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Adult Abuse-Stalking Petition For Order Of Protection AA40 - Missouri
| Adult Abuse-Stalking Petition For Order Of Protection Form. This is a Missouri form and can be used in Adult Abuse Circuit Court Statewide . |
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IN THE CIRCUIT COURT OF U OKRUZNOM SUDU Judge or Division: Sudija ili Odjeljenje: Case Number: Broj slucaja: Court ORI Number: Sudski ORI broj: Petitioner: Molielj/Moliteljica: Petitioner's DOB: Datum rodjenja molitelja/moliteljice: Sex: Spol: FZ MM COUNTY, MISSOURI OKRUGA, MISSOURI Respondent's Home Address: Kuna adresa odgovornog/odgovorne: Race: Rasa: vs. Protiv Home Phone Number: Kuni broj telefona: Respondent's Work Address: Poslovna adresa odgovornog/odgovorne: Work Phone Number: Poslovni broj telefona: Work Hours: Radni sati: (Date File Stamp) (Datum zig dosjea) Respondent: Odgovorni/odgovorna: Alias/Nicknames: Alias/nadimak: Respondent's DOB: Datum rodjenja odgovornog/odgovorne: SSN (if known): Broj socijalne sigurnosti (ako je poznat): Race: Rasa: Hair Color: Boja kose: Eye Color: Boja ociju : Hair Length/Style: Duzina kose/frizura: Sex: Spol: FZ Other Locations Where Respondent May Be Served: Druge lokacije gdje odgovorni/odgovorna mogu boraviti: MM Age: Starost: Height: Visina: Weight: Tezina: (Identifying Information for use by Law Enforcement) (Prepoznatljiva informacija za upotrebu od strane organa vlasti) Petitioner's Relationship to Respondent: Povezanost molitelja/moliteljice sa odgovornim/odgovornom: Spouse Bracni drug Ex-Spouse Bivsi bracni drug Unmarried with Child(ren) in Common Neozenjen/neudata sa zajednickim djetetom (djecom) Unmarried, Intimate Residing/Resided Together Neozenjen/neudata intimno borave/boravili zajedno Related by Blood/Marriage Srodstvo krvno/bracno Other (specify) Drugo (specificirati) ___________________ Visible Identifying Marks (e.g. tattoos, birthmarks, braces, mustache, beard, pierced ear, glasses) Vidljiva prepoznavajua obiljezja (npr. tetovaze, mladezi, zubna proteza, brkovi, brada, probuseno uho, aocale) ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ Adult Abuse/Stalking Petition for Order of Protection Molba za Nalog zastite protiv zlostavljanja/proganjanja odraslih 1. I am Petitioner and Ja sam molitelj/moliteljica a Respondent is odgovorni/odgovorna je at least 18 years of age najmanje 18 godina star/-a under 18 but emancipated ispod 18 godina star/-a ali emancipovan at least 18 years of age najmanje 18 godina star/-a under 18 but emancipated ispod 18 godina star/-a ali emancipovan/-a 2. I reside in ___________________ (city), ___________________ (state), in the County of ___________________. Respondent may be found in ___________________ (city), ___________________ (state), in the County of ___________________. Ja boravim u ________________________ (grad), ___________________ (drzava), u Okrugu ___________________. Odgovorni/odgovorna boravi u ________________________ (grad), ___________________ (drzava), u Okrugu ___________________. OSCA (12-04) AA40 (ASPO) 1 of 5 455.010, 455.030, 455.030.3, 455.085 RSMo American LegalNet, Inc. www.USCourtForms.com 3. An act of abuse or stalking occurred at ______________________________________________ (address), __________________________ (city), ____________ (state), in the County of _____________________________. Cin zlostavljanja ili proganja dogodio se u ______________________________________________ (adresa) _________________________ (grad), ____________ (drzava), u Okrugu _____________________________. 4. Respondent and I: (check one or more) Odgovorni/odgovorna i ja: (jedna ili vise kvacica) are related by blood. smo u krvnom srodstvu. are spouses. smo supruznici. were spouses. bili smo supruznici. have child(ren) in common. imamo zajednicko dijete (djecu). are or were residing together. boravimo ili smo boravilili zajedno. were related by marriage. bili smo u braku. are related by marriage. u braku smo. have no relationship other than Respondent has stalked me. nismo u vezi sem sto me je odgovorni/odgovorna proganjao/proganjala. are in a continuing romantic or intimate social relationship. smo u kontinuiranoj romanticnoj ili intimnoj drustvenoj vezi. were in a continuing romantic or intimate social relationship. bili smo u kontinuiranoj romanticnoj ili intimnoj drustvenoj vezi. Complete for Adult Abuse Petition Only. Popuniti samo za molbu zlostavljanja odraslih. 5. Respondent and I: (check one or more) Odgovorni/odgovornai i ja: (staviti jednu ili vise kvacica) reside together boravimo zajedno. previously resided together at ____________________________ (address), ______________________________ (city), ______________________, (state), in the County of _________________________. ranije smo boravili zajedno na _________________________________________ (adresa), _______________________________________________ (grad), ______________________ (drzava), u Okrugu _________________________________. never resided together. nikada nismo boravilili zajedno. Complete for Stalking Petition Only. Popuniti samo za Molbu proganjanja. 6. Respondent is stalking me. Explain relationship (example: co-workers, neighbors, etc.) Odgovorni/odgovorna me proganja. Objasniti odnos (primjer: poslovni suradnici, susjedi i sl.) _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ Complete for Adult Abuse Petition Only. Popuniti samo za Molbu zlostavljanja odraslih. 7. The residence in which I live is: (check one or more) Boravak u kojem ja zivim je: (Staviti jednu ili vise kvacica) jointly owned, leased or rented or jointly occupied by Respondent and me. zajednicki posjed,iznajmljen ili rentiran ili zajednicko boraviste odgovornog/odgovorne i mene. owned, leased, rented or occupied by me. posjedujem, iznajmljujem ili rentiram ja. jointly owned, leased, rented or occupied by me and someone other than Respondent. zajednicki posjed, iznajmljen ili rentiran ili zajednicko boraviste nekoga drugog ko nije odgovorni/odgovorna i mene. owned, leased, rented or occupied by someone else, and Respondent is my spouse. posjeduje, iznajmljuje, rentira ili u njemu boravi neko drugi, a odgovorni/odgovorna je moj supruznik. jointly occupied by me and another person, and Respondent has no property interest therein. zajednicki boravak mene i druge osobe, a odgovorni/odgovorna nema nikakvih svojinskih interesa u tome. Respondent has knowingly and intentionally: (check at least one) Odgovorni/odgovorna me je svj
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