Utah > Statewide > Protective Orders And Civil Stalking
Protective Order - Utah
| Protective Order Form. This is a Utah form and can be used in Protective Orders And Civil Stalking Statewide . |
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Protective Order Case Number: ________________ District:_____ County:________________________ State: Utah Judge: __________________________________ Commissioner: ____________________________ Petitioner (protected person): Other people protected by this order Name (Initials only if Relationship to Age Petitioner under 18) First Middle Last Address and phone # (to keep private, leave blank): Street City State Zip Phone #: Petitioner's Date of Birth: __________________________________ Petitioner's attorney (if any): Name Phone # Respondent (person Petitioner is protected from): Describe Respondent: Sex Race Date of Birth Ht Wt First Middle Last Other names used: Relationship to Petitioner: Address (street): City State Zip Eyes Hair Social Security # (only the last 4 numbers) Distinguishing features (like scars, tattoos, limp, etc.) Driver's license issued by (State): Expires: Warning! Weapon involved (Box to be initialed by Court, if applicable) There was a hearing on (date): . The Respondent was given notice and an opportunity to be heard in the hearing that gave rise to this order. The following people were present at the hearing: Petitioner Petitioner's attorney (name): Respondent Respondent's attorney (name): Other (name) The Court reviewed the Request for Protective Order and: received argument and evidence, accepted the stipulation of the parties, entered the default of the Respondent for failure to appear, finds that domestic violence or abuse has occurred or there is substantial likelihood of immediate danger of abuse or domestic violence by the Respondent, finds that a minor child witnessed the abuse or domestic violence, and makes the orders initialed below. The Court orders the Respondent to obey all orders initialed on this form and to not abuse or threaten to abuse anyone protected by this order. The criminal orders on page 2 do not expire unless dismissed by the Court. Warnings: This is a court order. No one except the court can change it. If you do not obey this order, you can be arrested, fined, and face other charges. This order is valid in all U.S. states and territories, the District of Columbia, and tribal lands. If you go to another U.S. state, territory or tribal land to violate this order, a federal judge can send you to prison. No guns or firearms! (See page 2, item 5.) Protective Order Approved Board of District Court Judges May 21, 2008 Page 1 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Violence Against Women Act of 1994, 18 U.S.C. §§ 2265, 2262, 18 U.S.C. § 922(g)(8) The Respondent must obey all orders initialed by the judicial officer. If you do not obey orders 1 6 below, the court can send you to jail for up to 1 year and order you to pay a fine. A second or subsequent violation can result in more severe penalties. 1 Personal Conduct Order Do not commit, try to commit or threaten to commit any form of violence against the Petitioner or any person listed on page 1 of this form. This includes stalking, harassing, threatening, physically hurting, or causing any other form of abuse. 2 3 No Contact Order Do not contact, phone, mail, e-mail, or communicate in any way with the Petitioner, either directly or indirectly. Contact for Mediation You are allowed to have contact with the Petitioner only during mediation sessions for your divorce or custody case that are scheduled with a Court Qualified Mediator. 4 Stay Away Order Stay away from: a. The Petitioner's current or future: Vehicle property (list current addresses below): Home address: Work address: School address: Vehicle description: Job School Home, premises and b. The school or childcare of the children listed on page 1 of this form. (List current School/Childcare addresses here): c. Other (specify): 5 No Guns or Other Weapons The Court finds that your use or possession of a weapon poses a serious threat of harm to the Petitioner. You cannot possess, have, or buy a gun or firearm or any of these weapons: Warning! It is a federal crime for you to have, possess, transport, ship, or receive any firearm or ammunition, including hunting weapons, while this protective order is in effect, even if 5 above is not initialed. 6 Property Orders Unless a judicial officer makes a different order later, only the Petitioner can use, control and possess the following property and things, but cannot dispose of this property without court approval: a. Home at (address): ___________________________________________________________________________ b. Car, truck or other property (describe): Protective Order Approved Board of District Court Judges May 21, 2008 Page 2 of 4 American LegalNet, Inc. www.FormsWorkFlow.com You must obey orders 7 12 initialed by the judge. If you do not, you will be in contempt of court and may be punished. These orders will expire be reviewed by the court in ____ days. 7 8 Property Orders Do not interfere with or change the Petitioner's phone, utility or other services. Child Custody & Parent-time Orders The Petitioner (the protected person) will have temporary custody of the minor children listed below. The Petitioner may give a copy of this order to the principal or director of the child's school or daycare. If you do not obey the custody and parent-time orders listed here, the Petitioner may ask for the court's help (such as an order to show cause for contempt):__________________________________________________ _________________________________________________________________________________________________________ You will have parent-time as follows: ________________________________________________________________ _________________________________________________________________________________________________________ If there is a "No Contact" order, you can communicate with the Petitioner only about parent-time matters through: _______________________________________________________________________________________ 9 No Alcohol or Illegal Drugs Do not use alcohol or illegal drugs before or during visitation. No Travel with Children Do not take the children listed above out of the state of Utah. Child Support, Spousal Support and other Expenses The Respondent will: a. Pay $ ______ / month in child support. b. Have child support withheld from the Respondent's earnings. (Utah Code § 62A-11, Parts 4 and 5) c. Pay $ ______ / month in spousal support. d. Pay 50% of the minor children's childcare expenses. e. Pay 50% of the minor children's medical expenses, including premiums, deducti
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