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Verified Petition For Order Of Protection - Illinois
| Verified Petition For Order Of Protection Form. This is a Illinois form and can be used in Order of Protection Dekalb Local County . |
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IN THE CIRCUIT COURT OF THE SIXTEENTH JUDICIAL CIRCUIT DEKALB COUNTY, ILLINOIS Case No. Plaintiff/Petitioner Defendant/Respondent File Stamp VERIFIED PETITION FOR ORDER OF PROTECTION (Fill in lines and check boxes as applicable) Independent Proceeding Criminal Proceeding Matrimonial Other: on his/her own Now comes the Petitioner behalf or on behalf of , a minor child(ren), or on behalf of , an adult who cannot file a petition because of age, health, disability or inaccessibility on his/her own behalf, pursuant to the Illinois Domestic Violence Act (IDVA), and moves this Honorable Court to issue an Order of Protection in this cause and in support thereof states as follows: ALLEGATIONS THIS COURT HAS JURISDICTION OF THE SUBJECT MATTER AND OVER ALL NECESSARY PERSONS, WITH APPROPRIATE VENUE, BECAUSE: A. Petitioner resides at (Street Address, City) in the County of Petitioner resides at in the County of State of State of (Street Address, City) ; OR , and (Street Address, City) the person on whose behalf this Petition is brought, resides at in the County of State of ; OR ). B. Respondent resides at in the County of C. Spouse; Child(ren); Sharing or formerly sharing a common dwelling; Sharing a blood relationship through child(ren); P1-OP-01 (03/06) Page 1 of 5 White - Clerk (Street Address, City) Petitioner's address is omitted pursuant to statute. (Alternative address for notice of any motion is State of Former Spouse; Having or allegedly having a child in common; Having or having had dating or engagement relationship; Parent; Stepchild(ren); Other person related by blood or marriage; Respondent stands in relationship to the Petitioner or alleged abused person/s as: Personal assistant to person with disabilities or a person who has responsibility for a high-risk adult with disabilities; Green - Petitioner Yellow - Sheriff Pink - Respondent Gold - Attorney/SAO American LegalNet, Inc. www.USCourtForms.com Verified Petition for Order of Protection Continued D. There is no other pending court action involving the parties, OR There is another pending court action involving the parties in County of E. State of Case No. Court, known as Case No. As referred to herein, "the minor child/ren of the parties " are (full name, D.O.B) Other minor child/ren that reside in household (full name, D.O.B) F. Venue in civil proceedings is appropriate because: Petitioner resides in the County of DeKalb, State of Illinois; OR Respondent resides in the County of DeKalb, State of Illinois; OR The alleged abused occurred in the County of DeKalb, State of Illinois; OR The Petitioner is temporarily located in the County of DeKalb, State of Illinois, to avoid further abuse, and could not obtain safe, accessible, and adequate temporary housing in the county of his/her residence. PETITIONER ALLEGES AS TO RESPONDENT THAT: G. The following individual(s) are alleged to be person(s) who need to be protected from abuse by Respondent: (full name, D.O.B) H. Respondent has acted in the following manner toward the Abused: [State details of incident(s) of abuse (including time and place)] P1-OP-01 (03/06) Page 2 of 5 White - Clerk Green - Petitioner Yellow - Sheriff Pink - Respondent Gold - Attorney/SAO American LegalNet, Inc. www.USCourtForms.com Verified Petition for Order of Protection Continued Case No. ADDITIONAL ALLEGATIONS FOR EMERGENCY ORDERS ONLY I. For requested remedies 1, 3, 5, 7, 8, 9, 11, 14, 15, and 17, the harm which that remedy is intended to prevent would be likely to occur if Respondent were given any prior notice, or greater notice than was actually given of Petitioner's efforts to obtain judicial relief. For requested remedy 2, the immediate danger of further abuse of Petitioner by Respondent if Petitioner chose or had chosen to remain in the household while Respondent was given any prior notice or greater notice than was actually given outweighs the hardship to Respondent of an emergency order granting Petitioner exclusive possession of the residence or household. For requested remedy 10, improper disposition of the personal property would be likely to occur if Respondent were given any prior notice or greater notice than was actually given of Petitioner's effort to obtain judicial relief, or that Petitioner has an immediate and pressing need for possession of that property. J. K. WHEREFORE, PETITIONER REQUESTS THE ENTRY OF AN ORDER OF PROTECTION SETTING FORTH THE FOLLOWING REMEDIES: 1. With respect to Petitoner and other Protected Person(s), Respondent be prohibited from commiting the following: Physical abuse; Harassment; Interference with personal liberty; Intimidation of a dependent; Willful deprivation; Neglect; Exploitation; Stalking. P1-OP-01 (03/06) Page 3 of 5 White - Clerk Green - Petitioner Yellow - Sheriff Pink - Respondent Gold - Attorney/SAO American LegalNet, Inc. www.USCourtForms.com Verified Petition for Order of Protection Continued 2. 3. Case No. Petitioner be granted exclusive possession of the residence and Respondent be prohibited from entering or remaining at such premises: (address + county) a. Respondent be ordered to stay away from Petitioner and other protected persons; and/or b. Respondent be prohibited from entering or remaning at while any Protected Person is present; and/or c. Respondent be allowed access to the residence on (date) in the presence of (name) at (time) to remove items of clothing, personal adornments, medication used exclusively by the Respondent and other items, as follows: d. Respondent be prohibited from both physical presence and nonphysical contact with the petitioner whether direct, indirect (including, but not limited to, telephone calls, mail, email, faxes and writings), or through third parties. Respondent be ordered to undergo counseling for a period of time to be determined by this court. (Not available in Emergency Order) a. Petitioner be granted physical care and possession of the minor child/ren; and/or b. Respondent be ordered to: Return the minor child/ren to the physical care of Not remove the minor child/ren from the physical care of Petitioner or 6. 7. Petitioner be granted temporary legal custody of the minor child/ren (Not available in Emergency Order) a. Respondent be awarded visitation rights on the following dates and times or under the following conditions or parameters: (No order shall merely refer to the term "reasonable visitation") ; and/or 4. 5. b. Respondent's visitation be restricted as follows: c. Respondent's visitation
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