Rev. 7/2019 KSJC Page 1 of 3 IN THE DISTRICT COURT OF COUNTY, KANSAS Protection from Stalking, Sexual Assault, or Human Trafficking (K.S.A. 60-31a01 et seq.) Temporary Order of Protection from Stalking, Sexual Assault, or Human Trafficking Judge or Division: Case Number: Court ORI Number: Plaintiff : vs. Protected Person Identifiers: Name: Year of Birth Sex: (Date File Stamp) Defendant : Address Defendant Identifiers: SEX RACE YOB HT WT HAIR EYES LAST 4 DIGITS OF SSN (IF KNOWN) DRIVERS LICENSE # DL STATE DL EXP. DATE Protected Person: (name) This order and its terms are directed at and apply to Defendant only. T HIS TEMPORARY ORDER SHALL REMAIN IN EFFECT UNTIL SERVICE OF THE FINAL ORDER OR UNTIL TERMINATED BY ORDER OF THE COURT. ONLY THE COURT CAN CHANGE THIS ORDER. The Court F inds: (Only the provision(s) initialed by the j udge apply.) Plaintiff filed a written verified petition on , 20 requesting a Temporary Order of Protection from Stalking, Sexual Assault, and Human Trafficking. This Court has jurisdiction over Plaintiff, Defendant and subject matter. Plaintiff has established a prima facie case of stalking, sexual assault, or human trafficking sufficient for the court to issue a temporary order of protection from stalking, sexual assault, or human trafficking. A hearing has been set for , 20 , at : a.m. p.m. at (Court) and summons has been issued. American LegalNet, Inc. www.FormsWorkFlow.com Rev. 7/2019 KSJC Page 2 of 3 Order The Court Orders: Plaintiff222s address and telephone number shall remain confidential for the protection of the Protected Person. Defendant shall not follow, harass, abuse, molest, assault, threaten, stalk, or interfere with the privacy rights of the Protected Person, and the Protected Person222s family or household. [ NCIC 01 & 02 ] Defendant shall not enter or come on or around the premises, the residence, the property, school, or place of employment of the Protected Person or other family or household member. [ NCIC 04 ] Defendant shall not communicate in any manner with the Protected Person, the Protected Person222s employer, employees, fellow workers, or others with whom the communication would be likely to cause annoyance or alarm the Protected Person. [ NCIC 05 ] Defendant shall not direct or request another to contact the Protected Person, either directly or indirectly. [ NCIC 04 & 05 ] Defendant shall not commit or attempt to commit a nonconsensual sexual act against the Protected Person. Defendant shall not commit or attempt to commit a sexual act against the Protected Person by force, threat of force, duress, or when the Protected Person is incapable of giving consent. Defendant shall not follow, harass, telephone, contact, recruit, harbor, transport, or commit or attempt to commit human trafficking upon the Protected Person. CERTIFICATE OF COMPLIANCE WITH THE VIOLENCE AGAINST WOMEN ACT (VAWA): This Order meets all the requirements of the Violence Against Women Act, 18 U.S.C. 247 2265. This Court has jurisdiction of the parties and the subject matter; Defendant has been afforded notice and a timely opportunity to be heard as provided by the laws of Kansas. This Order is enforceable in all 50 states, the District of Columbia, all Indian tribal courts and all United States territories and shall be enforced as if it were an order of that jurisdiction pursuant to 18 U.S.C. 247 2265. Additional terms of this order are set forth below, if any. Other Provisions: 1. Other orders necessary to promote the safety of the Protected Person: SO ORDERED: Date Judge of the District Court American LegalNet, Inc. www.FormsWorkFlow.com Rev. 7/2019 KSJC Page 3 of 3 WARNINGS TO DEFENDANT This order is effective when signed by the judge. Law enforcement officials shall immediately enforce this order. Violation of this order may constitute an offense under chapter 21 of the Kansas Statutes Annotated, including, but not limited to: violation of a protective order as provided in K.S.A. 21-5924, and amendments thereto; a sex offense under article 55 of chapter 21 of the Kansas Statutes Annotated, and amendments thereto; stalking as provided in K.S.A. 21-5427, and amendments thereto; assault as provided in K.S.A. 21-5412(a), and amendments thereto; battery as provided in K.S.A. 21-5413(a), and amendments thereto; and criminal trespass as provided in K.S.A. 21-5808(a)(1)(C), and amendments thereto, and may result in prosecution and conviction under Kansas criminal statutes. Violation of this order may also be punishable as contempt of this court. If Defendant has a concealed carry license, that license is subject to revocation pursuant to K.S.A. 75-7c07, and amendments thereto. After a defendant222s concealed carry license has been revoked, continuing to carry a concealed weapon may constitute a violation of K.S.A. 21-6302, and amendments thereto. Violation of this order may subject Defendant to prosecution for such federal crimes, including but not limited to: Interstate travel to commit domestic violence; Interstate stalking; and Interstate violation of a protection order. Notice of Extension of this Temporary Order (Pursuant to K.S.A. 60-31a05) If a hearing on the petition for protection is continued, the court may extend this Temporary Order of Protection from Stalking, Sexual Assault, or Human Trafficking for additional periods of time as it deems necessary. N otice of Default (Pursuant to K.S.A. 60-255) If you fail to appear at the hearing, a default order may be entered against you and this Temporary Order of Protection from Stalking, Sexual Assault, or Human Trafficking may turn into a Final Protection from Stalking, Sexual Assault, or Human Trafficking without further notice to you. American LegalNet, Inc. www.FormsWorkFlow.com