Verified Petition For Protective Order | Docx | Utah

Verified Petition For Protective Order

Utah/Statewide/Protective Orders And Civil Stalking/
Verified Petition For Protective Order |  Docx | Utah

Verified Petition For Protective Order Form

This is a Utah form that can be used for Protective Orders And Civil Stalking within Statewide.

Last updated: 4/18/2012

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CASE NO.____________________ INFORMATION SHEET (This information must be attached to the Protective Order) (Fill out information as completely as possible. Please write clearly) * * * * * * * * * * Respondents name: ____________________________________________________________ Date of birth: __________________________ SSN: _______________________________ Address for service: ____________________________________________________________ Best times to reach at address: ____________________________________________________ Alias/nicknames: _______________________________________________________________ Respondents Employers name/address: ____________________________________________ ______________________________________________________________________________ Other addresses (hangouts): ______________________________________________________ Race: ________________________________ Height: _____________________________ Weight: ______________________________ Age: _______________________________ Hair: ________________________________ Eyes: ______________________________ Special Characteristics/Tattoos/Scars/etc: ___________________________________________ Make, Year. License No.. and Color of Vehicles: ____________________________________ Weapons/Violent History: _______________________________________________________ Additional Information: _________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Law enforcement agencies to which the Protective Orders and this sheet should be delivered:_____________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 8/2003 1 of 9 8/03<<<<<<<<<********>>>>>>>>>>>>> 2______________________________ Petitioners Name ______________________________ Address (may be omitted for privacy) ______________________________ City, State, ZIP ______________________________ Telephone (may be omitted) IN THE _____________________ JUDICIAL DISTRICT COURT _____________________ COUNTY, STATE OF UTAH ) ____________________________, ) ) VERIFIED PETITION FOR Petitioner, ) PROTECTIVE ORDER ) vs. ) ) Civil No. ____________________________, ) ) Judge Respondent. ) PETITIONER IS ADVISED THAT KNOWING FALSIFICATION OF ANY STATEMENT OR INFORMATION PROVIDED FOR THE PURPOSE OF OBTAINING A PROTECTIVE ORDER MAY SUBJECT THE PETITIONER TO FELONY PROSECUTION (Utah Code Ann. Section 30-6-4(1)(b)(i)). The Petitioner alleges against the Respondent and states as follows: 1. Either Petitioner or Respondent resides, or the acts occurred, in this County. 2. Neither party is the minor child (step, adoptive, or natural) of the other party. 3. Petitioner is 16 or older, or emancipated. Petitioner and Respondent have the following relationship (check and circle all that apply): [] currently married [] formerly married; divorced on:____________ 2 of 9 8/03<<<<<<<<<********>>>>>>>>>>>>> 3 [] currently living as if married [] have lived as if married; _________________________________________________________] [] have one or more children together; [] have an unborn child together; [] currently residing in the same residence [] have resided in the same residence. 4. Petitioner and Respondent are the parents of the following minor children: NAME BIRTH DATE ADDRESS Are the minor children subject to a court order in this or another jurisdiction? If so, please describe the type of order and where it was issued. ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 3 of 9 8/03<<<<<<<<<********>>>>>>>>>>>>> 4 5. On or about __________________, at_______________________, the Respondent threatened, attempted, or caused the following acts of abuse or domestic violence. [Describe in detail what happened, where, who was involved (including the minor children and family and household members), if weapons were involved, and if injuries resulted. Attach more sheets if necessary but only write on one side.] ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 6. The following is a description of other acts of abuse or domestic violence by Respondent. (Describe with the same detail as in paragraph 5. Attach more sheets if necessary but only write on one side.) ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 4 of 9 8/03<<<<<<<<<********>>>>>>>>>>>>> 5________________