South Dakota > Statewide > Protection Orders > Domestic
Order For Protection (Domestic Modification Of Temporary Order) UJS-091E - South Dakota
| Order For Protection (Domestic Modification Of 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 EX PARTE TEMPORARY ORDER FOR PROTECTION TPO NO. _____________________ PETITIONER IDENTIFIERS: MODIFICATION PETITIONER First Middle Last Date of Birth of Petitioner And/or on behalf of minor family member(s): (list name and DOB):______________________________ _____________________________________________ _____________________________________________ Other Protected Persons/DOB:_________________ ______________________________________________ __________________________________________ __________________________________________________ V. RESPONDENT First Middle Last RESPONDENT IDENTIFIERS: SEX RACE HEIGHT WEIGHT EYES HAIR DATE OF BIRTH STATE EXPDATE Relationship to Petitioner: _____________________________________________ _____________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ DRIVERS LICENSE # Respondent's Address: CAUTION: Weapon Involved Distinguishing Features: _____________________________________________ _____________________________________________ 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. 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 issued, until that order is served. Month/Day Year or if a permanent protection order is issued, until that order is served. Month/Day Year THE COURT FINDS: THE COURT ORDERS: 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). Form UJS-091E (Domestic Modification of Temporary Order) Rev. 11/07 1 American LegalNet, Inc. www.FormsWorkflow.com Having considered the Motion to Modify presented to the Court, this Court FINDS: The original ex parte temporary order of protection will be modified as follows: ADDITIONAL ORDERS: 1) The Respondent shall immediately be excluded from and shall not come within a distance of ________________________of the Petitioner or the children named above unless otherwise specified in this order and of the following: A. The Petitioner's residence including: (street/apt/box)_____________________________ (city) ____________________________ (state)______ (zip)___________B. The Petitioner's place of employment including (street/apt/box) _____________________ (city) ,(state) ______ (zip) C. Other places including: (street/apt/box)_________________________ _________ (city)____________________________, (state) ______ (zip)___________-_________ (street/apt/box) ________________________________ (city) ____________________________,(state) ______ (zip)___________-_________ (street/apt/box) ________________________________ (city) ____________________________,(state) ______ (zip)___________-_________ 2) The Petitioner shall have temporary custody of the minor child(ren), whose names are: _________ ______________________________________________________________________________ 3) 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: ______________________________________________________________ _______________________________________________________________________________ 4) 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. 5) Phone calls, emails, third party contact, and correspondence, direct or indirect, is not permitted except as follows: _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ 6) Respondent is ordered to immediately turn over all weapons and ammunition to local sheriff. 7) Other relief as follows:______________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Form UJS-091E (Domestic Modification of Temporary Order) Rev. 11/07 2 American LegalNet, Inc. www.FormsWorkflow.com 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 NOTICE OF ENTRY OF ORDER AND ACKNOWLEDGMENT OF PERSONAL SERVICE I acknowledge receipt of a copy of this Order of Protection. _______________________________________ Petitioner ___________________________________________ Respondent UNDER A PERMANENT PROTECTION ORDER: You may be subject to the following federal laws: (1) Effective immediately, you may not possess, carry, ship o
|
|||||||
