Print Form Stalking No Contact Order Clear Form (Rev. 8/23/10) CCG 0813 A IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS People ex rel. __________________________________________ Case No. ______________________________ ____________________________________________ on behalf of _____________________________________ self and/or on behalf of ‰ Independent Proceeding ‰ Criminal Proceeding ___________________________________________________________ Petitioner v. ___________________________________________________________ Respondent ‰ Juvenile Proceeding LEADS NO. __________________________ _____________________________________________________________________________________________________________________________________________ PETITIONER ADDRESS CITY/STATE/ZIP ‰ (Check if omitted pursuant to Statute) ___________________________________________________________________________________________________________________________________________ RESPONDENT ADDRESS CITY/STATE/ZIP _____________________________________________________________________________________________________________________________________________ Birthdate Sex Race Height Weight Hair Eyes (Required for LEADS) _____________________________________________________________________________________________________________________________________________ STALKING NO CONTACT ORDER 4665 ‰ Emergency 4666 ‰ Plenary AN INITIAL KNOWING VIOLATION OF A STALKING NO CONTACT ORDER IS A CLASS A MISDEMEANOR. ANY SECOND OR SUBSEQUENT KNOWING VIOLATION IS A CLASS 4 FELONY. BASED ON THE FINDINGS OF THIS COURT, ‰ WHICH WERE MADE ORALLY FOR TRANSCRIPTION, OR ‰ WHICH ARE SET OUT IN A SEPARATE INSTRUMENT FILED WITH THE COURT. IT IS HEREBY ORDERED THAT: The following persons are protected by this Order: ___________________________________________________________ ____________________________________________________________________________________________________________________ “The minor child/ren” referred to herein are :______________________________________________________________ _______________________________________________________________________________________________________________ ‰ (b) (1) The Respondent is prohibited from threatening to commit stalking or committing stalking. “Stalking” means engaging in a “course of conduct” directed at a specific person, when you know or should know that this course of conduct would cause a reasonable person to fear for his or her safety or the safety of a third person or suffer emotional distress. A stalking “course of conduct” includes acts in which you directly, indirectly, or through third parties, by any action, method, device, or means follow, monitor, observe, surveil, threaten, or communicate to or about, a person; or engage in other contact; or interfere with or damage a person’s property or pet. Stalking can include contact via electronic communications. See 740 ILCS 21/10 for additional definitions. Page 1 of 2 (Rev. 8/23/10) CCG 0813 B ‰ (b) (2) The Respondent is prohibited from having any contact with Petitioner and/or ____________________. ‰ (b) (3) The Respondent is prohibited from knowingly coming within, or knowingly remaining within, ________ feet of Petitioner’s ‰ residence ‰ school ‰ daycare ‰ place of employment or ‰______________ _____________________________________________________________________________________________ Said addresses are:_____________________________________________________________________________ _________________________________________________________________________________________ ‰ (b) (3) (Actual notice to Respondent required) The Respondent is prohibited from remaining at Respondent’s own ‰ residence ‰ school ‰ place of employment. Said addresses are: ___________________________ ________________________________________________________________________________________ ‰ (b) (4) The Respondent is prohibited from possessing a Firearm Owner’s Identification Card or possessing or buying firearms. ‰ (b) (5) The following other injunctive relief is ordered:_____________________________________________________ ___________________________________________________________________________________________ _______________________________________________________________________________________________ ‰ (c) The Respondent is ordered to pay the Petitioner’s costs, including attorney fees: ________________________________________________________________________________________ ‰ ________________________________________________________________________________________________ If an emergency order, the reasons for entering the above remedies without prior notice to the Respondent: ______________________________________________________________________________________ ____________________________________________________________________________________________ If Respondent did not receive notice of the petition, the Respondent may petition the court to reopen the order if s/he has a meritorious defense or the remedy is not authorized. This Order was issued on: This Order will be in effect until: Date: _______________________ Time: _______________ Date: _______________________ (Emergency: not less that 14 nor more than 21 days. Plenary: not to exceed 2 years.) Time: _______________ Date, time and place for further hearing: Date: ____________________________ Time: _________________ Courtroom/Calendar No.: _________________________ Location: _____________________________________________ Atty. No. ___________________ Pro Se 99500 Attorney (or Pro Se Petitioner) Name: _______________________ Date: _______________________________, __________ Address: ___________________________________________ State/City/Zip: ________________________________________ _________________________________________________ Judge Judge’s No. Telephone: (__________) ________________________________ Page 2 of 2 DOROTHY BROWN, CLERK OF THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS