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Petition For Protection From Stalking Order Form. This is a Kansas form and can be use in District Court Statewide.
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Tags: Petition For Protection From Stalking Order, Kansas Statewide, District Court
IN THE DISTRICT COURT OF ______________ COUNTY, KANSAS
______________________________,
Plaintiff
vs.
Case No. _______________
______________________________,
Defendant
PETITION FOR PROTECTION FROM STALKING ORDER
(K.S.A. 60-31a01 et seq.)
1.
Plaintiff seeks an order for protection from stalking for:
myself; or
my minor child (under age 18); or
a minor child who lives with me.
2.
The minor child for whom Plaintiff seeks protection is: (give full name and year
of birth)
NAME
3.
YOB
Defendant, ______________________________ (name), can be served at:
(please provide all available addresses)
HOME: street
city
state
zip code
phone number
times when defendant is usually there
WORK: street
city
state
zip code
phone number
times when defendant is usually there
OTHER: street
city
state
zip code
phone number
times when defendant is usually there
4.
12/3/10
Describe the incidents of stalking. Include specific facts, dates and locations:
Incident #1:
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Incident #2:
Additional Incident(s), if any:
(Attach additional pages as needed.)
5.
Plaintiff needs a protection from stalking order because:
6.
The stalking occurred in this county.
7.
Plaintiff requests that the court issue an ex parte Temporary Order of Protection
and Final Order of Protection restraining defendant from:
following, harassing, telephoning, contacting or otherwise communicating
with the protected person
abusing, molesting or interfering with the privacy or rights of the protected
person
entering or coming on or around the premises or the residence of the protected
person located at:
,
and the workplace located at:
.
(Give address or other description of residence and workplace from which
Defendant is to be excluded. DO NOT include the residential address if it is to
remain confidential.)
8.
9.
12/3/10
The court shall give copies of orders to the appropriate law enforcement agencies;
set a date, time and hearing on this matter; and issue summons to Defendant,
notifying Defendant of this action and the relief requested.
After a hearing, the court should issue a Final Order of Protection from Stalking
prohibiting Defendant from committing any acts of stalking against the protected
person; order Defendant to pay court costs and attorney fees if appropriate; and
order any other relief necessary for the safety of the protected person including:
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__________________________________________
Plaintiff's Signature
Plaintiff’s Name:
(Plaintiff’s address is to remain confidential. DO NOT include the residential address of the
Plaintiff in this petition. Plaintiff must complete the Protection from Stalking Confidential
Address form and include it with this petition.)
Attorney representing Plaintiff (if any)
Attorney’s Name:
Address 1:
Address 2:
City, State, Zip:
Telephone:
VERIFICATION
STATE OF ____________________ )
) ss:
COUNTY OF __________________ )
I swear or affirm that the statements made in this petition are true and correct to the best
of my knowledge and belief and that I am the person filing this petition.
__________________________________________
Plaintiff’s Signature
SUBSCRIBED AND SWORN to before me, a Notary Public, this ______ day of
_______________________________ 20
.
__________________________________________
Notary Public
My Appointment Expires:
___________________
12/3/10
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