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 CASE NO. 6TH JUDICIAL CIRCUIT DIVISION COUNTY OF OAKLAND PERSONAL PROTECTION ORDER AGAINST STALKING BY A MINOR (NON DOMESTIC), PAGE 1 { } EX PARTE Court address 1200 N. Telegraph Rd, Pontiac, MI 48341 Court telephone no (248) 858-8720 ORI MI-630013J Petitioner’s name Respondent’s name, address, and telephone no. Address and telephone no. where court can reach petitioner V Confidential address on file with the court Driver’s license number (if known) Full name of respondent (type or print) * Height Weight Race* 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. Full name of respondent’s parent, guardian, custodian (type or print) Full name of respondent’s parent, guardian, custodian (type or print) Address and telephone no. if different from above Address and telephone no. if different from above. Date: Judge: Bar no. 1. This order is entered without a hearing. after hearing. THE COURT FINDS: 2. 3. 4. 5. 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. The respondent is less than 18 years of age, is unemancipated, and is not the minor child of the petitioner. The petitioner is less than 18 years of age, is unemancipated, and is not the minor child of the respondent. 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. 6. Respondent committed the following acts of willful, unconsented contact: (state the reasons for issuance) IT IS ORDERED: 7. is prohibited from stalking as defined under Name MCL 750.411h and MCL 750.411i which includes but is not limited to: a. following or appearing within the sight of the petitioner. b. appearing at the workplace/residence of the petitioner. c. approaching or confronting the petitioner in a public place or on private property. d. entering onto or remaining on property owned, leased, or occupied by the petitioner. . . (PLEASE SEE OTHER SIDE) MCL 600.2950a, MCL 712A.2h, MCR 3.705, MCR 3.706 CC 380M (3/06) PERSONAL PROTECTION ORDER AGAINST STALKING BY A MINOR (Non Domestic), Page 1 American LegalNet, Inc. www.FormsWorkflow.com STATE OF MICHIGAN 6TH JUDICIAL CIRCUIT DIVISION COUNTY OF OAKLAND CASE NO. PERSONAL PROTECTION ORDER AGAINST STALKING BY A MINOR (NON DOMESTIC), PAGE 2 EX PARTE Court address 1200 N. Telegraph Rd, Pontiac, MI 48341 Court telephone no (248) 858-8720 ORI MI-630013J Petitioner’s name Respondent’s name V IT IS FURTHER ORDERED: 7. (continued from page 1) e. sending mail/other communications to the petitioner. f. contacting the petitioner by telephone. g. placing an object on or delivering an object to property owned, leased, or occupied by the petitioner. h. threatening to kill or physically injure Name i. j. 8. purchasing or possessing a firearm. other: 10. If the respondent is 17 years of age or more, violation of this order subjects the respondent to immediate arrest and to the civil and criminal contempt powers of the court. If found guilty of a violation, the respondent shall be imprisoned for not more than 93 days and may be fined not more than $500.00 b. 9. a. If the respondent is less than 17 years of age, violation of this order subjects the respondent to immediate apprehension or being taken into custody. If found guilty of a violation, the respondent shall be subject to the dispositional alternatives listed in MCL 712A.18. 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 who shall enter it into the LEIN. OCSD/COUNTY CLERK Name of law enforcement agency 11. The respondent may file a motion to modify or terminate this order. If this is an ex parte order, a motion to modify or terminate this order and a request for a hearing must be made within 14 days after the respondent has been served or has received actual notice of this order. Forms and instructions are available from the clerk of the court. 12. A motion to extend the order must be filed 3 days before the expiration date in item 9 or else a new petition must be filed. 13. Other: Date and time issued CC 380M (3/06) Judge PERSONAL PROTECTION ORDER AGAINST STALKING BY A MINOR (Non Domestic), Page 2 American LegalNet, Inc. www.FormsWorkflow.com