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Order Of Protection (Family Offense) CRIM-1 - New York
| Order Of Protection (Family Offense) Form. This is a New York form and can be used in Domestic Violence And Family Offense Family Court Statewide . |
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ORI No: _______________ Order No: ________________ NYSID No: _______________ CJTN No._______________ Criminal Form 1 8/2010 At a term of the _________________Court, County of ________________________ , at the Courthouse at __________________________________, State of New York ORDER OF PROTECTION Family Offenses - C.P.L. 530.12 Youthful Offender (check if applicable) Part:____________ Index/Docket No: ___________________ Indictment No., if any: ___ Charges: PRESENT: Hon._________________________________, PEOPLE OF THE STATE OF NEW YORK _____________________________________ against [Check box]: Ex Parte Defendant Present In Court ______________________________________, Defendant Date of Birth: NOTICE: YOUR FAILURE TO OBEY THIS ORDER M AY SUBJECT YOU TO M ANDATORY ARREST AND CRIM INAL PROSECUTION W HICH M AY RESULT IN YOUR INCARCERATION FOR UP TO SEVEN YEARS FOR CONTEM PT OF COURT. IF THIS IS A TEM PORARY ORDER OF PROTECTION AND YOU FAIL TO APPEAR IN COURT W HEN YOU ARE REQUIRED TO DO SO, THIS ORDER M AY BE EXTENDED IN YOUR ABSENCE AND THEN CONTINUES IN EFFECT UNTIL A NEW DATE SET BY THE COURT. TEM PORARY ORDER OF PROTECTION - W hereas good cause has been shown for the issuance of a temporary order of protection [as a condition of recognizance release on bail adjournment in contemplation of dismissal] ORDER OF PROTECTION - W hereas defendant has been convicted of [specify crime or violation]: ________________________; And the Court having made a determination in accordance with section 530.12 of the Criminal Procedure Law, IT IS HEREBY ORDERED that the above-named defendant observe the following conditions of behavior: [Check applicable paragraphs and subparagraphs]: [01] Stay away from [A] [name(s) of protected person(s) or witness(es)]:_______________________________and/or from the [B] home of _____________________________, [C] school of __________________________________________, [D] business of ___________________________, [E] place of employment of ___________________________, [F] other _________________________________________________________________________________; [14] Refrain from communication or any other contact by mail, telephone, e-mail, voice-mail or other electronic or any other means with [specify protected person(s)]: ; [02] Refrain from assault, stalking, harassment, aggravated harassment, menacing, reckless endangerment, strangulation, criminal obstruction of breathing or circulation, disorderly conduct, criminal mischief, sexual abuse, sexual misconduct, forcible touching, intimidation, threats, or any criminal offense against [specify name(s) of protected person(s), members of protected person's family or household, or person(s) with custody of child(ren)]: ; [15] Refrain from intentionally injuring or killing without justification the following companion animal(s) (pet(s)) [specify type(s) and, if available, name(s)]: _________________________________________________________________________ ; [11] Permit [specify individual]: ____________________ to enter the residence at [specify ]:_____________________________ during [specify date/time]: ____________ with [specify law enforcement agency, if any]: __________________ to remove personal belongings not in issue in litigation [specify items]: ; [04] Refrain from [indicate acts]: _________________________________________________________________________that create an unreasonable risk to the health, safety, or welfare of [specify child(ren), family or household member]: __________________________________________________________________________________________ ; [05] Permit [specify individual(s)]: __________________________________________________________________, entitled by a court order or separation or other written agreement, to visit with [specify child(ren)]:____________________ _______________________ during the following periods of time [specify]: _____________________________________ _________________________ , under the following terms and conditions [specify]: _______________________________ ___________________________________________________________________________________________________; [12] Surrender any and all handguns, pistols, revolvers, rifles, shotguns and other firearms owned or possessed, including, but not limited to, the following and do not obtain any further guns or other firearms. Such surrender shall take place immediately, but in no event later than [specify date/time]: at: __________________________________________________________________________________________________. [99] Specify other conditions defendant must observe for the purposes of protection: IT IS FURTHER ORDERED that the above-named Defendant's license to carry, possess, repair, sell or otherwise dispose of a firearm or firearms, if any, pursuant to Penal Law ยง400.00, is hereby [ 13A] suspended or [13B] revoked (note: final order only), and/or [13C] the Defendant shall remain ineligible to receive a firearm license during the period of this order. (Check all applicable boxes). IT IS FURTHER ORDERED that this order of protection shall remain in force until and including [specify date]: , but if you fail to appear in court on this date, the order may be extended and continue in effect until a new date set by the Court. DATED: _________________________ JUDGE / JUSTICE Defendant advised in Court of issuance and contents of Order. Court (Court Seal) Order personally served on Defendant in Court ______________________________________________ (Defendant's signature) Order to be served by other means [specify]: W arrant issued for Defendant ADDITIONAL SERVICE INFORMATION: [specify]: _________________________________________ The Criminal Procedure Law provides that presentation of a copy of this order of protection to any police officer or peace officer acting pursuant to his or her special duties shall authorize and in some situations may require, such officer to arrest a defendant who is alleged to have violated its terms and to bring him or her before the Court to face penalties authorized by law. Federal law requires that this order be honored and enforced by state and tribal courts, including courts of a state, the District of Columbia, a commonwealth, territory or possession of the United States, if the person against whom the order is sought is an intimate partner of the protected party and has been or will be afforded reasonable notice and opportunity to be heard in accordance with state law sufficient to protect tha
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