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This is a Washington form that can be used for Antiharassment within Statewide.
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Court of Washington For NO. Minor (Protected person), Petitioner, vs. Respondent. Temporary Protection Order and Notice of Hearing Respondent Under Age 18 Harassment (TORAH18/ORWPN) (Clerk's action required) Next Hearing Date and Time: ______________________________ At: ______________________________ Warning to the Respondent: Willful disobedience of the terms of this order may be contempt of court and may subject you to detention under RCW 7.21.030(4). RCW 10.14.120 ____________________________________________ (Name) is a responsible and proper person to be appointed and is appointed guardian ad litem of Respondent in this proceeding. Based upon the petition, testimony, and case record, the court is satisfied that there is reasonable proof that the respondent committed unlawful harassment as defined in RCW 10.14.020 and .080, and that great or irreparable harm or injury will result to the protected minors if this order is not granted. After considering the facts of the case, the severity of the alleged offense, any continuing physical danger or emotional distress to the minors to be protected, and the expense, difficulty, and educational disruption that would be caused by a transfer of the respondent to another school. It is therefore ordered that: No Contact: Respondent is restrained from making any attempts to contact the protected person. Surveillance: Respondent is restrained from making any attempts to keep under surveillance the protected person. Stay Away: Respondent is restrained from entering or being within _______________ (distance) of the protected person's residence work place Other: The address is confidential. person's address which is: Petitioner waives confidentiality of the protected Temp Protection Or/Nt of Hrg.- Resp. Under 18 - Harassment (TORAH18,ORWPN) - Page 1 of 2 UH-05.0300 (12/2014) CR 65(b), - RCW 10.14.040, .080 (1), (2), RCW 4.28.020, RCW 9.41.800 American LegalNet, Inc. www.FormsWorkFlow.com School Transfer: Respondent is restrained from attending __________________________________________________________ school at ________________________________________________________ (address) attended by the protected person and shall transfer to a different school. Other:______________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ Surrender of Weapons The respondent must turn in any firearms or other dangerous weapons as stated in the Order to Surrender Weapons Issued Without Notice filed separately. Washington Crime Information Center (WACIC) Data Entry It is further ordered that the clerk of court shall forward a copy of this order on or before the next judicial ________________________ County Sheriff's Office _______________________ Police day to: Department where Petitioner lives which shall enter it into WACIC. Service The clerk of court Petitioner shall forward a copy of this order on or before the next judicial day to: __________________________ County Sheriff's Office _________________________ Police Department where respondent lives which shall personally serve the respondent with a copy of this order and shall promptly complete and return to this court proof of service. Or Petitioner has made private arrangements for service of this order. If Respondent is age 14 or older, serve Respondent. If Respondent is under age 14, serve Respondent and Respondent's guardian. The respondent is directed to appear and show cause why the court should not enter an order for protection effective for one year or more and order the relief requested by the petitioner or other relief as the court deems proper, which may include payment of costs. Failure to appear at the hearing or to otherwise respond will result in the court issuing an order for protection pursuant to Chapter 10.14 RCW effective for a minimum of one year from the date of the hearing. The next hearing date and time is shown below the caption on page one. A copy of this Temporary Protection Order and Notice of Hearing has been filed with the clerk of the court. This Temporary Order for Protection is effective until the next hearing date and time shown below the caption on page (1) one. Dated at ______ a.m./p.m. Judge/Court Commissioner I acknowledge receipt of a copy of this Order: Signature of Respondent/Lawyer WSBA No. Signature of Petitioner/Lawyer WSBA No. Print Name Print Name Date Date Petitioner or Petitioner's lawyer must complete a Law Enforcement Information Sheet (LEIS) and include addresses for the respondent and the respondent's guardian. Temp Protection Or/Nt of Hrg.- Resp. Under 18 - Harassment (TORAH18,ORWPN) - Page 2 of 2 UH-05.0300 (12/2014) CR 65(b), - RCW 10.14.040, .080 (1), (2), RCW 4.28.020, RCW 9.41.800 American LegalNet, Inc. www.FormsWorkFlow.com