County Court District Court Denver Juvenile Denver Probate __________________________ County, Colorado Court Address: Petitioner: _________________________________ v. Respondent: ________________________________ Address: ____________________________________________ ____________________________________________ COURT USE ONLY Case Number: 16 Character #: _______________________ Division Courtroom EMERGENCY PROTECTION ORDER ISSUED PURSUANT TO §13-14-103, C.R.S. Full Name of Restrained Person Date of Birth Sex Race Weight Height Hair Color Eye Color Protected Party alleges Weapon Involved M F Full Name of Protected Person Date of Birth Sex Race Full Name of Protected Person Date of Birth Sex Race The Court Finds: That physical or emotional harm would result if __________________________ (Name of Restrained Person) is not excluded from the family home or the home of the other party. There are reasonable grounds to believe that the Protected Person(s) named in this action are in danger in the reasonably foreseeable future of being the victims of an unlawful sexual offense or domestic abuse. That the award of temporary care and control of the above-named minor children to __________________________________ (name of person) is necessary to prevent domestic abuse and/or to prevent the children from witnessing domestic abuse. This Emergency Protection Order expires on (date) unless continued by the Court. Therefore, it is Ordered that the Restrained Person: 1. Shall not contact, harass, threaten, molest, intimidate, touch, stalk, sexually assault, abuse, or injure the Protected Persons named in this action. 2. Shall not molest, injure, kill, take, transfer, encumber, conceal, dispose of, or threaten harm to an animal owned, possessed, leased, kept or held by any other party, a minor child of any other party, or an elderly or at-risk adult. JDF 394 R8/13 EMERGENCY PROTECTION ORDER ISSUED PURSUANT TO §13-14-103, C.R.S. © 2013 Colorado Judicial Department for use in the Courts of Colorado Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com 3. Shall be excluded from the family home or from the home of another party and shall stay at least________ yards away from the following places: (Identify the address(es) where the Protected Persons reside, work, or attend school.) The Protected Person has requested that the address be omitted from the written order of the Court, including the Register of Actions. Home: ______________________________________________________________________________ Work: Name: _____________________ Address: ___________________________________________ School: Name: _____________________ Address: ________________________________________ Other: ___________________________________________________________________________ Exceptions: 4. _______________________________ minor children. (name of person) is awarded temporary care and control of the 5. Arrangements for possession and care of an animal are as follows: 6. Shall not interfere with the protected person at the person's place of employment or place of education and shall not engage in conduct that impairs the protected person's employment, educational relationships, or environment. 7. Additional Orders are as follows: Date: _________________ (time) __________ ____________________________________ Judge Magistrate By signing, I acknowledge receipt of this Order. Date: _____________________________ ______________________________________ Signature of Restrained Person Law enforcement shall use all reasonable means to enforce this Protection Order. JDF 394 R8/13 EMERGENCY PROTECTION ORDER ISSUED PURSUANT TO §13-14-103, C.R.S. © 2013 Colorado Judicial Department for use in the Courts of Colorado Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com IMPORTANT INFORMATION ABOUT PROTECTION ORDERS GENERAL INFORMATION This Order or injunction shall be accorded full faith and credit and be enforced in every civil or criminal court of the United States, Indian Tribe or United States Territory pursuant to 18 U.S.C. §2265. The Restrained Party may be subject to 18 U.S.C. §922(g)(8), which makes it unlawful for any person to possess or transfer a firearm who is subject to a court order that restrains such person from harassing, stalking or threatening an intimate partner of such person or a child of such intimate partner or person, or engaging in other conduct that would place an intimate partner in reasonable fear of bodily injury to the partner or child. NOTICE TO RESTRAINED PARTY A knowing violation of a protection order is a crime under §18-6-803.5, C.R.S. A violation may be subject you to fines up to $5000.00 and up to 18 months in jail. A violation may also constitute contempt of Court. You may be arrested or taken into custody without notice if a law enforcement officer has probable cause to believe that you have violated this Order. If you violate this Order thinking that the other party or anyone else has given you permission, you are wrong, and can be arrested and prosecuted. The terms of this Order cannot be changed by agreement of the parties. Only the Court can change this Order. Possession of a firearm while this Protection Order is in effect may constitute a Felony under Federal Law, 18 U.S.C. §922(g)(8). NOTICE TO PROTECTED PARTY You are hereby informed that if this Order is violated you may call law enforcement. You may initiate contempt proceedings against the Restrained Party. You cannot give the Restrained Party permission to change or ignore this Order in any way. Only the Court can change this Order. NOTICE TO LAW ENFORCEMENT OFFICERS You shall use every reasonable means to enforce this Emergency Protection Order. You shall arrest or take into custody, or, if an arrest would be impractical under the circumstances, seek a warrant for the arrest of the Restrained Party when you have information amounting to probable cause that the Restrained Party has violated or attempted to violate any provision of this Order and that the Restrained Party has been properly served with a copy of this Order or has received actual notice of the existence and substance of this Order. You shall enforce this Order even if there is no record of it in the Protection Order Central Registry. You shall take the Restrained Party to the nearest jail or detention facility. You are authorized to use every reasonable effort to protect the Protected Parties to prevent further violence. You may transport or arrange transportation to a she