STATE OF SOUTH CAROLINA COUNTY OF vs. ) ) ) ) ) COMPLAINANT(S) ) ) ) ) ) RESPONDENT(S). ) ) IN THE COURT OF GENERAL SESSIONS THE ______ JUDICIAL CIRCUIT CASE No.: ______-GS-______-______ PERMANENT RESTRAINING ORDER RESPONDENT IDENTIFIERS SEX * WEIGHT And/or on behalf of minor family member(s) or other protected persons: (List name) Relationship to Complainant: RACE * HAIR DOB* EYES HEIGHT STATE Respondent's Address CAUTION: Weapon Involved *Indicates required information for entry into NCIC Weapon Present on Respondent's Property Access to weapons THE COURT HEREBY FINDS: That it has jurisdiction over the parties and subject matter. Respondent has been provided with reasonable notice and opportunity to be heard. Additional findings of this order are as set forth below. THE COURT HEREBY ORDERS: That the above named Respondent be restrained from committing further acts of abuse or threats of abuse. That the above named Respondent be restrained from any contact with the Protected Person as set forth on the attached pages. The terms of the this order shall be effective until , . WARNINGS TO RESPONDENT: This order shall be enforced in any county of South Carolina and by the courts of any state, District of Columbia, any U. S. Territory, and may be enforced by Tribal Lands (18 U.S.C. Section 2265). Crossing state, territorial, or tribal boundaries to violate this order may result in federal imprisonment (18 U.S.C. Section 2262). State and federal law provides penalties for possessing, transporting, shipping, or receiving any firearm or ammunition (18 U.S.C. Section 922). Only the Court can change this order. For Additional Information Call: Sheriff Phone Number Phone Number Clerk of Court SCCA 292G (June 2015) Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com The Court held a hearing on _______________. After hearing the evidence, and examining the supporting documentation, the Court has determined that the Complainant has/ has not proved by a preponderance of evidence the need for issuance of a Permanent Restraining Order. The Court makes the following finding of fact: (Check all that apply) 1. The Complainant resides in _______________ County, _______________ (State). 2. The Respondent lives at _____________________________________________ (Street Address) which is in _______________ County, _______________ (State). 3. The Respondent is employed at ______________________________ which is located at ______________ ______________________________. 4. 5. The Respondent is a nonresident of this state or cannot be found. The Respondent: was convicted of a criminal offense (as defined in SC Code Ann. § 16-3-1900(3)) for which the victim was the subject of the crime. was convicted of a criminal offense (as defined in SC Code Ann. § 16-3-1900(3)) for which the witness assisted the prosecuting entity/agency. 6. The conviction took place on this date _______________ in the ______________________________ court. The prosecuting entity/agency was ______________________________. The qualifying conviction was: _____________________________________________. 7. A restraining order has expired, is set to expire, or is not available and the common pleas court is not in session for the complainant to obtain a permanent restraining order. IT IS THEREFORE ORDERED THAT (Check all that apply): A. The Respondent is restrained, prohibited and forbidden from abusing, threatening to abuse, or molesting the Complainant or members of Complaint's family. The Respondent is restrained, prohibited and forbidden from entering or attempting to enter the Complainant's place of residence, employment, or education. The Respondent is restrained, prohibited and forbidden from communicating or attempting to communicate with the Complainant or members of the Complaint's family in any way that would violate Section 16-3-1910. B. C. D. Federal Firearms Prohibition, pursuant to 18 U.S.C § 922. 1. Does this Order protect an intimate partner, a child of an intimate partner, or a child of the respondent? 2. Did the person restrained have actual notice and an opportunity to participate in the hearing? 3. Does the Order find the restrained person a credible threat or explicitly prohibit the use, attempted use, or threatened use of physical force? E. YES YES YES NO NO NO A copy of this Order shall be served on the following law enforcement agencies: __________________________ ________________________________________________________________________________________ AND IT IS SO ORDERED. Entered at _______ __.M. on _______________. Circuit Court Judge SCCA 292G (June 2015) Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com VIOLATION OF THIS ORDER IS A FELONY CRIMINAL OFFENSE PUNISHABLE BY UP TO FIVE YEARS IN PRISON. TO LAW ENFORCEMENT OFFICERS: Pursuant to S.C. Code Ann. § 16-3-1910, notwithstanding any other provision of law, the terms of this Order are enforceable throughout this State. Law enforcement officers shall arrest a respondent who acts in violation of this Order after service and notice of the Order have been provided. A respondent who is in violation of a permanent restraining order is guilty of a felony, if the underlying conviction that was the basis for the permanent restraining order was a felony and, upon conviction, must be imprisoned not more than five years. If the underlying conviction that was the basis for the permanent restraining order was a misdemeanor, a respondent who is in violation of an permanent restraining order is guilty of a misdemeanor and, upon conviction, must be fined not more than two thousand dollars or imprisoned not more than three years, or both. COPY GIVEN TO COMPLAINANT BY (initials) COPY GIVEN TO RESPONDENT BY (initials) SCCA 292G (June 2015) Page 3 of 3 American LegalNet, Inc. www.FormsWorkFlow.com