Form CC 375PETITION FORPERSONAL PROTECTION ORDER(DOMESTIC RELATIONSHIP)Use this form if the person you want restrained is 18 years of age or older and:1) if you are married to the person you want restrained; or2) if you are not married to the person you want restrained but you live with or have lived with him or her and he or she is not your unemancipated minor child;or3) if you and the person you want restrained have a child in common even if you were never married to one another or never lived together;or4) if you and the person you want restrained have or had a dating relationship. American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTIONS FOR COMPLETING "PETITION FOR PERSONAL PROTECTION ORDER".you don't want him or her to do. If you are in immediate danger,which can be issued without waiting for a hearing. A þ Write your þ þ þ þ B þ C þ þ D þ þ þ þ þ þ þ þ E þ as much detail þ þ should be signed. Include dates and places. Write on a separate sheet of paper and attach it to this form. F þ þ þ þ þ þ þ G þ þ þ þ personal protection order. þ H þ þ I þ þ information and will give you your copies. American LegalNet, Inc. www.FormsWorkFlow.com A AgeAddress and telephone no. where court can reach petitioner 1. The petitioner and respondent are married to each other. þ were married to each other. þ have a child in common. þ have or had a dating relationship. þ reside or resided in the same household. 2. 3. a. þ There þ are þ are not þ other pending actions in this or any other court regarding the parties. þ Case number b. There þ are þ þ Case number b. entering onto the property at Address . . d. removing the minor children from the petitioner who has legal time order as long as removal of the chidlren does not violate other conditions of the personal protection order. following me or appearing within my sight. þ sending mail or other communications to me. þ contacting me by telephone. approaching or confronting me in a public place or on private property. f. interfering with efforts to remove my children/personal property from premises solely owned/leased by the respondent. . þ h. interfering with me at my place of employment or education or engaging in conduct that impairs my employment or educational relationship or environment. i. having access to information in records concerning a minor child of mine and the respondent that will reveal my þ ownership interest. þ removing any animal from my possession in which I have an ownership interest. þ retaining or obtaining possession of any animal in which I have an ownership interest. þ þ þ þ B C D F G H I E American LegalNet, Inc. www.FormsWorkFlow.com TO PROCESS SERVER: OFFICER CERTIFICATEOR þ AFFIDAVIT OF PROCESS SERVER adult who is not þ personal service þ Name of respondentComplete address of service þ I have personally attempted to serve a copy of the petition for personal protection order on the following respondent and have been unable to complete service. Name of respondentComplete address of service Signature Title Subscribed and sworn to before me on Signature . Signature of respondent CERTIFICATE/AFFIDAVIT OF SERVICE/NONSERVICE ACKNOWLEDGMENT OF SERVICE Petition forCase No.PROOF OF SERVICE Service fee$$Incorrect address fee$TOTAL FEE$$ American LegalNet, Inc. www.FormsWorkFlow.com