Order For Protection (Long Form) {PO-0113}

So that the Order of Protection is valid YOU MUST REPLACE THIS PAGE with Cover Sheet: Order of Protection American LegalNet, Inc. www.FormsWorkFlow.com STATE OF INDIANA COUNTY OF ________ ) ) SS: ) IN THE ________________COURT ____ (______________ DIVISION, ROOM __) CASE NO._________________________ _______________________, ) Petitioner ) vs. ) _______________________, ) Respondent ) ORDER FOR PROTECTION FINDINGS This matter having been heard by the Court on ____________________ pursuant to Indiana Code § 34-26-5-10, the Court now makes the following Findings (strike through those which do not apply): a. _______________________ filed a timely Request for Hearing pursuant to Indiana Code § 34-26-5-10(a); and/or, b. The Court is required to hold a hearing pursuant to Indiana Code § 34-26-5-10(b). c. The Petitioner was present at the hearing and the Respondent was / was not present. d. This order does / does not protect an intimate partner or child. e. The Respondent had notice and an opportunity to be heard. f. The Respondent represents a credible threat to the safety of the Petitioner or a member of the Petitioner's household. g. The Petitioner has shown, by a preponderance of the evidence, that domestic or family violence, a sex offense, or stalking has occurred sufficient to justify the issuance of this Order. h. The Respondent does/does not agree to the issuance of the Order for Protection. i. The following relief is necessary to bring about a cessation of the violence or the threat of violence. ORDER (strike through those which do not apply) Section 1--General Provisions 1. The Respondent is hereby enjoined from threatening to commit or committing acts of domestic or family violence, stalking and sex offenses against the Petitioner and the following designated family or household members, if any: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________. IDACS Codes: 01 Petitioner 02 - Others Page 2 of ____ pages TCM-PO-0113 Approved 07/02 Rev. by Ind. Office Ct. Serv. 07/17 American LegalNet, Inc. www.FormsWorkFlow.com 2. The Respondent is prohibited from harassing, annoying, telephoning, contacting, or directly or indirectly communicating with the Petitioner, except: ____________ __________________________________________________________________. 3. The Respondent shall be removed and excluded from the Petitioner's residence. 4. The Respondent is ordered to stay away from the residence, school, and/or place of employment of the Petitioner. The Respondent is further ordered to stay away from the following place(s) that is/are frequented by the Petitioner and/or the Petitioner's family or household members: _____________________________________________________. 5. The Petitioner shall have the possession and use of the residence/motor vehicle/other essential personal effects as follows: _________________________________________________________________ _____________________________________________________________________________. 05 03 04 03 ­ Residence 08 - Other 08 6. The Court orders the following additional relief to provide for the safety and welfare of the Petitioner and each family or household member designated in Paragraph 1 of this Order: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________. 7. Respondent is prohibited from removing, transferring, injuring, concealing, harming, attacking, mistreating, threatening to harm, or otherwise disposing of the following animals: Animal 1 Name: __________________________________ Age/Type: __________________________________ Size/Breed: __________________________________ Color/Description: __________________________________ Animal 2 Name: __________________________________ Age/Type: __________________________________ Size/Breed: __________________________________ Color/Description: __________________________________ (attach a separate sheet if necessary) 8. Petitioner shall have the exclusive possession, care, custody, or control of the following animal(s): Animal 1 Name: __________________________________ Age/Type: __________________________________ Size/Breed: __________________________________ Color/Description: __________________________________ Animal 2 Name: __________________________________ Age/Type: __________________________________ Size/Breed: __________________________________ Color/Description: __________________________________ (attach a separate sheet if necessary) 9. To law enforcement officers: You are hereby directed to accompany the Petitioner to the residence of the parties to ensure that the Petitioner is safely restored to the possession of the residence/motor vehicle/other essential Page 3 of ____ pages TCM-PO-0113 Approved 07/02 Rev. by Ind. Office Ct. Serv. 07/17 08 08 08 American LegalNet, Inc. www.FormsWorkFlow.com personal effects/animals listed above; or, you are to supervise the Petitioner's or Respondent's removal of personal belongings/animals. 10. The Respondent is prohibited from using or possessing a firearm, ammunition, or deadly weapon. The Respondent is ordered to surrender the following firearm[s], ammunition, and/or deadly weapon[s] which the Court finds are in the control, ownership, or possession of the Respondent or in the control or possession of another person on behalf of the Respondent: a. ___________________________________________________; b. ___________________________________________________; c. ___________________________________________________; (attach a separate sheet if necessary). 11. The Respondent shall surrender the items listed above between the hours of __:__ and __:___ on the date of ________________ to the following law enforcement agency ____________________________ at the following location: ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________. 12. The law enforcement agency listed above shall provide the Respondent with a receipt for the items the Court h