COURT COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : : Index No. Calendar No. ORI ___________________ : JUDICIAL SUBPOENA Plaintiff(s) THE SUPERIOR COURT FOR THE COUNTY OF________________ -against- : STATE OF GEORGIA : : ] ] Defendant(s) : . . . . . . . . . . . . .Petitioner, . . . . . . . . . . . . . . . . . . . . ]. . . .Civil .Action File ......... .... ... v. ] ] _________________, THE PEOPLE OF THE STATE OF NEW YORK ] No._____________________ ] Respondent. ] TO ________________, STALKING PERMANENT PROTECTIVE ORDER GREETINGS: hearing was held on this matter on ___________________, 20___ at which the A civil Respondent appeared and/or was provided with the opportunity to be heard and the Petitioner WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before requested, pursuant to O.C.G.A. §§ 16-5-94 (e) and 19-13-4 (c), that a permanent Protective , the Honorable at the Court Order be issued. Having heard the evidence presented, reviewed the petition and the record located at County of concerning this case and for good cause shown, ,IT IS HEREBY ORDERED AND noon, and at any recessed ADJUDGED: in room , on the day of 20 , at o'clock in the or adjourned date, to testify and give evidence as a witness in this action on the part of the The Respondent has knowingly and wilfully violated O.C.G.A. §§ 16-5-90 et seq. and placed the Petitioner in reasonable fear for the Petitioner’s safety, because __________________________________________________________________ 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 Respondent is result of your failure to comply.hereby enjoined and restrained from doing or attempting to do, or threatening to do any act constituting a violation of O.C.G.A. §§ 16-5-90 et seq. and of harassing, interfering, or intimidating the Petitioner or Petitioner’s of the Witness, Honorable , one of the Justices immediate family. Any future acts committed by the Respondent towards the Court in County, day of , 20 Petitioner which are in violation of this statute and this Protective Order can amount to AGGRAVATED STALKING, pursuant to O.C.G.A. § 16-5-91, which is a felony. A person convicted of Aggravated Stalking shall be punished by (Attorney must sign above and type name below) imprisonment for not less than one nor more than ten years and by a fine of not more than $10,000.00. 1. [pco01,02] 2. [pco01,04] Attorney(s) for Respondent is permanently enjoined and restrained from approaching within _____ yards of Petitioner and/or Petitioner’s immediate family, and/or residence, place of employment, or school or subsequent residence, place of employment or school. Office and P.O. Address 3. [pco05] Respondent is not to have any contact of any type, direct, indirect, or through another person with the Petitioner or her/his immediate family, including but not limited to telephone, fax, e-mail, voice mail,Telephoneany other type of contact. mail, or No.: 1 Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : Index No. CIVIL ACTION :FILE Calendar No. NO. ____________________ : 4. JUDICIAL SUBPOENA Plaintiff(s) That this order be filed in the office of the Clerk of this Court. 5. This Order shall remain in effect permanently and shall not terminate unless modified : by the Court. -against- : : That this Order applies in every county throughout the state and it shall be the duty of every court and every law enforcement official to enforce and carry out the Defendant(s) : . . . . . . . . . . . . .provisions .of .this . . . . . . pursuant. to. O.C.G.A.. §§ 16-5-94(e) and 19-13-4(d). Law . . . . . . . . . . . . . Order . . . . . . . . . . . . . . . . . Enforcement may use their arrest powers pursuant to O.C.G.A. §§ 16-5-91 and 17-420 to enforce the terms of this Order. 6. THE PEOPLE OF THE STATE OF NEW YORK 7. 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 TO notice and had the opportunity to be heard before this Order was issued sufficient to 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 GREETINGS: other state or local jurisdiction and shall be enforced as if an Order of the enforcing state or jurisdiction. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court ONLY the following that are initialed by the JUDGE shall apply: located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed ____ 8.. date, to testify andto receive appropriate psychiatric or psychological the or adjourned Respondent is give evidence as a witness in this action on the part of services. ____ 9. Petitioner is awarded costs and attorney fees in the amount of _________. Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to 10. Petitioner/protected party is either a spouse, former spouse, parent of a common the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a [pco07] child, Petitioner’s child, child of Respondent, cohabitates or has cohabited with result of your failure to comply. ____ Respondent and qualifies for 18 U.S.C. § 922(g) Witness, Honorable County, , one of the Justices of the SO ORDERED this _____ day of ___________________, 20_____. Court in day of , 20 ___________________________ name below) (Attorney must sign above and type JUDGE, SUPERIOR COURT __________________ County Attorney(s) for ___________________________ Print or stamp Judge’s name Office and P.O. Address Violation of the above Order may be punishable by arrest. 2 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. NOTICE TO RESPONDENT : Plaintiff(s) Violation of this Order may result in immediate arrest and crimin al JUDICIAL SUBPOENA prosecution that may result in jail time and/or fines and/or may subject you to pro secution and pen alties for contempt of court. 1. -against- : 2. This Order shall remain in effect unless specifically superceded by a subsequent signed and filed Order, by operation of law, or by Order of dismissal, whichever 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 is prohibited from possessing, receiving, or transporting a firearm or ammunition which has Defendant(s) : been shipped . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .or. transported .in .interstate or foreign commerce for the duration of the Order. 18 U.S.C. § 922(g ). ..... 4. THE TO A person comm its the offense of Aggravated Stalking when such person, in violation of a temporary or permanent protectiv e O rder pro hibiting this behavior follow s, places under surveillance, or contacts Petitioner on public or private property for the PEOPLE OF THE STATE OF NEW YORK 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 n ot less than 1 year nor more than 1 0 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 GREETINGS: O.C.G.A. § 19-13-53. To order a specific provision, please initial in the space provided. The court should delete or otherwise make inoperative any provision in the standardized form which is not WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before supported by the evidence in the case and in order to comply with the court's application of the law , the Honorable at the Court and facts to an individual case. 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 SHEET of the on the part RESPONDENT’S IDENTIFYING FACT (please comp lete 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 subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this number was issued for a maximum of birth $50 and all damages sustained as a Respondent’s social security subpoenais _______________, datepenalty of is _________, sex ___, result of hair ___________, color of your failure to comply. color of eyes ______________, height _______, weight _____. Respondent’s race is ______, ethnic background ____________. Respondent has distinguishing Witness, Honorable one of the Justices of the marks (tattoos, scars, etc.)_____________________. Respondent drives a ,_____________________, Court in tag numberCounty, day of , 20 a ____(state) driver’s license number license _________________ and has ___________. 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 ______ Office and P.O. Address ___________________________ DOB __________ sex ____ race ______ ___________________________ DOB __________ sex ____ race ______ “ TRANSMITTED TO GEORGIA PROTECTIVE ORDER REGISTRY 3 Telephone No.: CLERK ________ DATE _______ Rev’d 1/10/03 Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : Index No. * REMOVE THIS PAGE FROM ORDER * : Plaintiff(s) Pursuant to O.C.G.A. Section 19-13-3, -againstPetitioner assisted by Calendar No. : JUDICIAL SUBPOENA : : Name: _________________________ Address: _______________________ : _______________________________ : Telephone: _____________________ . . . .Defendant(s) . . . . . . . ................................. .......... 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. Court in Witness, Honorable 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 4 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com