Rev. 7/2018 KSJC Page 1 of 5 IN THE DISTRICT COURT OF COUNTY, KANSAS Plaintiff vs. Case No. Defendant Petition Pursuant to K.S.A. Chapter 60 PETITION FOR PROTECTION FROM STALKING, SEXUAL ASSAULT, OR HUMAN TRAFFICKING ORDER (K.S.A. 60-31a01 et seq.) 1.Plaintiff seeks an order for protection from stalking, sexual assault, or humantrafficking for: a. myself; OR b. a minor child (under age 18) Plaintiff is: the parent of the child an adult who resides with the child the child222s court appointed legal custodian the child222s court-appointed legal guardian a county or district attorney the Kansas attorney general The minor child222s name and year of birth are: Minor Child222s Name: Year of Birth: 2.Defendant can be served at: (please provide all available addresses) HOME: streetcity state zip code phone number times when defendant is usually there American LegalNet, Inc. www.FormsWorkFlow.com Rev. 7/2018 KSJC Page 2 of 5 WORK: street city state zip code phone number times when defendant is usually there OTHER: street city state zip code phone number times when defendant is usually there 4.If the defendant is a minor, a Minor Defendant Addendum is attached. 5.List any other related court cases involving Plaintiff, minor child (if applicable),or Defendant.(give type of case, county filed in, case number and date filed, if known) Plaintiff: Minor Child: Defendant: 6.Select and complete either section A, B, or C. Attach more pages as needed. A. Describe the incidents of stalking. Include specific facts, dates and locations: Incident #1: American LegalNet, Inc. www.FormsWorkFlow.com Rev. 7/2018 KSJC Page 3 of 5 Incident #2: Additional Incident(s), if any: OR B. Describe the incident of sexual assault. Include specific facts, dates and locations: OR C. Describe the incident of human trafficking. Include specific facts, dates, and locations: American LegalNet, Inc. www.FormsWorkFlow.com Rev. 7/2018 KSJC Page 4 of 5 7.Plaintiff/child needs a protection from stalking, sexual assault, or humantrafficking order because: 8.Plaintiff requests that the court issue an ex parte Temporary Order of Protectionand Final Order of Protection restraining defendant from: abusing, molesting or interfering with the privacy or rights of the protected person. following, harassing, telephoning, contacting or otherwise communicating with the protected person. committing or attempting to commit a sexual assault upon the protected person. following, harassing, telephoning, contacting, recruiting, harboring, transporting, or committing or attempting to commit human trafficking upon the protected person. entering or coming around the residence or area of the protected person. other: other: 9.(Check box if you are asking for the transfer of wireless telephone numbers.Leave box blank if you are not asking for the transfer of wireless telephonenumbers.) Plaintiff asks the court to order the transfer of rights to and billing responsibility for the wireless telephone number of Plaintiff and/or minor child(ren) in the care of Plaintiff. 10.The court should give copies of orders to the appropriate law enforcementagencies; set a date, time and hearing on this matter; and issue summons toDefendant, notifying Defendant of this action and the relief requested. 11.After a hearing, the court should issue a Final Order of Protection from Stalking,Sexual Assault, or Human Trafficking prohibiting Defendant from committingany acts of stalking, sexual assault, or human trafficking against the protectedperson; order Defendant to pay court costs and attorney fees if appropriate; andorder any other relief necessary for the safety of the protected person including: American LegalNet, Inc. www.FormsWorkFlow.com Rev. 7/2018 KSJC Page 5 of 5 VERIFICATION I verify under penalty of perjury under the laws of the state of Kansas that the foregoing is true and correct. Executed on , 20 . Plaintiff's Signature Plaintiff222s Name: (DO NOT include the residential address of Plaintiff in this petition. Plaintiff must complete the Protection from Stalking, Sexual Assault, or Human Trafficking Confidential Information form and include it with this petition.) Attorney representing Plaintiff (if any) Attorney222s Name: Address 1: Address 2: City, State, Zip: Telephone: American LegalNet, Inc. www.FormsWorkFlow.com