Georgia > Statewide > Superior Court > Protective Orders
Family Violence Three Year-Permanent Protective Order - Georgia
| Family Violence Three Year-Permanent Protective Order Form. This is a Georgia form and can be used in Protective Orders Superior Court Statewide . |
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ORI Number ____________________ THE SUPERIOR COURT FOR THE COUNTY OF________________ STATE OF GEORGIA _____________________, Petitioner, vs. _____________________, Respondent. : : : : : No._____________________ Civil Action File FAMILY VIOLENCE THREE YEAR/PERMANENT PROTECTIVE ORDER A hearing was held on this matter on ______________________, 20_____ for which the Respondent had notice as required by law and at which the Respondent appeared and/or had the opportunity to be heard and the Petitioner requested that the Protective Order entered in this case be converted to a Permanent Family Violence Protective Order. This Court has determined that it had jurisdiction over the subject matter and the parties. Having heard the evidence presented, reviewed the Motion and the entire record concerning this case and for good cause shown, IT IS HEREBY ORDERED AND ADJUDGED: 1. 2. That these proceedings be filed in the office of the Clerk of this Court. That this Order applies in every county throughout the state and it shall be the duty of every court and every law enforcement official to enforce and carry out the provisions of this Order pursuant to O.C.G.A. § 19-13-4(d). Law Enforcement officers may use their arrest powers pursuant to O.C.G.A. §§ 19-13-6 and 17-4-20 to enforce the terms of this Order. This Order and the Order issued ______________________, 20_____ shall be permanent pursuant to O.C.G.A. § 19-13-4(c) and have NO expiration date. 3. OR 3.1 This Order shall be in effect for three (3) years and shall expire on ______________________, 20_____. That the Respondent has violated the Family Violence Act, at O.C.G.A. § 19-13-1 et seq., by committing family violence, has placed the Petitioner in reasonable fear for Petitioner's safety, and represents a credible threat to the physical safety of Petitioner and/or Petitioner's child/ren. Respondent is hereby enjoined and restrained from doing, or attempting to do, or threatening to do, any act of injury, maltreating, molesting, following, harassing, harming, or abusing the Petitioner and/or the minor child/ren in any manner. Respondent is not to interfere with Petitioner's travel, 4. [pco01] 1 American LegalNet, Inc. www.FormsWorkflow.com CIVIL ACTION FILE NO. _____________________ transportation, or communication. Respondent shall not follow, place under surveillance, or contact the Petitioner at any place of the Petitioner for the purpose of harassing and intimidating the Petitioner. 5. [pco02] That the Respondent is enjoined and restrained from doing or attempting to do, or threatening to do, any act of injury, maltreating, molesting, harassing, harming, or abusing the Petitioner's family or household. That this Court determined that it had jurisdiction over the parties and the subject matter under the laws of the State of Georgia and Respondent received reasonable notice and had the opportunity to be heard before this Order was issued sufficient to protect the Respondent's due process rights and this Order shall be presumed valid and pursuant to18 U.S.C. § 2265(a) shall be accorded full faith and credit by any other state or local jurisdiction and shall be enforced as if an Order of the enforcing state or jurisdiction. 6. ONLY THE FOLLOWING THAT ARE INITIALED BY THE JUDGE SHALL APPLY _____ 7. [pco04] Respondent is ordered to stay away from Petitioner's and Petitioner's child/ren's residence and workplace and/or school and any subsequent residence or workplace or school of Petitioner and/or Petitioner's minor child/ren. That Respondent is restrained and enjoined from approaching within 100 yards of Petitioner and/or Petitioner's minor children. Respondent is ordered not to have any contact, direct, indirect or through another person with Petitioner, by telephone, pager, fax, e-mail or any other means of communication except as specified in this Order. That Petitioner is awarded custody of the minor child/ren, namely: __________________________________ DOB ____________ sex __________ __________________________________ DOB ____________ sex __________ __________________________________ DOB ____________ sex __________ __________________________________ DOB ____________ sex __________ Respondent is ordered not to interfere with the physical custody of the minor child/ren. Initial here only if Respondent is awarded temporary custody of the child/ren. The _______________ shall pay to the _______________, for the support of the minor child/ren, the sum of _________________________________ Dollars ($___________) per ___________________________, beginning ______________________, 20_____. _____ 8. [pco01,04] _____ 9. [pco05] _____ 10. [pco09] _____ [pco06] _____ 11. 2 American LegalNet, Inc. www.FormsWorkflow.com CIVIL ACTION FILE NO. _____________________ All payments are to be made by or to: ____ ____ ____ or ____ income deduction order child support receiver by mail directly to the Petitioner _____________________________ In determining child support the Court finds as follows: The Father's gross monthly income (before taxes) is $____________________; The Mother's gross monthly income (before taxes) is $____________________. Number of children The number of children for whom support is being provided under this order is ____________________. Deviations: ( ) It has been determined that none of the Deviations allowed under OCGA §19-6-15 applies in this case. OR ( ) It has been determined that one or more of the Deviations allowed under OCGA §19-6-15 applies in this case, as shown by the attached Schedule E. The Presumptive Amount of Child Support that would have been required under OCGA §19-6-15 if the deviations had not been applied is $____________________ per month, as shown on the attached Child Support Worksheet. The attached Schedule E explains the reasons for the deviation, how the application of the guidelines would be unjust or inappropriate considering the relative ability of each parent to provide support, and how the best interest of the child/ren who is/are subject to this child support determination is served by deviation from the presumptive amount of child support. The Child Support Order Addendum is attached and made a part of this Order. _____ 12. Respondent is ordered to pay temporary support for the Petitioner in the amount of $___________ every ___________________ beginning ________________________. All payments are to be made by or to: ____ ____ ____ or ____ _____ 13. income deduction order child support receiver by
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