Georgia > Statewide > Superior Court > Protective Orders
Family Violence Six Month Protective Order - Georgia
| Family Violence Six Month Protective Order Form. This is a Georgia form and can be used in Protective Orders Superior Court Statewide . |
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ORI Num ber _________________ THE SUPERIOR COURT FOR THE COUNTY OF________________ STATE OF GEORGIA _______________________, : Petitioner, : Civil Action File v. : _______________________, : No._____________________ Respondent. : FAMILY V IOLENCE SIX M ONTH PROTEC TIVE ORDER A hearing was held on this matter on ______________________, 20_____ for which theRespondent had notice as required by law and at which the Respondent appeared and/or had theopportunity to be heard and the Petitioner requested that the Protective Order entered in this casebe continued. Having heard the evidence presented, reviewed the petition and the entire recordconcerning this case and for good cause shown, IT IS HEREBY ORDERED AND ADJUDGED: 1. That these proceedings be filed in the office of the Clerk of this Court. 2. That this Order applies in every county throughout the state and it shall be the duty of every court and every law enforcement official to enforce and carry out the provisions of this Order pursuant to O.C.G.A. 19-13-4(d). Law Enforcement officers may use their arrest powers pursuant to O.C.G.A. 19-13-6 and 17-4-20 to enforce the terms of this Order. 3. This Order shall be in effect for six (6) months from ____________________, 20_____ until ____________________, 20_____. 4. That the Respondent has violated the Family Violence Act, at O.C.G.A. 19-13-1 [pco01] et seq., by committing family violence, has placed the Petitioner in reasonable fear for Petitioners safety, and represents a credible threat to the physical safety of Petitioner and/or Petitioners child/ren. Respondent is hereby enjoined and restrained from doing, or attempting to do, or threatening to do, any act of injury, maltreating, molesting, following, harassing, harming, or abusing the Petitioner and/or the minor child/ren in any manner. Respondent is not to interfere with Petitioners travel, transportation, or communication. Respondent shall not follow, place under surveillance, or contact the Petitioner at any place of the Petitioner for the purpose of harassing and intimidating the Petitioner. 1 <<<<<<<<<********>>>>>>>>>>>>> 2 CIVIL ACTION FILE NO. ______________ 5. That the Respondent is enjoined and restrained from doing or attempting to do, or [pco02] threatening to do, any act of injury, maltreating, molesting, harassing, harming, or abusing the Petitioners family or household. 6. That this Court determined that it had jurisdiction over the parties and the subject matter under the laws of the State of Georgia and Respondent received reasonable notice and had the opportunity to be heard before this Order was issued sufficient to protect the Respondents due process rights and this Order shall be presumed valid and pursuant to18 U.S.C. 2265(a) shall be accorded full faith and credit by any other state or local jurisdiction and shall be enforced as if an Order of the enforcing state or jurisdiction. ONLY THE FOLLOWING THAT ARE INITIALED BY THE JUDGE SHALL APPLY_____ 7. Petitioner is awarded sole and exclusive possession of the residence at _________ [pco03] _______________________________________________________________________ 8. Respondent is ordered to leave the family residence immediately and law enforcement at ________________ (sheriff or police department) is ordered to assist Petitioner in returning to the family residence and the removal of the Respondent. Respondent shall immediately surrender to law enforcement _________________ (sheriff or police department) all and any keys, garage door openers and other security devices to the family residence and law enforcement shall insure that these are given to the Petitioner._____ 9. Respondent is ordered to stay away from Petitioners and Petitioners child/rens [pco04] residence and workplace and/or school and any subsequent residence or workplace or school of Petitioner and/or Petitioners minor child/ren._____ 10. Respondent is ordered to provide suitable alternate housing for Petitioner and/or Petitioners children by _______________________, 20_____._____ 11. That Respondent is restrained and enjoined from approaching within ______ yards [pco01,04] of Petitioner and/or Petitioners minor children._____ 12. Respondent is ordered not to have any contact, direct, indirect or through another [pco05] person with Petitioner, by telephone, pager, fax, e-mail or any other means of communication except as specified in this Order. 2 <<<<<<<<<********>>>>>>>>>>>>> 3 CIVIL ACTION FILE NO. ___________________ 13. That Petitioner is awarded temporary custody of the minor child/ren, namely: ___________________ DOB __________ sex ______ ___________________ DOB __________ sex ______ ___________________ DOB __________ sex ______ ___________________ DOB __________ sex ______ Respondent is ordered not to interfere with the physical custody of the minor child/ren. _____ [pco06] Check here only if Respondent is awarded temporary custody of child/ren._____ 14. Respondent is ordered to pay to the Petitioner support for the minor child/ren in the amount of $________ every _______________ beginning the _______ of _________________, 20_____. All payments are to be made by or to: ____ income deduction order ____ child support receiver ____ by mail directly to the Petitioner or ____ _____________________________ In determining child support the Court finds as follows: The gross income of the father is $________ yearly or $_______ monthly. The gross income of the mother is $_______ yearly or $_______ monthly. The applicable percentages of obligors gross income to be considered by the trier of fact to determine child support are: One child 17 to 23 percent Four children29 to 35 percent Two children 23 to 28 percent Five children31 to 37 percent Three children 25 to 32 percent In this case child support is being determined for ___ child/ren and the applicable percentage of gross income to be considered is ____ to ____ percent. The court has considered the existence of special circumstances, and has found that no special circumstances OR the following special circumstances exist: ______________________________________________________________________ 15. Respondent is ordered to pay temporary support for the Petitioner in the amount of $________ every ______beginning ________________, 20_____. All payments are to be made by or to: ____ income deduction order ____ child support receiver ____ by mail directly to the Petitioner or ____ _____________________________ 3 <<<<<<<<<********>>>>>>>>>>>>> 4 CI
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