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Consent Agreement And Domestic Violence Civil Protection Order 10.01-J - Ohio
| Consent Agreement And Domestic Violence Civil Protection Order Form. This is a Ohio form and can be used in Domestic Relations Cuyahoga County (Court Of Common Pleas) . |
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FORM 10.01-J: CONSENT AGREEMENT AND DOMESTIC VIOLENCE CIVIL PROTECTION ORDER IN THE COURT OF COMMON PLEAS COUNTY, OHIO Case No. Judge Order of Protection Per R.C. 3113.31(F)(3), this Order is indexed at County LAW ENFORCEMENT AGENCY WHERE INDEXED State OHIO ( ) PHONE NUMBER CONSENT AGREEMENT AND DOMESTIC VIOLENCE CIVIL PROTECTION ORDER (R.C. 3113.31) WITH SUPPORT ORDER PERSON(S) PROTECTED BY THIS ORDER: DOB Petitioner: Petitioner's Family or Household Member(s)(May attach additional forms): PETITIONER: First Middle v. RESPONDENT: Last DOB DOB DOB DOB RESPONDENT IDENTIFIERS RACE HT HAIR EXP. DATE SEX EYES First Middle Last WT DATE OF BIRTH STATE DRIVER'S LIC. NO. Relationship to Petitioner: Address where Respondent can be found: Distinguishing Features: WARNING TO LAW ENFORCEMENT: RESPONDENT HAS FIREARMS ACCESS PROCEED WITH CAUTION (Violence Against Women Act, 18 U.S.C. 2265, Federal Full Faith & Credit Declaration: Registration of this Order is not required for enforcement.) THE COURT HEREBY FINDS: That it has jurisdiction over the parties and subject matter, and the Respondent was provided with reasonable notice and opportunity to be heard within the time required by Ohio law. Additional findings of this Order are set forth below. THE COURT HEREBY ORDERS: That the above named Respondent be restrained from committing acts of abuse or threats of abuse against the Petitioner and other protected persons named in this Order, as set forth below. Additional terms of this Order are set forth below. The terms of this Order shall be effective until / / (DATE CERTAIN FIVE YEARS MAXIMUM) WARNING TO RESPONDENT: See the warning page attached to the front of this Order. FORM 10.01-J: CONSENT AGREEMENT AND DOMESTIC VIOLENCE CIVIL PROTECTION ORDER Amended: July 1, 2010 Discard all previous versions of this form American LegalNet, Inc. www.FormsWorkFlow.com [Page 2 of Form 10.01-J] Case No.__________________________ This proceeding came on for a hearing on . The following individuals were present: before the Court and the Ex Parte Order filed on The parties agree to waive their notice and hearing rights and their rights under Civ. R. 53, including the right to request findings of fact and conclusions of law and to file objections to the Magistrate's Decision in this matter. ALL OF THE PROVISIONS CHECKED BELOW APPLY TO THE RESPONDENT. 1. RESPONDENT SHALL NOT ABUSE the protected persons named in this Order by harming, attempting to harm, threatening, following, stalking, harassing, forcing sexual relations upon them, or by committing sexually oriented offenses against them. [NCIC 01 and 02] RESPONDENT SHALL IMMEDIATELY VACATE the following residence: 2. 3. EXCLUSIVE POSSESSION OF THE RESIDENCE located at: is granted to: . Respondent shall not interfere with this individual's right to occupy the residence including, but not limited to canceling utilities or insurance, interrupting telephone service, mail delivery, or the delivery of any other documents or items. [NCIC 03] RESPONDENT SHALL SURRENDER all keys and garage door openers to the above residence at the earliest possible opportunity after service of this Order to the law enforcement agency that serves Respondent with this Order or as follows: RESPONDENT SHALL NOT ENTER or interfere with the residence, school, business, place of employment, day care center, or child care providers of the protected persons named in this Order, including the buildings, grounds, and parking lots at those locations. Respondent may not violate this Order even with the permission of a protected person. [NCIC 04] RESPONDENT SHALL STAY AWAY FROM PETITIONER and all other protected persons named in this Order and not be present within 500 feet or (distance) of any protected persons, wherever those protected persons may be found, or any place the Respondent knows or should know the protected persons are likely to be, even with Petitioner's permission. If Respondent accidentally comes in contact with protected persons in any public or private place, Respondent must depart immediately. This Order includes encounters on public and private roads, highways, and thoroughfares. [NCIC 04] RESPONDENT SHALL NOT INITIATE OR HAVE ANY CONTACT with the protected persons named in this Order or their residences, businesses, places of employment, schools, day care centers, or child care providers. Contact includes, but is not limited to, telephone, fax, e-mail, voice mail, delivery service, writings, or communications by any other means in person or through another person. Respondent may not violate this Order even with the permission of a protected person. [NCIC 05] RESPONDENT SHALL IMMEDIATELY SURRENDER POSSESSION OF ALL KEYS TO THE FOLLOWING , to the law enforcement agency that served Respondent with the MOTOR VEHICLE, Order or as follows and Petitioner is granted exclusive use of this motor vehicle. RESPONDENT SHALL NOT REMOVE, DAMAGE, HIDE, OR DISPOSE OF ANY PROPERTY OR PETS owned or possessed by the protected persons named in this Order. Personal property shall be apportioned as follows: 4. 5. 6. 7. 8. 9. 10. RESPONDENT SHALL NOT CAUSE OR ENCOURAGE ANY PERSON to do any act prohibited by this Order. FORM 10.01-J: CONSENT AGREEMENT AND DOMESTIC VIOLENCE CIVIL PROTECTION ORDER Amended: July 1, 2010 Discard all previous versions of this form American LegalNet, Inc. www.FormsWorkFlow.com [Page 3 of Form 10.01-J] Case No.___________________________ 11. RESPONDENT SHALL NOT POSSESS, USE, CARRY, OR OBTAIN ANY DEADLY WEAPON. Respondent shall turn over all deadly weapons in Respondent's possession to the law enforcement agency that serves Respondent with this Order or as follows: Any law enforcement agency is authorized to take possession of deadly weapons pursuant to this paragraph and hold them in protective custody until further Court order. [NCIC 07] 12. PARENTAL RIGHTS AND RESPONSIBILITIES ARE TEMPORARILY ALLOCATED AS FOLLOWS: [NCIC 09] This Order applies to the following child(ren): 13. VISITATION ORDERS DO NOT PERMIT RESPONDENT TO VIOLATE THE TERMS OF THIS ORDER. (A) Respondent's visitation rights are suspended; or (B) As a limited exception to paragraphs 6 and 7, temporary visitation rights are established as follows: [NCIC 06] This Order applies to the following child(ren): 14. LAW ENFORCEMENT AGENCIES, including, but not limited to, are ordered to assist Petitioner in gaining physical custody of the child(ren) if necessary. 15. RESPONDENT SHALL SUPPORT the protected persons
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