1. I, , the petitioner, want relief from abuse by ,the respondent, and I request a Permanent Protective Order against him or her.3.(NOTE: Fill in the following, checking the appropriate boxes. Petitioners need not give an address if doingso risks further abuse or reveals the confidential address of a shelter. If this is the case, check here .If you need additional paper, ask the clerk.)PETITION FOR PERMANENT PROTECTIVE ORDER(Family Law 247 4-506)CC-DC-DV-018 (Rev. 10/2018)2. I was the victim of the act of abuse and the person eligible for relief in the Interim Temporary Final Protective Order.PetitionerDate 5. I have filled in the Addendum to Petition for Protective Order (Description of Respondent), CC-DC-DV-001A.4. The original protective order also protected, and I want the Permanent Protective Order also to protect, thefollowing person(s):a. , age , who is a minor child vulnerable adult, and whoserelationship to respondent is:Nameb. , age , who is a minor child vulnerable adult, and whoserelationship to respondent is:Namec. , age , who is a minor child vulnerable adult, and whoserelationship to respondent is:Named. , age , who is a minor child vulnerable adult, and whoserelationship to respondent is:Namee. , age , who is a minor child vulnerable adult, and whoserelationship to respondent is:Name(Note: In a Permanent Protective Order, the court may only order the respondent not to abuse, threaten toabuse, contact, attempt to contact, and/or harass a person eligible for relief, and only if the court ordered thisrelief in the original protective order.)The respondent was convicted and sentenced to serve a term of imprisonment of at least five (5) years forthe act of abuse that led to the issuance of the Interim Temporary Final Protective Order andthe respondent has served at least 12 months of the sentence in Case Number .During the term of the Interim Temporary Final Protective Order, the individualcommitted an act of abuse against me (the person eligible for relief) and the respondent was convictedand sentenced to serve a term of imprisonment of at least five (5) years for the act and has served atleast 12 months of the sentence in Case Number .Street Address, Apt. No.Located at Case No.Court AddressCity/Countyvs.RespondentPetitioner Street Address, Apt. No.City, State, ZipHome:Work:Telephone City, State, ZipHome:Work:Telephone CIRCUIT COURT DISTRICT COURT OF MARYLAND FOR American LegalNet, Inc. www.FormsWorkFlow.com