Order GrantinG PetitiOn fOr injunctiOn aGainst Harassment in tHe district cOurt Of tHe fiftH circuit state Of Hawai`i Petitioner(s) Form #5DC52 date filed: _______________________ time filed: _______________________ clerk: ____________________________ Reserved for Court Use SS No. Respondent(s) Petitioner(s)/Petitioner(s)' Attorney (Name, Attorney Number, Firm Name (if applicable), Address, Telephone and Facsimile Number(s) Hearing Date & Time: Judge: order granting petition for injunction against harassment The Petition, having come on for hearing on the Hearing Date and Time listed, before the Honorable Judge above named for the Division of the District Court of the above Circuit. with Petitioner(s) appearing: pro se with Counsel ____________________________________________________________________________________________ and Respondent(s): appearing pro se appearing with Counsel ___________________________________________________________________________________ having been duly served, but failing to appear for the hearing on the Petition the Court having reviewed the Petition, and upon the failure of the Respondent(s) to appear, the Respondent(s) having stipulated to the granting of the Petition and no Findings of Fact having been made, evidence having been adduced thereon and the Court having found the allegations of the Petition proven by clear and convincing evidence, Petitioner(s) and Respondent(s) served with a copy of this Order in open court. IT IS ORDERED, ADJUDGED AND DECREED THAT 1. 2. The Petition is granted. The Ex Parte Temporary Restraining Order herein is made absolute as of _____________________________________________ . I certify that this is a full, true and correct copy of the original on file in this office. ______________________________________________________ Clerk, District Court of the Above Circuit, State of Hawai`i RepRogRaphics (08/08) American LegalNet, Inc. www.FormsWorkFlow.com tRooRdeR 5d-p-232 order granting petition for injunction against harassment (continued) 3. The Respondent(s) and any other person acting on behalf of the Respondent(s) is hereby restrained and enjoined from: a. Contacting, threatening, or physically harassing the Petitioner(s) and any person(s) residing at Petitioner(s)' residence b. Telephoning the Petitioner(s) c. Entering or visiting the Petitioner(s)' residence, including yard and garage and Entering or visiting the Petitioner(s)' place of employment. Said injunction shall be effective as of _________________________________ and shall be in full force and effect for a period of ___________month(s) ___________year(s) from said date unless terminated or modified by appropriate order by this Court. respondent(s) is prohiBited from possession or controlling a firearm or ammunition While this injunction order is in effect. anY firearm or ammunition in the possession of the respondent(s) shall Be turned oVer to the police department for safekeeping While this injunction order is in effect. Special conditions or modification: ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ 7. it is furthered ordered, adjudged and decreed that anY knoWing or intentional Violation of this order against harassment shall Be punishaBle as prescriBed under haWai`i reVised statutes §604-10.5. in addition, anY Violation of paragraph 5 shall Be punishaBle as a misdemeanor offense under haWai`i reVised statutes §134.7. Court costs are awarded to Petitioner(s). Reasonable attorney's fees are awarded to Petitioner(s). to anY police officer or anY other laW enforcement officer: You are ordered to arrest respondent(s) if You oBserVe and/or haVe proBaBle cause to BelieVe that during the period stated in paragraph 4 herein, respondent(s) has Violated the conditions of paragraph 3 herein. 4. 5. 6. 8. 9. Date: Judge of the above-entitled Court In accordance with the americans with disabilities act if you require an accommodation for your disability, please contact the District Court Administration Office at PHONE NO. 482-2347, FAX 482-2509, OR TTY 482-2533 at least (10) working days in advance of your hearing or appointment date. RepRogRaphics (08/08) American LegalNet, Inc. www.FormsWorkFlow.com tRooRdeR 5d-p-232