Georgia > Local County > Gwinnett > Superior Court > Domestic Violence
Petition For Relief Under Family Violence Act MAG 60-14 - Georgia
| Petition For Relief Under Family Violence Act Form. This is a Georgia form and can be used in Domestic Violence Superior Court Gwinnett Local County . |
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IN THE SUPERIOR COURT OF GWINNETT COUNTY STATE OF GEORGIA _________________________________________ * Petitioner * Civil Action File No: * v. * ___________________________________ * _________________________________________ * Prior/Pending Case Nos: Respondent * * ____________________________________ PETITION FOR RELIEF UNDER THE FAMILY VIOLENCE ACT Comes now the Petitioner and submits this Petition for Relief Under the Family Violence Act, as follows: 1. The Petitioner: (In the event Petitioner is staying at a confidential location, list an alternate address and alternate phone number(s) through which Petitioner can still receive mail and messages which will not affect Petitioners safety.) Name: Mailing Address: City, State, Zip: All Phone Numbers: 2. Respondent: Name: Home Address: City, State, Zip: Phone Numbers: You Must Complete Document Labeled Respondents Identifying Fact Sheet Listing Additional Information Concerning This Respondent. 3. This Court has jurisdiction over this matter because: (a) [ ] the Respondent is a resident of Gwinnett County, Georgia (b) [ ] the Respondent is a resident of the State of _______________________________, and the Respondent has committed an act of family violence within the State of Georgia or has committed an act of family violence outside of the State of Georgia having an effect inside the State of Georgia, and (1) [ ] the Petitioner is a resident of Gwinnett County, Georgia. (2) [ ] the Petitioner is a resident of the State of Georgia and the act of family violence committed by the Respondent occurred in Gwinnett County. W:\ MAGFORMS\ MAG 60-14 Petition Relief FV Act Oct. 03 Page 1 of 5 <<<<<<<<<********>>>>>>>>>>>>> 24. This action is brought under the provisions of the Family Violence Act (O.C.G.A. 19-13-1, et seq.) The parties are related to each other as follows: Check Relationship Date Relationship Date Relationship One Began Ended Present Spouse [ ] Ceremonial [ ] Common Law Not Applicable Former Spouse Persons living in the same household Not Applicable Persons formerly living in the same household Parents of the Same Children Not Applicable Not Applicable Parent and Child Not Applicable Not Applicable Stepparent and Stepchild Not Applicable Not Applicable Foster Parent and Foster Child Not Applicable Not Applicable 5. The Minor Children of the parties or children residing with the parties are as follows: Name of Child Date of Birth Resides with: Related to: [ ] Both [ ] Petitioner [ ] Both [ ] Petitioner [ ] Respondent [ ] Respondent [ ] Both [ ] Petitioner [ ] Both [ ] Petitioner [ ] Respondent [ ] Respondent [ ] Both [ ] Petitioner [ ] Both [ ] Petitioner [ ] Respondent [ ] Respondent [ ] Both [ ] Petitioner [ ] Both [ ] Petitioner [ ] Respondent [ ] Respondent [ ] Both [ ] Petitioner [ ] Both [ ] Petitioner [ ] Respondent [ ] Respondent This section MUST be completed in any case in which custody or visitation may be an issue. The present address of my minor children is: [ ] Petitioners address; [ ] Respondents address; [ ] Other: ________________________________________________________________________________________ During the last five years my minor child(ren) has/have resided at the following additional addresses: ___________________________________________________________________________________________________________ I [ ] have [ ] have not participated as a party, witness, or in any other capacity in any litigation concerning the custody of my children in Georgia or in any other state. I [ ] have [ ] do not have information of any custody proceeding concerning my child(ren) pending in a court of Georgia or any other state. I [ ] know [ ] do not know of any person, not a party to this action, who has physical custody of my child(ren) or claims to have custody or visitation rights with respect to my child(ren). If you answered affirmatively (I have/know) to any of the above questions you must list and describe all such cases, including the name of each court(s), and the most recent judgment or order: __________________________ W:\ MAGFORMS\ MAG 60-14 Petition Relief FV Act Oct. 03 Page 2 of 5 <<<<<<<<<********>>>>>>>>>>>>> 3 ________________________________________________________________________________________ 6. The Respondent has committed the following acts of Family Violence against the Petitioner or the minor children: (Please refer to the legal definitions on th e instruction sheet. A family violence petition MUST set out facts to support at least one of these offenses. If none of these offenses has occu rred, you should consider another more appropriate legal remedy.) [ ] Simple Battery [ ] Battery [ ] Simple Assault [ ] Aggravated Assault [ ] Criminal Trespass [ ] Criminal Damage to Property [ ] Unlawful Restraint [ ] Stalking [ ] Aggravated Stalking [ ] Other Felonies 7. The specific facts concerning the above listed acts of Family Violence are as follows (Attach additional sheets and exhibits as necessary): ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ 8. Other documents supporting the allegations o
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