rd 3 copy – Petitioner (pink) th 4 copy - Return (yellow) th 5 copy - Return (goldenrod) Original - Court st 1 copy - Law enforcement agency (file) (green) nd 2 copy - Respondent (blue) Approved, SCAO STATE OF MICHIGAN 6th JUDICIAL CIRCUIT-FAMILY DIVISION OAKLAND COUNTY CASE NO. PERSONAL PROTECTION ORDER AGAINST STALKING (NON DOMESTIC) EX PARTE Court address 1200 N. Telegraph Rd, Pontiac, MI 48341 Court telephone no. (248) 858-8720 ORI MI-630015J Petitioner’s name Respondent’s name Address and telephone no. where court can reach petitioner V Address and telephone no. where court can reach defendant Confidential address on file with the court Full name of respondent (type or print) * Height Weight Race * Driver’s license number (if known) Sex * Date of birth or Age * Hair Color Eye Color Other identifying information *these items must be filled in for the police/sheriff to enter on LEIN; the other items are not required but are helpful. Date: Judge: Bar no. 1. This order is entered without a hearing. after hearing. THE COURT FINDS: 2. A petition requesting an order to restrain conduct prohibited under MCL 750.411h and 750.411i has been filed under the authority of MCL 600.2950a. 3. Petitioner requested an ex parte order which should be entered without notice because irreparable injury, loss, or damage will result from delay required to give notice or notice itself will precipitate adverse action before an order can be issued. 4. Respondent committed the following acts of willful, unconsented contact: (state the reasons for issuance) IT IS ORDERED: is prohibited from stalking as defined under 5. Full name of respondent MCL 750.411h and MCL 750.411i which includes but is not limited to: following or appearing within sight of the petitioner. appearing at workplace/residence of the petitioner. approaching or confronting the petitioner in a public place or on private property. entering onto or remaining on property owned, leased, or occupied by the petitioner. sending mail/other communications to the petitioner. contacting the petitioner by telephone. placing an object on or delivering an object to property owned, leased, or occupied by the petitioner. threatening to kill or physically injure the petitioner. purchasing or possessing a firearm. other: 6. Violation of this order subjects the respondent to immediate arrest and to the civil and criminal contempt powers of the court. If found guilty, respondent shall be imprisoned for not more than 93 days and may be fined not more than $500.00 7. . This order is effective when signed, enforceable immediately, and remains in effect until This order is enforceable anywhere in this state by any law enforcement agency when signed by a judge, and upon service, may also be enforced by another state, an Indian tribe, or a territory of the United States. If respondent violates this order in a jurisdiction other than this state, respondent is subject to enforcement and penalties of the state, Indian tribe, or United States territory under whose jurisdiction the violation occurred. The court clerk shall file this order with OCSD/COUNTY CLERK who will enter it into the LEIN. 8. 9. 10. Respondent may file a motion to modify or terminate this order. For ex parte orders, the motion must be filed within 14 days after being served with or receiving actual notice of the order. Forms and instructions are available from the clerk of court. A motion to extend the order must be filed 3 days before the expiration date in item 7 or else a new petition must be filed. Date and time issued CC 380 (3/06) Judge PERSONAL PROTECTION ORDER AGAINST STALKING (NON DOMESTIC) MCL 600.2950a, MCR 3.705, MCR 3.706 American LegalNet, Inc. www.FormsWorkflow.com