COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : ORI No. Index___________________ Calendar No. THE SUPERIOR COURT FOR THE COUNTY :OF________________ Plaintiff(s) STATE OF GEORGIA -against- : JUDICIAL SUBPOENA : ________________, ] : ] : Petitioner, ] Civil Action File v. ] Defendant(s) : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ]. . . . . . . . . . . . _________________, ] No._____________________ ] Respondent. ] THE PEOPLE OF THE STATE OF NEW YORK PERMANENT FAMILY VIOLENCE PROTECTIVE ORDER TO A hearing was held on this matter on ______________________, 20____ for which the Respondent had notice as required by law and at which the Respondent appeared and/or had the GREETINGS: opportunity to be heard and the Petitioner requested that the Protective Order entered in this case be converted to a Permanent Family Violence Protective Order. This Court has determined that WE COMMAND subject matter and the parties. being laid aside, you and each of you attend before it had jurisdiction over theYOU, that all business and excusesHaving heard the evidence presented, , the Honorable at the Court reviewed the Motion and the entire record concerning this case and for good cause shown, IT IS located at County of HEREBY ORDERED AND ADJUDGED: in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the 1. That these proceedings be filed in the office of the Clerk of this Court. 2. That this Order applies in every county throughout the state and it shall be the duty Your failure to comply and every law enforcement official to enforce and carry make you liable to of every court with this subpoena is punishable as a contempt of court and will out the the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a provisions of this Order pursuant to O.C.G.A. § 19-13-4(d). Law Enforcement result of your failure to comply. officers may use their arrest powers pursuant to O.C.G.A. §§ 19-13-6, 17-4-20 to enforce the terms of this Order. Witness, Honorable Court in County, 3. 4. [pco01] , one of the Justices of the , 20 This Order and theday of issued _______________, 20_____ shall be permanent Order pursuant to O.C.G.A. § 19-13-4(c) and have NO expiration date. (Attorney must sign That the Respondent has violated the Family Violence Act,above and type name19-13-1 at O.C.G.A. § below) et seq., by committing family violence, has placed the Petitioner in reasonable fear for Petitioner’s safety, and represents a credible threat to the physical safety of Attorney(s) for Petitioner and/or Petitioner’s child/ren. Respondent is hereby enjoined and restrained from doing, or attempting to do, or threatening to do, any act of injury, maltreating, molesting, following, harassing, harming, or abusing the Petitioner and/or the minor child/ren in any manner. Respondent is not to interfere with Petitioner’s travel, Office shall not follow, transportation, or communication. Respondent and P.O. Address place under surveillance, or contact the Petitioner at any place of the Petitioner for the purpose of harassing and intimidating the Petitioner. 1 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. CIVIL ACTION: FILECalendar No. NO. ___________________ 5. [pco02] : That the Respondent is enjoined and restrained fromJUDICIAL SUBPOENA doing or attempting to do, or Plaintiff(s) threatening-against- act of injury, maltreating, molesting, harassing, harming, or to do, any : abusing the Petitioner’s family or household. : 6. That this Court determined that it had jurisdiction over the parties and the subject : matter under the laws of the State of Georgia and Respondent received reasonable notice and had the opportunity to be heard before this Order was issued sufficient to Defendant(s) : . . . . . . . . . . . . .protect .the .Respondent’s. due .process .rights and this Order shall be presumed valid ...... .. ........... ... ...... ........ and pursuant to18 U.S.C. § 2265(a) shall be accorded full faith and credit by any other state or local jurisdiction and shall be enforced as if an Order of the enforcing state or jurisdiction. THE PEOPLE OF THE STATE OF NEW YORK ONLY THE FOLLOWING THAT ARE INITIALED BY THE JUDGE SHALL APPLY TO _____ 7. Respondent is ordered to stay away from Petitioner’s and Petitioner’s child/ren’s residence and workplace and/or school and any subsequent residence or workplace GREETINGS: or school of Petitioner and/or Petitioner’s minor child/ren. [pco04] _____ 8.WE COMMAND YOU, that all business and excuses from approaching within _____ yards before That Respondent is restrained and enjoined being laid aside, you and each of you attend , the Honorable of Petitioner and/or Petitioner’s minor children. Court at the [pco01,04] located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed _____ 9. date, to testify and ordered not to have any contact, direct, indirectof the or adjourned Respondent is give evidence as a witness in this action on the part or through another [pco05] person with Petitioner, by telephone, pager, fax, e-mail or any other means of communication except as specified in this Order. Your failurePetitioner is awarded temporary custody of the minor child/ren, namely: _____ 10. That to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a ___________________ DOB __________ sex ______ result of your failure to comply. ___________________ DOB __________ sex ______ ___________________ DOB __________ sex ______ Witness, Honorable , one of the Justices of the ___________________ DOB __________ sex ______ Court in County, day of , 20 Respondent is ordered not to interfere with the physical custody of the minor child/ren. _____ [pco06] _____ 11. (Attorney must sign above Check here only if Respondent is awarded temporary custody ofand type name below) child/ren. Respondent is ordered to pay to the Petitioner support for the minor child/ren in the Attorney(s) for amount of $________ every _______________ beginning the _______ of ______________, _____. All payments are to be made by or to: ____ income deduction order ____ child support receiver Office and P.O. Address ____ by mail directly to the Petitioner or ____ _____________________________ 2 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. CIVIL ACTION: FILECalendar No. NO. ___________________ JUDICIAL SUBPOENA In determining child support the Court finds as: follows: Plaintiff(s) -against- : The gross income of the father is $________ yearly or $_______ monthly. The gross income of the mother is $_______ yearly or $_______ monthly. : The applicable percentages of obligor’s gross income to be considered by the trier of : fact to determine child support are: Defendant(s) Four: . . . . . . . . . . . . .One. child. . . . . . . . . . . .17. to .23. percent. . . . . . . . children ... .... . .. . ...... Two children Three children 23 to 28 percent 25 to 32 percent Five children 29 to 35 percent 31 to 37 percent THE PEOPLE OF THE STATE OF NEW YORK TO In this case child support is being determined for ___ child/ren and the applicable percentage of gross income to be considered is ____ to ____ percent. The court has considered the existence of special circumstances, and has found that no special circumstances OR the following special circumstances exist: _________________________________________________________________ GREETINGS: _____ 12. Respondent is ordered to pay temporary support for the Petitioner in the amount of WE COMMAND YOU, that all business and____________. aside, you and each of you attend before $________ every ______beginning excuses being laid , the Honorable All payments are to be made by or the ____ income deduction order at to: Court located at County of ____ child support receiver in room , on the day of , 20 , at o'clock in the noon, and at any recessed ____ by mail directly to the Petitioner or adjourned date, to testify and give evidence as a witness in this action on the part of the or ____ _____________________________ _____ 13. Respondent shall have visitation with the minor child/ren according to the Your failure to comply with beginning__________________: following schedule, this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a ____ no visitation result of your failure to comply. ____ no visitation until ____________________________ ____ supervised visitation, supervised by a third party as follows:_______ Witness, Honorable , one of the Justices of the ______________________________________________________ Court in County, visitation every other weekend from Friday at 6 p.m. until Sunday at day of , 20 ____ 6 p.m., beginning__________________, ___________ ____ other visitation _________________________________________ (Attorney must sign above pick up and return ____ circumstances concerning how Respondent shall and type name below) the minor child/ren shall be _____________________________________ Strict compliance with this visitation provision shall not be a violation of the Attorney(s) for restraining provisions of this Order. _____ 14. (Respondent)(Petitioner)(Both Petitioner and Respondent)[strike through appropriate] is/are ordered not to sell, encumber, trade, damage, contract to sell, or Office and P.O. Address otherwise dispose of or remove from the jurisdiction of this Court any of the property or pets of the Petitioner or joint property or pets of the parties except in the ordinary course of business. 3 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Calendar No. CIVIL ACTION FILE NO. ___________________ _____ 15. : JUDICIAL SUBPOENA (Respondent)(Petitioner)(Both Petitioner and Respondent) [strike through Plaintiff(s) appropriate] is/are ordered not to disconnect or have disconnected home utilities, -against: change or have changed and/or cancel or have canceled auto, health or life insurance for Respondent, Petitioner, and/or Petitioner’s child/ren or interfere with, : Respondent’s, Petitioner’s and/or Petitioner’s child/ren’s mail. : _____ 16. Petitioner is awarded costs and attorney fees in the amount of _______________. _____ 17. Petitioner/protected party is either a spouse, former spouse, parent of a common child, Petitioner’s child, child of Respondent, cohabitates or has cohabited with Respondent and qualifies for 18 U.S.C. 922(g). Defendant(s) : ...................................................... [pco07] THE PEOPLE OF THE STATE OF NEW YORK _____ 18. TO It is further Ordered __________________________________________________ [pco08] __________________________________________________________________. GREETINGS: SO ORDERED this _____ day of ___________________, 20_____. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of ___________________________ in room , on the day of , 20 , at o'clock in the noon, and at any recessed JUDGE, SUPERIOR COURT or adjourned date, to testify and give evidence as a witness in this action on the part of the __________________ County ___________________________ Your failure to comply with this subpoena isPrint or stampaJudge’s name punishable as contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Witness,Violation of the above Order may be punishable byone of the Justices of the Honorable , arrest. Court in County, day of , 20 (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address 4 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. CIVIL ACTION FILE NO. ___________________ : Calendar No. : NOTICEPlaintiff(s) TO RESPONDENT JUDICIAL SUBPOENA 1. Violation of this Order may result in immediate arrest and criminal prosecution that may result in jail -against: time and/or fines and/or may subject you to pro secution and pen alties for contempt of court. 2. This Order shall remain in effect unless specifically superceded by a subsequent signed and filed Order, : by operation of law, or by O rder of dism issal, whichev er occurs first. Only this Court can void, modify or dismiss this Order. Either party may ask this Court to change or dismiss this Order. 3. If after a hearing, of which the Defendant received notice and opportunity to participate, a protective order is issued which restrains Defendant from harassing, stalking or threatening an intimate partner, Defendant(s) : Defendant . prohibited . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .is . . . . . . . . .from. possessing,. receiving,.or. transporting a firearm or ammunition which has been shipped or transported in interstate or foreign commerce for the duration of the Order. 18 U.S.C. § 922(g ). : ..... 4. A person comm its the offense of Aggravated Stalking when such person, in violation of a temporary or permanent THE STATE OF NEW YORK THE PEOPLE OF protective Or der prohibiting this behavior follow s, places under surveillance, or contacts TO Petitioner on public or private property for the purpose of harassing and intimidating the other person. This activity can subject the Respondent to arrest and prosecution for felony Aggravated Stalking, which carries penalties of imprisonment for not less than 1 year nor more than 10 years and a fine of up to $10,000.00. Note to Judges: This form is promulgated as a Uniform Superior Court Rule under the auspices of O.C.G.A. GREETINGS: § 19-13-53. To order a specific provision, please initial in the space provided. The court should delete or otherwise WE COMMAND any provision in the standardized form which is not supportedeach of evidence before make inoperative YOU, that all business and excuses being laid aside, you and by the you attend in the case and in order to comply with the court's application of the law and facts to an individual case. , the Honorable at the Court located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed RESPONDENT’S IDENTIFYING FACT SHEET or adjourned date, to testify and give evidence as a witness in this action on the part of the (please complete as much as possible; one of these must be provided to have the order placed in the National Crime Information Center registry: Respondent’s date of birth, social security number, or driver’s license number) Your failure to comply with this _______________, as a of birth of court and will make you Respondent’s social security number issubpoena is punishabledate contemptis _________, sex ___, liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a color of hair ___________, color of eyes ______________, height _______, weight _____. result of your failure to comply. Respondent’s race is ______, ethnic background ____________. Respondent has distinguishing marks (tattoos, scars, etc.)_____________________. Respondent drives a _____________________, Witness, Honorable , one of the Justices of the license tag number _________________ and has a ____(state) driver’s license number Court in County, day of , 20 ___________. Respondent’s home address ______________________________ and is employed by________________ at _______________________ and works from ____ to ____ on (days)___________. (Attorney must sign above and type name below) PETITIONER’S IDENTIFYING INFORMATION Attorney(s) for Protected parties ___________________________ DOB __________ sex ____ race ______ ___________________________ DOB __________ sex ____ race ______ ___________________________ DOB __________ sex ____ race ______ Office and P.O. Address ___________________________ DOB __________ sex ____ race ______ “ TRANSMITTED TO GEORGIA PROTECTIVE ORDER REGISTRY 5 Telephone No.: DATE _______ CLERK ________ Facsimile No.: Rev’d 1/10/03 E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. * REMOVE THIS PAGE FROM ORDER * Plaintiff(s) -against- : JUDICIAL SUBPOENA : Pursuant to O.C.G.A. Section 19-13-3, Petitioner assisted by : : Name: _________________________ Defendant(s) Address: _______________________ : ...................................................... _______________________________ Telephone: _____________________ THE PEOPLE OF THE STATE OF NEW YORK TO GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Witness, Honorable Court in County, , one of the Justices of the day of , 20 (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address 6 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com