South Dakota > Statewide > Protection Orders > Domestic
Order For Protection (Domestic Temporary Order) UJS-091C - South Dakota
| Order For Protection (Domestic Temporary Order) Form. This is a South Dakota form and can be used in Domestic Protection Orders Statewide . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
STATE OF SOUTH DAKOTA COUNTY OF ______________ DOMESTIC ) ) ) STALKING PERMANENT IN CIRCUIT COURT _________ JUDICIAL CIRCUIT ORDER FOR PROTECTION TPO NO. _____________________ EX PARTE TEMPORARY MODIFICATION PETITIONER First Middle Last PETITIONER IDENTIFIERS: Date of Birth of Petitioner By (name and DOB):__________________________ _____________________________________________ On behalf of a minor child by parent/guardian. Other Protected Persons (name and DOB):______ ______________________________________________ __________________________________________ (See also 1B Additional Orders.) V. RESPONDENT First Middle Last SEX EYES RESPONDENT IDENTIFIERS: RACEH HEIGHT WEIGHT HAIR DATE OF BIRTH STATE EXPDATE Relationship to Petitioner: _____________________________________________ _____________________________________________ Respondent's Address: __________________________________________________ __________________________________________________ __________________________________________________ DRIVERS LICENSE # CAUTION: Weapon Involved Distinguishing Features: _____________________________________________ _____________________________________________ THE COURT FINDS: That it has jurisdiction over the parties and subject matter, and the Respondent has been provided with reasonable notice and opportunity to be heard, and that in the case of an ex parte order, the Respondent will be provided with reasonable notice and opportunity to be heard sufficient to protect the Respondent's due process rights. THE COURT ORDERS: That the Respondent is restrained from acts of abuse and physical harm, making threats of abuse, stalking or harassment. That the Respondent is restrained from contact with the Petitioner by any direct or indirect means except as authorized in this order. Additional findings and orders are on the following pages. This order shall be effective through Month/Day Year Or if a permanent order is issued, until that order is served. Month/Day Year Only this Court can change this order. VIOLATION OF THIS PROTECTION ORDER IS A CRIMINAL OFFENSE. WARNING TO RESPONDENT: This order shall be enforced, even without registration, by courts of any state, the District of Columbia, any U.S. Territory, and may be enforced by Tribal Lands (18 U.S.C.§2265). Crossing state, territorial, or tribal boundaries to violate this order may result in federal imprisonment (18 U.S.C. §2262). 1 Form UJS-091C (Domestic Temporary Order) Rev. 11/09 American LegalNet, Inc. www.FormsWorkFlow.com Having considered the Petition and Affidavit presented by the Petitioner, this Court FINDS: A. That jurisdiction and venue are properly before this Court; B. That the above-named Petitioner and Respondent are "family or household members" within the meaning of SDCL 25-10-1(2); C. That the Petitioner has alleged that the Respondent has committed one or more acts of domestic abuse as defined by law; and D. That the Petitioner alleges that he/she will suffer immediate and irreparable injury, loss, or damage before the Respondent or the Respondent's attorney can be heard in opposition. ADDITIONAL ORDERS: 1) That the Respondent is excluded from the Petitioner's residence listed in 2C. 2) That the Respondent shall not come within a distance of ___________ from the following persons and places: A. The Petitioner personally B. The following minor children named as other protected persons: Name Date of birth Relationship ___________________________ ___________ _______________________________ ___________________________ ___________ _______________________________ ___________________________ ___________ _______________________________ C. The Petitioner's residence(street/apt)_______________________________________________ (city)_______________________________, (state) _______ (zip) _________-_______ D. The Petitioner's place of employment (street)________________________________________ (city)_______________________________, (state) _______ (zip) __________- _______ E. Other places (street/apt) (city) , (state)_______ (zip) (street/apt) (city) , (state)_______ (zip) (street/apt) (city) , (state)_______ (zip) This distance restriction applies unless otherwise specified in this order. 3) The Petitioner shall have temporary custody of the minor child(ren), whose names are: _________ ______________________________________________________________________________ 4) Temporary visitation for the respondent with the minor child(ren) named above shall consist of: Existing order in File #_____________________ Supervised at or by_________________ Jurisdiction: South Dakota South Dakota tribe Other State ____________ Other Other Visitation: ______________________________________________________________ _______________________________________________________________________________ 5) The Respondent shall pay temporary: child support in the amount of $ a month starting on and continuing until further order of the Court; Child support shall be paid to: Office of Child Support Enforcement Kneip Building 700 Governors Drive Pierre, SD 57501 spousal support in the amount of $ a month starting on and continuing until further order of the Court. Spousal support shall be paid to the Clerk of Courts Office in the county this order was filed. 2 Form UJS-091C (Domestic Temporary Order) Rev. 11/09 American LegalNet, Inc. www.FormsWorkFlow.com 6) Phone calls, emails, third party contact, including correspondence, direct or indirect, are not permitted, to a protected person, except as follows:_______________________________________________ _____________________________________________________________________________ 7) Respondent is ordered to immediately turn over all weapons and ammunition to local sheriff. 8) Other relief as follows:______________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ AND IT IS FURTHER ORDERD THAT: the Petitioner shall, immediately upon the granting of this modified Order, deliver two copies of this Order and two copies of the Motion to Modify to the sheriff of this county. One copy of each shall be personally served by the sheriff upon the Respondent. DATED / / . Service of this order is authorized on any day including Sunday. Judge Attest: By: , Clerk of Courts , Deputy NOTIC
|
|||||||
