STATE OF SOUTH CAROLINA COUNTY OF ) ) ) IN THE MAGISTRATES COURT VS. ) ) ) PLAINTIFF(S) ) ) ) ) ) ) DEFENDANT(S) ) The Plaintiff alleges: COMPLAINT AND MOTION FOR RESTRAINING ORDER (Harassment and Stalking) CIVIL CASE NUMBER 1. 2. The Plaintiff lives in ______________________ County. The Defendant lives at _______________________________________, which is in _______________________, ________. The Harassment First or Second _______________________, ________. Degree or Stalking occurred in 3. 4. Plaintiff further alleges that the following conduct occurred by the defendant on the times, dates, and places listed below, and such conduct falls within the definition of: HARASSMENT, FIRST DEGREE (§16-3-1700 (A)), or HARASSMENT, SECOND DEGREE (§ 16-3-1700 (B), or STALKING (§ 16-3-1700 (C). 5. __________________ ________, 20_______, at ______ O'clock, A.M./P.M. (circle one), at ______________________________________________, which is in _______________________, ________, the conduct complained of occurred when the defendant: On ___________________ ________, 20_______, at ______ O'clock, A.M./P.M. (circle one), at ______________________________________________, which is in _______________________, ________, the conduct complained of occurred when the defendant: SCCA/749 (Amended 12/2015) American LegalNet, Inc. www.FormsWorkFlow.com On ___________________ ________, 20_______, at ______ O'clock, A.M./P.M. (circle one), at ______________________________________________, which is in _______________________, ________, the conduct complained of occurred when the defendant: (State details of harassment/stalking and other facts and circumstances upon which relief is sought above. Attach additional sheets if necessary.) 6. Plaintiff requests: (Check one or more) a. That the defendant by enjoined from abusing, threatening to abuse, or molesting the plaintiff or members of the plaintiff's family. b. That the defendant be enjoined from entering or attempting to enter the plaintiff's place of residence, employment, education, or other location. c. That the defendant be enjoined from communicating or attempting to communicate with the plaintiff in a way that would violate Article 17, Chapter 16 of the 1976 South Carolina Code of Laws, as amended. SWORN to and Subscribed before me ) ) This ___ day of ________________, 20_____. ) ) ) Notary Public for South Carolina ) Signature of Plaintiff or Person Filing My Commission expires: _______________ ) e on Behalf of Plaintiff NOTICE: THE NON-PREVAILING PARTY IN THIS ACTION IS ASSESSED A FILING FEE OF FIFTY-FIVE DOLLARS ($55.00). THE COURT MAY HOLD A PERSON IN CONTEMPT OF COURT FOR FAILURE TO PAY THIS FILING FEE. §16-03-170(D). NOTICE TO DEFENDANT: YOU HAVE THE RIGHT TO EMPLOY COUNSEL TO REPRESENT YOU. SCCA/749 (Amended 12/2015) American LegalNet, Inc. www.FormsWorkFlow.com