Nevada > Statewide > District Court > Domestic Violence
Domestic Violence Protection Order Information - Nevada
| Domestic Violence Protection Order Information Form. This is a Nevada form and can be used in Domestic Violence District Court Statewide . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
DOMESTIC VIOLENCE ORDER FOR PROTECTION INFORMATION SHEET Instructions to the Applicant: Please provide all information known to you in printed format. All requested information is necessary for service. Shaded areas ( ) are mandatory for entry into the statewide repository. APPLICANT DATA List person(s) requesting order for protection: Name (Last) (First) (Middle) Date Of Birth / / ___ (M) (D) (Y) Race ____ ____ ____ Sex ____ ____ ____ / / ADVERSE PARTY DATA Full Name: (Last) (First) (Middle) / ___ / ___ Other Name Used: (Last) (First) (Middle) Relationship To You: Home Address: (Street Address) Date of Birth (M) / (D) / (Y) And/ Or Social Security No.: (Building/Apartment #) (Building/Apartment #) (City) (City) (County) (County) (State) (State) Other Likely Address: (Street Address) Occupation: Work Address: (Street Address) Employer: (City) (County) (State) Work Days: Hair Color: Eye Color: Height: Work Hours: Weight: Sex Race: Scars/Marks/Tattoos Description and Location: Vehicle Make: Model: Year: License Plate Number/State: Additional Contact Person:________________________Phone:_____________Address:__________________________ Does the Adverse Party speak English? (Yes or No) If not, what language? (Circle one) Yes or No Yes or No Yes or No Yes or No Yes or No Yes or No Are you and the Adverse Party living together now? Are you and the Adverse Party employed by the same employer? Is the Adverse Party likely to react violently when served? Is the Adverse Party likely to avoid service? Does the Adverse Party have access to weapons? Does the Adverse Party have a Carrying Concealed Weapon (CCW) Permit? If yes, please describe type and location: Does the Adverse Party's history include (please circle): assaults, assaults w/weapon, batteries, mental health problems, drug/alcohol abuse, outstanding/prior arrest warrants, other? Do not write in this space. For court purposes only. Issuing Court ORI: NV______________ Court Case Number: _______________ Confidential Y/N _____ (1 copy attached to Service document.) (1 copy with Order forwarded to Repository.) American LegalNet, Inc. www.FormsWorkFlow.com
|
|||||||
