Protection Order Case No. Temporary Ex Parte Order and Notice of Hearing Amended Temporary Order and Notice of Hearing PETITIONER [ ] PROTECTED PERSON First Middle And Or on behalf of Court _______________Judicial District County State Idaho PETITIONER/PROTECTED PERSON IDENTIFIERS Last minor family member(s) (list name and DOB) Date of Birth of Petitioner other Protected Person(s): (list name and DOB) _______________________________________ _______________________________________ _______________________________________ _______________________________________ RESPONDENT RESPONDENT IDENTIFIERS SEX First Middle RACE EYES HAIR DOB HT WT Last __________________________________________________ DISTINGUISHING FEATURES Respondent’s Address __________________________________________________ Relationship to Protected person: spouse: former spouse; living together; formerly living together; child in common; parent related by blood, adoption or marriage; are in, or have been in, a dating relationship. DRIVERS LICENSE # CAUTION: † STATE Weapon Alleged to be Involved. The court has jurisdiction over the parties and subject matter, the Respondent will be provided with reasonable notice and opportunity to be heard. The Respondent represents an immediate and present danger of domestic violence to the Protected Person(s) and irreparable injury could result from domestic violence if an order is not issued immediately without prior notice to Respondent. The terms of this order shall be effective until earlier by another court order. , at 11:59 P.M. /unless terminated WARNINGS: This order shall be enforced, even without registration, by the courts of any state, the District of Columbia, any U.S. Territory, and may be enforced on Tribal Lands (18 U.S.C. Section 2265). Crossing state, territorial, or tribal boundaries to violate this order may result in federal imprisonment (18 U.S.C. Section 2262). Federal law provides penalties for possessing, transporting, shipping, or receiving any firearm or ammunition (18 U.S.C. Section 922(g)(8)). Violation of any provision of this order by the respondent after actual notice of its terms, is a misdemeanor and may result in arrest and sentencing for up to one (1) year in jail and a five thousand dollar ($5,000) fine, even if the protected person consents to the violation. Only the Court can change this order. Temporary Ex Parte Protection Order & Notice of Hearing CAO DV 4-1 Revised 12/10/2007 Page 1 of 4 American LegalNet, Inc. www.FormsWorkflow.com THE COURT ORDERS: 1. Personal Conduct Order. Respondent shall not harass, annoy, disturb the peace of, telephone, contact or otherwise communicate with (either directly or indirectly, in person or through any other person): [01] The Protected Person The minor child/ren residing in the Protected Person’s household. Exceptions are: to meet with or through attorneys or during legal proceedings [05] contact by telephone to arrange visitation of the child/ren contact by telephone between .m. and .m. on for the following purposes: to participate in counseling/mediation, if Court ordered to respond to an emergency involving the child/ren Other: 2 Stay-Away Order. Respondent shall not, EVEN IF INVITED BY THE PROTECTED PERSON, go to: go within feet of: Protected Person Protected Person’s residence at Protected Person’s school campus or work place at [04] Protected Person’s child/ren’s school campus or work place at Other: 3 Move-out Order. Respondent Protected Person is ordered to move from the residence at and [03] take from the residence only items needed for employment and necessary personal effects (at peace officer’s discretion). Temporary Ex Parte Protection Order & Notice of Hearing CAO DV 4-1 Revised 12/10/2007 Page 2 of 4 American LegalNet, Inc. www.FormsWorkflow.com 4. Child custody. Custody of the minor child/ren is awarded as provided in the existing child custody order/divorce decree entered as follows: [06] Name of Child Protected Person [09] (first, middle initial, last) Birth Date Sex Custody Awarded To Respondent shall NOT have the child/ren until further order of the Court shall have the child/ren as follows (list days, times and conditions): [06] supervised by: neutral drop off/pick up location: child/ren to be transported by: Neither party shall remove the child/ren from 5. Law enforcement assistance. Peace officers are instructed to enforce this Court order by all necessary means, including arrest. Law enforcement officers are ordered to: Remove the Respondent from the residence at peace officer’s discretion, but no later than . The time for removal shall be at the hours after service of this order. Place the Protected Person in possession of the residence at Supervise the removal of Protected Person’s Respondent’s items needed for employment and necessary personal effects (at peace officer’s discretion) from the residence. 6. Conflicting Orders. If any term of another order conflicts with any term of this order you must follow the more restrictive term. 7. Order to clerk. It is further ordered that the clerk of the court shall forward a copy of this order to the appropriate law enforcement agency for immediate service upon Respondent; and the clerk shall deliver or mail a copy of this order to the Petitioner. Temporary Ex Parte Protection Order & Notice of Hearing CAO DV 4-1 Revised 12/10/2007 Page 3 of 4 American LegalNet, Inc. www.FormsWorkflow.com 8. Other: [07] [08] NOTICE OF HEARING The Petitioner and Respondent are notified that a hearing to decide whether a longer Protection Order will on be issued is scheduled before Judge 20 , at o’clock m, at the , County Courthouse located at , Idaho. in WARNING: IF THE RESPONDENT DOES NOT APPEAR AT THE HEARING, A LONGER PROTECTION ORDER MAY BE ISSUED AGAINST THE RESPONDENT. IF THE PETITIONER FAILS TO APPEAR, THE PETITION MAY BE DISMISSED. Signed: Date: Judge NOTICE: It is a misdemeanor under Idaho Code § 39-6312 for the respondent, after notice of this order, to violate the provisions of this order. Further, it is a crime under Idaho Code § 8-204 for any person to aid and abet a crime, or, not being present, to advise and encourage a crime. In addition, under Idaho Code §18-304, any person who counsels, aids, solicits or incites another to commit a misdemeanor is guilty of a misdemeanor. Therefore, it may be a crime for any person to encourage or invite contact between the respondent and the petitioner, except such contact as is expressly permitted by the above order. I have received a copy of this order [ ] and agree to receive copies of future notices by certified mail. Signed: Date: Petitioner I have received a copy of this order [ ] and agree to receive copies of future notices by certified mail. Signed: Date: Respondent ATTENTION: KEEP A COPY OF THIS ORDER IN YOUR POSSESSION AT ALL TIMES IN ORDER TO ASSIST PEACE OFFICERS. IMMEDIATELY REPORT ANY VIOLATION OF THIS ORDER TO LAW ENFORCEMENT. Temporary Ex Parte Protection Order & Notice of Hearing CAO DV 4-1 Revised 12/10/2007 Page 4 of 4 American LegalNet, Inc. www.FormsWorkflow.com