1 Case No. ______________ Dept.No. ______________ 2 3 IN THE JUSTICE COURT OF _____________ TOWNSHIP 4 COUNTY OF __________________, STATE OF NEVADA 5 6 7 8 9 10 _______________________________________ ) Applicant,) ) vs. ) ) _______________________________________ ) Adverse Party.) EXTENDED ORDER FOR PROTECTION OF CHILDREN (NRS 33.400) Date Issued: _________________ Date Expired: _________________ 11 12 13 14 15 16 17 18 19 20 21 22 YOU, THE ADVERSE PARTY, ARE HEREBY NOTIFIED that ANY INTENTIONAL VIOLATION OF THIS ORDER IS A CRIMINAL VIOLATION and can result in your immediate arrest or issuance of an arrest warrant. Unless a more severe penalty is prescribed by law for the act that constitutes the violation of the Order, a violation of an Extended Order for Protection of Children is a category C felony which is punishable by imprisonment in the state prison for not more than five (5) years, and a fine of not more than $10,000.00. PURSUANT TO NRS 193.166, if the act that constitutes the violation of a protection order is itself a felony, the violator shall, in addition to the term of imprisonment prescribed by statute for the crime, be punished by imprisonment in the state prison for a minimum term of not less than 1 year and a maximum term of not more than 20 years. YOU ARE FURTHER NOTIFIED that you CAN BE ARRESTED even if the person who obtained the Order invites or allows you to contact them. You have the sole responsibility to avoid or refrain from violating the terms of this Order. Only the Court can change the Order upon written application. WARNING: Possession of a firearm or ammunition while this Order is in effect may constitute a felony under federal law punishable by a fine of up to $250,000 and/or a prison sentence of up to ten (10) years. This Order meets the Full Faith and Credit provisions of the Violence Against Women Act and is enforceable in all 50 states, the District of Columbia, U.S. Territories and Indian Nations. All other Courts and law enforcement with jurisdiction within the United States and all Indian Nations shall give full faith and credit to this Order pursuant to 18 U.S.C. Sec. 2265. 23 24 Violation of the Order may subject you to federal charges and punishment pursuant to 18 U.S.C. Sec. 2261(a)(1) and (2) and 2262(a)(1) and (2). 25 Form C16 Extended Order for Protection of Children (NRS 33.400) Page 1 of 4 ©2007 Nevada Supreme Court Revised July 27, 2007 1 The Court having considered the filings, testimony (if applicable) and evidence 2 presented at hearing, and the Court having found that the Adverse Party received notice of 3 hearing at which such person had an opportunity to participate, and the Adverse Party 4 present, 5 _______________________________________________________________________ and 6 the above-named Applicant(s) 7 8 9 was was not present, was represented by counsel ________________________ was present, was not present, was represented by counsel ________________________, and the Court having proper jurisdiction over the parties and this subject matter, and it appearing to the satisfaction of the Court that the Adverse Party has committed 10 and/or is committing or remains a threat to commit an offense that is classified as 11 harmful to minors under NRS 33.400, and an Extended Order is warranted 12 or 13 based upon the stipulation of the parties, 14 The Court enters an Extended Order, and as a result: 15 YOU ARE PROHIBITED, either directly or through an agent, from contacting, 16 intimidating, using, attempting to use, or threatening the use of physical force, or otherwise 17 interfering in any way with ___________________________, a Minor, and/or the following 18 persons: ___________________________________________________________________ 19 ____________________________________________________________________________ 20 including, but not limited to, in person, by telephone, through the mail, through electronic 21 mail (e-mail), facsimile, or through another person; 22 23 24 25 1.  YOU ARE ORDERED to stay away from the following places:  Residence(s): ________________________________________ ________________________________________________________ Form C16 Extended Order for Protection of Children (NRS 33.400) Page 2 of 4 ©2007 Nevada Supreme Court Revised July 27, 2007 1  Place(s) of Employment (Name & Address): ________________ 2 _____________________________________________________ 3  School(s) (Name & Address):_____________________________ 4 ________________________________________________________ 5  Other Locations Frequented (Name & Address): _____________ 6 _________________________________________________________ 7 2. 8  YOU ARE FURTHER ORDERED: ______________________________ __________________________________________________________________________________ 9 10 __________________________________________________________________________________ 3. On the issue of costs and official fees, the Court Orders as follows: 11 _______________________________________________________________ 12 _______________________________________________________________ 13 14 15 4. THIS ORDER WILL REMAIN IN EFFECT UNTIL 11:59 P.M. ON THE DATE SET FORTH ON PAGE 1 UNLESS THE JUDGE ORDERS OTHERWISE. 5. IT IS FURTHER ORDERED that the Clerk of the Court shall transmit a copy 16 of this Order together with the application, to the _____________________ County Sheriff’s 17 Office and/or the _________________ Constable and/or any other appropriate law 18 enforcement agency. 19 6. IT IS FURTHER ORDERED that said law enforcement agency will promptly 20 attempt to serve this Order upon the Adverse Party, without charge to the Applicant, and upon 21 service file a return of service with the Court by the end of the next business day after service 22 is made. 23 24 25 NOTICE TO LAW ENFORCEMENT Any law enforcement officer, with or without a warrant, may arrest and take into custody the Adverse Party, when the law enforcement officer has probable cause to Form C16 Extended Order for Protection of Children (NRS 33.400) Page 3 of 4 ©2007 Nevada Supreme Court Revised July 27, 2007 1 believe that (a) an Order has been issued pursuant to NRS 33.400 against the Adverse 2 Party; (b) the Adverse Party has been served a copy of the Order; and (c) the Adverse 3 Party is acting or has acted in violation of the Order. This arrest may occur regardless 4 of whether the violation occurred in the officer’s presence. 5 Any law enforcement agency in this state may enforce a Court Order issued 6 pursuant to NRS 33.400, without regard to the county in which the Order is issued. 7 IT IS SO ORDERED this ________ day of ______________, 20_____. 8 _____________________________ JUDGE 9 10 11 12 13 14 PROOF OF SERVICE UPON ADVERSE PARTY I, the undersigned, personally served the Adverse Party above named with a copy of this Extended Order for Protection of Children on the date set forth below. 15 ______________________________ Signature 16 ______________________________ Print Name 17 18 ______________________________ Date of Service 19 20 21 22 23 24 25 Form C16 Extended Order for Protection of Children (NRS 33.400) Page 4 of 4 ©2007 Nevada Supreme Court Revised July 27, 2007