................................... DC/PO 1 (Rev. 2/2003) American LegalNet, Inc. www.USCourtForms.com
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