Kansas > Local District Court > 4th Judicial District > Domestic
Petition For Protection From Stalking Order - Kansas
| Petition For Protection From Stalking Order Form. This is a Kansas form and can be used in Domestic 4th Judicial District Local District Court . |
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IN THE DISTRICT COURT OF ______________________ COUNTY, KANSAS ______________________________, Plaintiff vs. Case No. _____________________________________________, Defendant PETITION FOR PROTECTION FROM STALKING ORDER (Pursuant to L. 2002, Ch. 141, 1 et seq.) 1. My name is ________________________. I live in the City of _________________, in the County of __________________, Kansas. 2. I am seeking protection for: (check all that apply) _____ myself _____ my minor child (under age 18) _____ a minor child who lives with me 3. These minor children are involved in this matter: (give full names and ages) 4. The defendants name is _________________________________. 5. I am seeking a protection from stalking order because the defendant has: (Briefly describe the facts about why you are seeking a protection from stalking order) 6. The defendants conduct has caused me to feel: 7. The acts complained of occurred on these dates: in the county of _______________, Kansas. 8. I have/have not filed a police report. (Please circle one.) The case number is .9. The defendant can be found at: (give all available addresses, if known) HOME: street __________________________________________________________ city _______________________ state ______________ zip code __________ phone number ___________________________________________________ times when defendant is usually there ________________________________ WORK: street __________________________________________________________ city _______________________ state ______________ zip code __________ phone number ___________________________________________________ times when defendant is usually there ________________________________ Page 1 <<<<<<<<<********>>>>>>>>>>>>> 2 OTHER: please explain ___________________________________________________ street __________________________________________________________ city _______________________ state ______________ zip code __________ phone number ___________________________________________________ times when defendant is usually there ________________________________ WHEREFORE, plaintiff requests that the Court issue an order of protection restraining defendant from: _____ a) following, harassing, telephoning, contacting or otherwise communicating with the victim _____ b) abusing, molesting or interfering with the privacy rights of the victim _____ c) entering upon or in the victims residence or the immediate vicinity thereof. _____ d) other _____________________________________________________ Plaintiff further requests that copies of orders be given to the appropriate law enforcement agencies; that a date, time and place for a hearing on this matter be set; and that summons be issued to defendant, notifying the defendant of this action and the relief requested. Plaintiff further requests that upon hearing of this cause, the Court issue a final order of protection from stalking, enjoining defendant from any acts of stalking against the plaintiff and/or the minor child, and that the Court award to plaintiff the following additional relief: _____ a) attorneys fees, if represented by counsel; and costs _____ b) other, please specify: and for such other and further relief, all as appropriate and as the Court deems necessary. Plaintiffs signature (If attorney represents the plaintiff, the attorneys address and phone number must be provided.) VERIFICATION STATE OF KANSAS ) ) ss: COUNTY OF __________) _____________________________, of lawful age, being first duly sworn states that (she)(he) is the plaintiff in the above action; that (she)(he) has read the foregoing Petition and knows the contents of it and that the declarations in it are true and correct to the best of plaintiffs knowledge and belief. Plaintiffs signature SIGNED AND SWORN to (or affirmed) before me on this _____ day of _______________, ______. Clerk of the District Court/Notary PublicMy Appointment Expires: ___________________ Page 2
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