Request For Modification To Harassment Protection Order Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Request For Modification To Harassment Protection Order Form. This is a Nebraska form and can be use in District Court Statewide.
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Tags: Request For Modification To Harassment Protection Order, DC19-23, Nebraska Statewide, District Court
Nebraska State Court Form REQUEST FOR MODIFICATION TO HARASSMENT PROTECTION ORDER DC 19:23 Rev. 1/17 Neb. Rev. Stat. 247 28-311.09 Page 1 of 2 Request for Modification to Harassment Protection Order DC 19:23 Rev. 1/17 COUNTY, NEBRASKA IN THE DISTRICT COURT OF Petitioner, Additional Petitioner/Minor Child(ren), Additional Petitioner/Minor Child(ren), vs. Respondent. Case No. REQUEST FOR MODIFICATION TO HARASSMENT PROTECTION ORDER 1.I/We, , am/are the petitioner(s) in this case. I am requesting amodification to the existing harassment protection order issued on, , pursuant to Neb. Rev. Stat. 247 28-311.09. 2.This request will apply to the following protected party(ies): 3.The modification(s) requested is/are detailed below: 4.Reasons for modification are stated below: 1. 2. 3. 4. 5. 6. American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2 Request for Modification to Harassment Protection Order DC 19:23 Rev. 1/17 NOTE: DO NOT SIGN UNTIL THE CLERK OF THE DISTRICT COURT OR A NOTARY IS PRESENT AND WITNESSES YOU SIGNING I hereby swear, or affirm, under penalty of perjury, the forgoing is true. *If you are concealing your address or phone, do not provide them. Make separate arrangements with the clerk. Date Signature of Petitioner Name *Street Address/P.O. Box Bar Number and Firm Name (attorneys only) City/State/ZIP Code Phone E-mail Address Subscribed and sworn before me on , Clerk of the District Court/Notary Public (Seal) My Commission Expires: American LegalNet, Inc. www.FormsWorkFlow.com