Print Form Clear Form Civil No Contact Order (Rev. 12/17/14) CCG N806 IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS ______________________________________________________ ______________________________________________________ __________________________ himself/herself and/or on behalf of ______________________________________________________ Petitioner v. ______________________________________________________ Respondent Petitioner Address (Check if omitted pursuant to Statute Respondent Address City/State/Zip Code City/State/Zip Code Case No. ______________________________ Independent Proceeding Criminal Proceeding Delinquency Petition Birth Date (Required for LEADS) Sex Race Height Weight Hair Color Eye Color CIVIL NO CONTACT ORDER 4653 Emergency 4654 Plenary The following persons are protected by this Order; (1) Petitioner's Name: _____________________________________________________________ (2) Other Protected Parties (if minor child, list only initials): _____________________________________________________________________ Date, time and place for further hearing: Date: __________________________________ , ________ This Order was issued on: Date: _______________________, ______ Time: ________________ Time: ____________ Courtroom/Calendar No. ____________________________ Location: _________________________________________ This Order will be in effect until: Date: _____________________, ______ Time: ________________ FOR EMERGENCY ORDERS ONLY: The Court finds good cause to grant the remedy, regardless of prior service of process or of notice upon the Respondent, because the harm which that remedy is intended to prevent would be likely to occur if the Respondent were given any prior notice, or greater notice than was actually given, of the Petitioner's efforts to obtain judicial relief. Based on the findings of this court, q which were made orally for transcription, or q which are set out in a separate instrument filed with the court, and with the court having jurisdiction of the subject matter and over all necessary parties, IT IS HEREBY ORDERED THAT: 1. The Respondent is to stay away from the Petitioner. 2. The Respondent is to stay away from any other person protected under this Civil No Contact Order. 3. The Respondent is prohibited from physical abuse, harassment, intimidation of a dependent, interference with personal liberty, or stalking any person protected under this Civil No Contact Order. 4. The Respondent is prohibited from entering or remaining present at the school place of employment of any person protected under this Civil No Contact Order. Atty. No.: ________________________ Pro se 99500 ENTERED: Dated: ___________________________________________, __________ ____________________________________________________________ Judge Judge's No. Name: ___________________________________________________ Atty. for: _________________________________________________ Address: __________________________________________________ City/State/Zip Code: ________________________________________ Telephone: ________________________________________________ any knowing violation of a civil no contact order is a class a misdemeanor. any second or subsequent violation is a class 4 felony. DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS Page 1 of 1