Municipal Court County Court District Court Denver Juvenile Denver Probate _________________________________________ County, Colorado Court Address: Plaintiff/Petitioner: ________________________________ v. COURT USE ONLY Case Number: Defendant/Respondent: ________________________________ Address: _________________________________________ 16 Character #: ______________________ _________________________________________ Division Courtroom TEMPORARY CIVIL PROTECTION ORDER ISSUED PURSUANT TO §13-14-102, C.R.S. Full Name of Restrained Person Protected Person alleges Weapon Involved Date of Birth Sex Race Weight Height Hair Color Eye Color 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 it has jurisdiction over the parties and the subject matter; that __________________________________________ (Restrained Person) constitutes a credible threat, that an imminent danger exists to the life and health of the Protected Persons named in this action, and sufficient cause exists for the issuance of a Civil Protection Order. The Court Orders that you, the Restrained Person shall not contact, harass, stalk, injure, intimidate, threaten, or molest the Protected Persons named in this action or otherwise violate this Order. You shall not use, attempt to use, or threaten to use physical force against the Protected Persons that would reasonably be expected to cause bodily injury. You shall not engage in any conduct that would place the Protected Persons in reasonable fear of bodily injury. A Temporary Injunction is hereby entered by this Court and upon personal service or upon waiver and acceptance of service by the Restrained Person is in effect until the next hearing date. This injunction restrains the Restrained Person from ceasing to make payments for mortgage or rent, insurance, utilities or related services, transportation, medical care, or child care when the Restrained Person has a prior existing duty or legal obligation to make such payments or from transferring, encumbering, concealing, or in any way disposing of personal effects or real property, except in the usual course of business or for the necessities of life. You must keep a distance of at least _______ yards from the Protected Persons. The next hearing is____________________ (date) _______ (time) at the court address above. This Temporary Protection Order expires at the conclusion of the Hearing date stated above unless continued by the Court to another date. 1. Contact. It is ordered that you, the Restrained Person, shall have no contact of any kind with the Protected Persons and you shall not attempt to contact said Protected Persons through any third person, except your attorney, except as follows: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ A violation of a Protection Order is a crime and may be prosecuted as a misdemeanor, municipal ordinance violation, or a delinquent act (if committed by a juvenile) pursuant to §18-6-803.5, C.R.S., and municipal ordinance. JDF 398 R7/07 TEMPORARY CIVIL PROTECTION ORDER ISSUED PURSUANT TO §13-14-102, C.R.S. Page 1 of 4 American LegalNet, Inc. www.FormsWorkflow.com Case Name _____________________ v. ______________________ Case Number: ___________________ 2. Exclusion from places. It is ordered that you be excluded from the following places and shall stay at least ______ yards away from the following places: (Please specify 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: _____________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ You may not remain in or return to any of the above locations after you receive this Order. You shall be permitted to return to a shared residence one time to obtain sufficient undisputed personal effects to maintain a normal standard of living until the next hearing date ONLY if you are accompanied at all times by a law enforcement officer. 3. Care and Control Provisions. It is in the best interest of the minor children that care and control of these children be awarded to ________________________________ (name of person) until the next hearing. At that hearing, the Court will determine who should receive temporary care and control of the minor children for up to 120 days. 4. Issues Concerning Children. (Parenting Time and Decision-Making Responsibilities) Restrained Person is granted parenting time with the minor children. Parenting time and decision-making responsibilities will be considered at the Permanent Protection Orders Hearing or at the next Hearing. Parenting time expires on ___________________ (next hearing date) and shall be as follows: _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ Interim decision-making responsibilities expire on _____________(next hearing date) and shall be as follows: __________________________ (name of person) shall have sole decision-making responsibilities. The parties shall jointly share decision-making responsibilities. Other as set forth in “Other Provisions” section 5. Parenting time and decision-making responsibilities shall be as previously ordered by the _________ District Court, Case #_______________. 5. Other Provisions. The Restrained Person shall not possess and/or purchase a firearm, ammunition, or other weapon. The Court waives all fees and no fees for service should be assessed pursuant to §13-14-102(21)(b), C.R.S. Fees shall be paid by the Plaintiff/Petitioner Defendant/Respondent. It is further ordered that: __________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ Date: _____________________________________ By signing, I acknowledge receipt of this Order or ___________________________________________ Judge Magistrate ___________________________________________ Print Name of Judicial Officer Restrained Person is not present in courtroom. Date: __________________________________ ___________________________________________ Signature I certify that this is a true and complete copy of the original order. Date: ______________________________________ ___________________________________________ Clerk JDF 398 R7/07 TEMPORARY CIVIL PROTECTION ORDER ISSUED PURSUANT TO §13-14-102, C.R.S. Page 2 of 4 American LegalNet, Inc. www.FormsWorkflow.com Law enforcement shall use all reasonable means to enforce this Protection Order. 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. This Court has jurisdiction over the parties and the subject matter. Pursuant to 18 U.S.C. §922(g)(8), it is 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 PERSON You are directed to appear before this Court on the date shown on the front of this form to show cause, if any exists, why this Temporary Protection Order should not be made permanent. This Temporary Protection Order shall be made permanent without further notice or service or the Court may continue the Temporary Protection Orders to a date certain. You are notified that the Permanent Civil Protection Order shall remain in effect until further order of the Court. Such Permanent Order will subject you to Federal Laws restricting firearms possession and sale 18 U.S.C., §922(g)(8), §924(a)(2). A violation of a Protection Order may be a misdemeanor, municipal ordinance violation or a delinquent act (if committed by a juvenile) and is a deportable offense. Anyone over the age of eighteen who violates this order may be subject to fines of up to $5000.00 and up to 18 months in jail. Violation of this Order may constitute contempt of court. Anyone under the age of 18 who violates this Order may be subject to commitment to the Department of Human Services for up to two years. 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 Protected Person 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 PERSON You are hereby informed that if this Order is violated you may call law enforcement. You may initiate contempt proceedings against the Restrained Person if the Order is issued in a civil action or request the prosecuting attorney to initiate contempt proceedings if the Order is issued in a criminal action. You cannot give the Restrained Person permission to change or ignore this Order in any way. Only the Court can change this Order. NOTICE TO LAW ENFORCEMENT OFFICERS If the Order has not been personally served, the law enforcement officer responding to a call of assistance shall serve a copy of said Order on the person named/Restrained Person therein and shall write the time, date, and manner of service on the Protected Persons’ copy of such Order and shall sign such statement. The officer shall provide the Court with a completed return of service form. (§13-14-102(11 - 12), C.R.S.) You shall use every reasonable means to enforce this 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 Person when you have information amounting to probable cause that the Restrained Person has violated or attempted to violate any provision of this Order subject to criminal sanctions pursuant to §18-6-803.5, C.R.S. or municipal ordinance and the Restrained Person has been properly served with a copy of this Order or the Restrained Person has received actual notice of the existence and substance of such 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 Person to the nearest jail or detention facility. You are authorized to use every reasonable effort to protect the Protected Persons to prevent further violence. You may transport, or arrange transportation to a shelter for the Protected Persons. JDF 398 R7/07 TEMPORARY CIVIL PROTECTION ORDER ISSUED PURSUANT TO §13-14-102, C.R.S. Page 3 of 4 American LegalNet, Inc. www.FormsWorkflow.com Municipal Court County Court District Court Denver Juvenile Denver Probate _________________________________________ County, Colorado Court Address: Plaintiff/Petitioner: ________________________________ v. COURT USE ONLY Case Number: Defendant/Respondent: ________________________________ Address: _________________________________________ 16 Character #: ______________________ _________________________________________ Division Courtroom TEMPORARY CIVIL PROTECTION ORDER ISSUED PURSUANT TO §13-14-102, C.R.S. RETURN OF SERVICE I declare under oath that I am 18 years or older and not a party to the action and that I served the Verified Complaint/Motion for Civil Protection Order and the Temporary Protection Order on the Defendant/Respondent in ______________________ (County) Plaintiff/Petitioner ________________ (State) on ______________ (date) _________ (time) at the following location: __________________________________________________________________________________________ By handing it to a person identified to me as the By leaving it with the Plaintiff/Petitioner Plaintiff/Petitioner Defendant/Respondent. Defendant/Respondent who refused service. By leaving it with __________________________________________________ (Type or write name legibly) who is designated to receive service for the Plaintiff/Petitioner Defendant/Respondent because of the following relationship: ___________________________________________ as provided for in C.R.C.P. 4(e). I attempted to serve the Plaintiff/Petitioner Defendant/Respondent _________ occasions but have not been able to locate the Plaintiff/Petitioner Defendant/Respondent. Return to the Plaintiff/Petitioner Defendant/Respondent is made on ______________________ (date). Private process server Sheriff, _________________________County Fee $ ____________ Mileage $ ___________ Fee waived, Domestic Violence Protection Order. _________________________________________ Signature of Process Server _________________________________________ Name (Print or type) My Commission Expires: ________________________ _________________________________________ Notary Public/Deputy Clerk JDF 398 R7/07 TEMPORARY CIVIL PROTECTION ORDER ISSUED PURSUANT TO §13-14-102, C.R.S. Date Page 4 of 4 American LegalNet, Inc. www.FormsWorkflow.com