Arizona > Local County > Coconino > Superior Court > Children And Family Law
Order Of Protection - Arizona
| Order Of Protection Form. This is a Arizona form and can be used in Children And Family Law Superior Court Coconino Local County . |
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COURTS OF ARIZONA NAME OF COURT Plaintiff: Date of Birth: -vsDefendant: Street Address Court Case No.: Court No., NCIC: Court No., DPS: City, Arizona Zip Code Phone Number ORDER OF PROTECTION [ ] MODIFIED WARNING TO DEFENDANT This is an official Court Order. If you disobey this Order, you may also be arrested and prosecuted for the crime of interfering with judicial proceedings and any other crime you may have committed in disobeying this Order. NOTICE: Only the Court can change this Order. Nothing the Plaintiff does can stop, change, or undo this Order without the Court's approval. You must return to Court to modify (change) or quash (stop) this Order. If you disagree with this Order, you may ask for a hearing by filing a written request for hearing with the Court named above. This Order is effective for one year after original service on you and is valid nationwide. NOTICE TO PARTIES This is not a custody or visitation Order. You can only file for custody or visitation as a Title 25 action in Superior Court. All violations of this Order should be reported to a law enforcement agency, not the Court. Either party should notify this Court if an action for dissolution (divorce), separation, annulment or paternity/maternity is filed. The Court finds reasonable cause to believe that the Defendant may commit an act of domestic violence or has committed an act of domestic violence within the past year (or good cause exists to consider a longer period). 1. IT IS THEREFORE ORDERED that the Defendant not: commit a dangerous crime against children defined in A.R.S. 13604.01 or custodial interference, or engage in conduct that would place the Plaintiff in reasonable fear of bodily injury; or threaten, intimidate, endanger, assault, unlawfully imprison, kidnap, harass, stalk, trespass upon or damage the property of, or commit any other disorderly conduct upon the Plaintiff and (Names and Dates of Birth): [ ] Check if any person listed is a member of Plaintiff's household/family. 2. [] The Defendant shall not contact Plaintiff: [ ] in person; [ ] by phone; [ ] in writing; [ ] The Defendant may contact the Plaintiff through legal counsel, legal process or with permission of the Court. 3. [] The Defendant shall not contact persons listed above: [ ] in person; [ ] by phone; [ ] in writing; [ ] You can file an action for custody or visitation separately in Superior Court. 4. [] The Court finds that physical harm may otherwise result and, therefore, the Plaintiff is granted the exclusive use and possession of the residence at (Address): The Defendant may return once with a law enforcement officer to obtain belongings. 5. [] Defendant shall not go on or near where Plaintiff and/or [] Reside(s) (Leave blank if protected): [] Place of employment (Leave blank if protected): [] School (Name or Address): [] Other Locations: Approved: July 2004 Order of Protection: A.R.S. 13-3602 (D) - (J) Page 1 of 2 American LegalNet, Inc. www.USCourtForms.com 6. [] The Court finds that the Defendant represents a credible threat to the physical safety of the Plaintiff or other protected person and/or may inflict bodily injury or death on the Plaintiff. Upon service of this Order: The Defendant shall not possess, receive and/or purchase firearms or [ ] ammunition. The Defendant shall transfer firearms immediately, but no later than 24 hours after service, to the following law enforcement agency: 7. [] The Defendant received actual notice of this hearing and had an opportunity to participate. The Defendant shall complete [ ] an approved domestic violence offender treatment program, [ ] or a screening and any recommended program, at the and provide the Court with written proof of completion no later than following agency: 8. [] Other Orders necessary for the protection of the Plaintiff and other designated persons: 9. [] The Defendant shall appear for a hearing: Date and Time: Address of Court: Street Address, City, Office/Room/Floor (Put individual court information here): WARNING: IF YOU FAIL TO APPEAR, AN ORDER MAY BE ISSUED WITHOUT YOUR INPUT. 10. [] The Defendant received actual notice of this hearing and had an opportunity to participate. The Plaintiff or other protected person(s) is an intimate partner, as defined by 18 U.S.C. 921(a), or a child of an intimate partner or of the Defendant. [ ] BRADY applies Judicial Officer: Date: CERTIFICATION I hereby certify that this is a true copy of the Order on file in this Court. Judicial Officer or Clerk of the Court By: DESCRIPTION OF DEFENDANT Sex Race Birthdate ALIAS (if known): Height Weight Eyes Hair SSN Defendant is: [ ] Military [ ] Law Enforcement Approved: July 2004 Order of Protection: A.R.S. 13-3602 (D) - (J) Page 2 of 2 American LegalNet, Inc. www.USCourtForms.com
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