CIRCUIT COURT OF ILLINOIS JUDICIAL CIRCUIT COUNTY _____________________________________ Petitioner Independent Criminal Juvenile on behalf of a minor child, or an adult who because of age, disability, health, or inaccessibility cannot file the petition _____________________________________ (file stamp) _____________________________________ Name(s) of additional Petitioner(s) vs. Case # _____________________________________ Respondent (to be completed by Court) CIVIL NO CONTACT ORDER (Sexual Conduct and/or Penetration) EMERGENCY CIVIL NO CONTACT ORDER Issued on: Date: Time: ________ a.m./p.m. Expires on: Date: Time: ________ a.m./p.m. NOTICE Hearing is set for: Date: Time: County Courthouse, Courtroom , IL a.m./p.m. at the , , (street address) (city) PLENARY CIVIL NO CONTACT ORDER (Requires Service of Process Under 740 ILCS 22/208) Issued on: Date: In effect until: Time: a.m./p.m. , 20 ________ (not to exceed 2 years unless * below). Final judgment is rendered in Case No. ________________________________. This No Contact Order is modified or vacated. (See attached Order.) Final disposition when a Bond Forfeiture Warrant has been issued (not to exceed 2 years). * Two years following expiration of any sentence of supervision, conditional discharge, probation, periodic imprisonment, imprisonment or mandatory supervised release on Petitioner Respondent given a copy of this Order in open court on / / . Form approved by the Conference of Chief Circuit Judges Effective: January 1, 2005 Page 1 of 5 American LegalNet, Inc. www.FormsWorkflow.com . PETITIONER INFORMATION Name: Address: (Street/P.O. Box) (City) (State) (Zip Code) Disclosure of Petitioner’s address would risk further abuse. The address listed above is Petitioner’s alternative address for service of notice. RESPONDENT INFORMATION (if known) Name: _________________________________ Sex: Male Female DOB: Race: ________ Height: _________ Weight: __________ Hair Color: ________ Eye Color: _________ Social Security #: Driver’s License #: License Plate #: Other Numeric Identifier: Description (e.g. passport #, military serial # or other) (number) Home Address: (Street/P.O. Box) (City) Name of Workplace: (State) (Zip) Work Hours: Work Address: (Street/P.O. Box) (City) (State) (Zip) Distinguishing Physical Features: CAUTION INDICATOR Respondent may be (A) considered armed and/or dangerous (S) suicidal (Y) considered armed, dangerous and suicidal Page 2 of 5 American LegalNet, Inc. www.FormsWorkflow.com NOTICE TO RESPONDENT ANY KNOWING VIOLATION OF A CIVIL NO CONTACT ORDER IS A CLASS A MISDEMEANOR. ANY SECOND OR SUBSEQUENT VIOLATION IS A CLASS 4 FELONY. FINDINGS [Emergency Order] The Court finds that good cause exists for granting the remedy regardless of prior service of process or notice upon the Respondent, because the harm which that remedy is intended to prevent would be likely to occur if Respondent were given any prior notice or greater notice than was given, of Petitioner’s efforts to obtain judicial relief. FINDINGS [Jurisdiction] The court finds that Respondent: has been served with process and notice pursuant to statute. has entered an appearance in this case. is present in court, in person, and/or with counsel, is in default. has filed an answer. Petitioner has diligently attempted to complete service of process, has not been able to serve Respondent, and has given notice by publication. FINDINGS [General] In granting the following remedies, the Court has considered all relevant factors, including but not limited to the nature, severity and consequences of Respondent’s past non-consensual sexual conduct or nonconsensual sexual penetration of Petitioner, including Respondent’s concealment of his/her location in order to evade service of process or notice, and the likelihood of danger of future non-consensual sexual conduct or non-consensual sexual penetration of the party to be protected. The Court further finds that: Venue is proper (740 ILCS 22/207). Upon examination of the Verified Petition, Petitioner under oath, and other evidence, Petitioner is a victim of non-consensual sexual conduct or non-consensual sexual penetration by the Respondent. The victim is unable to bring this Petition on his/her own behalf due to age, health, disability, or inaccessibility (740 ILCS 22/201). The parties stipulate to a factual basis for the issuance of a Civil No Contact Order. Page 3 of 5 American LegalNet, Inc. www.FormsWorkflow.com IT IS ORDERED THAT: 1. Stay Away and Additional Prohibitions. Respondent is ordered to stay feet away from the Petitioner, and not communicate with Petitioner in any way, directly, indirectly or through third parties, including, but not limited to, phone, written notes, mail, email, or fax. Respondent is prohibited from entering or remaining while Petitioner is present at her/his: place of residence, currently located at place(s) of employment, located at school(s), located at and any of the following specified places, when Petitioner is present: 2. Other Injunctive Relief as Follows: This order can be extended upon notice filed in the office of the Clerk of this Court and a hearing held prior to the expiration of this Order. JUDGE I hereby certify that this is a true and correct copy of the original Order on file with the court. Clerk of the Circuit Court of (Seal of the Clerk of Circuit Court) County, IL Date: cc: Petitioner Respondent Counsel of Record Sheriff Advocate Jail S/A Page 4 of 5 American LegalNet, Inc. www.FormsWorkflow.com DEFINITION OF TERMS USED IN THIS CIVIL NO CONTACT ORDER 1. Civil No Contact Order: an emergency order or plenary order granted under this Act, which includes a remedy authorized by 740 ILCS 22/213 of this Act. 2. Non-consensual: a lack of freely given agreement. 3. Petitioner: any named petitioner for the no contact order or any named victim of non-consensual sexual conduct or non-consensual sexual penetration on whose behalf the petition is brought. 4. Sexual Conduct: any intentional or knowing touching or fondling by the petitioner or the respondent, either directly or through clothing, of the sex organs, anus, or breast of the petitioner or the respondent, or any part of the body of a child under 13 years of age, or any transfer or transmission of semen by the respondent upon any part of the clothed or unclothed body of the petitioner, for the purpose of sexual gratification or arousal of the petitioner or the respondent. 5. Sexual Penetration: any contact, however slight, between the sex organ or anus of one person by an object, the sex organ, mouth or anus of another person, or any intrusion, however slight, of any part of the body of one person or of any animal or object into the sex organ or anus of another person, including but not limited to cunnilingus, fellatio or anal penetration. Evidence of emission of semen is not required to prove sexual penetration. 6. Stay Away: to refrain from both physical presence and nonphysical contact with the Petitioner directly, indirectly, or through third parties who may or may not know of the order. “Nonphysical contact” includes, but is not limited to, telephone calls, mail, e-mail, fax, and written notes. Page 5 of 5 American LegalNet, Inc. www.FormsWorkflow.com