1 Case No. ____________________ Dept. No.____________________ 2 3 IN THE JUSTICE COURT OF _____________ TOWNSHIP 4 COUNTY OF __________________, STATE OF NEVADA 5 _____________________________________, ) Employer, ) TEMPORARY ORDER FOR ) PROTECTION AGAINST HARASSMENT 7 ) IN THE WORKPLACE (NRS 33.270) ) vs. 8 ) Date Issued: ______________ ) Expiration Date: 9 _____________________________________, ) [ ] ________________, unless otherwise Adverse Party. Ordered by the Court 6 10 11 12 13 14 WARNING: This is an official Court Order. If you disobey this Order, you may be arrested and prosecuted for the crime of violating an Order for Protection Against Harassment in the Workplace and any other crime that you may have committed in disobeying this Order. An intentional violation of a Temporary Order for Protection Against Harassment in the Workplace is a misdemeanor, unless a more severe penalty is prescribed by law for the act that constitutes the violation of the Order. Under NRS 193.150, a misdemeanor is punishable by imprisonment in the county jail for not more than 6 months, or by a fine of not more than $1,000.00, or by both fine and imprisonment. 15 16 17 18 19 PURSUANT TO NRS 193.166, if the act that constitutes the violation of a protection order is itself a felony, the violator shall, in addition to the term of imprisonment prescribed by statute for the crime, be punished by imprisonment in the state prison for a minimum term of not less than 1 year and a maximum term of not more than 20 years. YOU ARE FURTHER NOTIFIED that you CAN BE ARRESTED even if the person who obtained the Order invites or allows you to contact them. You have the sole responsibility to avoid or refrain from violating the terms of this Order. Only the Court can change the Order upon written application. 20 An Application for an Order pursuant to NRS 33.270 having been filed by, or on behalf of, 21 the above-named employer, and the Court having reviewed said Application, and having 22 reviewed facts and any additional information provided to the Court, and the Court having 23 24 25 jurisdiction over the parties and the subject matter, and sufficient representations having been made that you, the Adverse Party, have threatened and/or committed Harassment in the Workplace, and good cause appearing therefore, the Court hereby finds: Form B-8 Temporary Order for Protection Against Harassment in the Workplace Page 1 of 5 ©2007 Nevada Supreme Court Revised July 27, 2007 NOTICE FINDINGS 1 2 3  The Adverse Party had advance notice about the Application for this Temporary Order for Protection Against Harassment in the Workplace. OR 4 5 6 7 8 9 The Adverse Party did not have advance notice about the Application for this Temporary Order for Protection Against Harassment in the Workplace. Therefore, the Court is required to convey the following information to the Adverse Party: (1) The Adverse Party is entitled to a hearing on this Order, pursuant to NRS 33.270. Upon the filing of a motion for hearing, the Court will proceed to hear and determine the motion as expeditiously as the ends of justice require. At the hearing, the Court may dissolve or modify the Order. 10 11 (2) The name and address of the Court in which the petition for a hearing may be filed is as follows: ______________________________________________________________________ 12 ______________________________________________________________________ 13 (3) This Order will be immediately filed with the clerk of the Court. 14 (4) The irreparable injury, loss, or damage which may result is: _____________________ 15 ______________________________________________________________________ 16 It is irreparable because of: 17  Possible economic or property damage which may include the following: 18 ____________________________________________________________________ 19 ____________________________________________________________________ 20 Continuous threat of stalking/harassment 21 Assault/Battery (personal injury) Possible death to specified individuals named in the Application. 22 Other: 23 24 ____________________________________________________________________ (5) This Order is being granted without notice for reasons set forth in the Application. 25 Form B-8 Temporary Order for Protection Against Harassment in the Workplace Page 2 of 5 ©2007 Nevada Supreme Court Revised July 27, 2007 1 2 IT IS HEREBY ORDERED that the Temporary Order for Protection Against Harassment in the Workplace is granted. 3 IT IS FURTHER ORDERED that you, the Adverse Party, are prohibited, either 4 directly or through an agent, from contacting, intimidating, using, attempting to use, or 5 threatening the use of physical force, or otherwise interfering in any way with the employer, 6 an employee of the employer while the employee is performing his duties of employment, and 7 any person while the person is present at the workplace of the employer, including, but not 8 limited to, in person, by telephone, through the mail, through electronic mail (e-mail), 9 facsimile (fax), or through another person. 10 IT IS FURTHER ORDERED that you stay away from the workplace of the 11 employer, wherever situated within the State, including, but not limited to, the following 12 specific workplace address(es): _________________________________________________ 13 Town/City of __________________, County of ________________, State of _____________ 14 Other: _____________________________________________________________________ 15 ___________________________________________________________________________ 16 ___________________________________________________________________________ 17 IT IS FURTHER ORDERED that the following additional restrictions apply: 18 ___________________________________________________________________________ 19 ___________________________________________________________________________ 20 ___________________________________________________________________________ 21 ___________________________________________________________________________ 22 ___________________________________________________________________________ 23 ___________________________________________________________________________ 24 ___________________________________________________________________________ 25 ___________________________________________________________________________ Form B-8 Temporary Order for Protection Against Harassment in the Workplace Page 3 of 5 ©2007 Nevada Supreme Court Revised July 27, 2007 1 IT IS FURTHER ORDERED THAT THIS TEMPORARY ORDER WILL 2 REMAIN IN EFFECT UNTIL 11:59 PM ON THE DATE SET FORTH ON PAGE 1 3 UNLESS THE COURT ORDERS OTHERWISE. If an application for an Extended Order is filed, this Temporary Order will remain in effect until the hearing on an Extended Order is 4 held. 5 IT IS FURTHER ORDERED that the Clerk of the Court shall transmit, by the end 6 of the next business day after this Temporary Order is issued, a copy of the Order, together 7 with a copy of the Application, to the following law enforcement agencies: 8 ___________________________________________________________________________ ___________________________________________________________________________ 9 ___________________________________________________________________________ 10 11 12 13 14 15 16 17 18 19 IT IS FURTHER ORDERED that the appropriate law enforcement agency/process server promptly attempt to serve this Order, together with a copy of the Application upon the Adverse Party, and upon service, file proof of service with the Court by the end of the next business day after service is made. Service must be made pursuant to the Rules of Civil Procedure. If an application for an Extended Order has been filed: ______ IT IS FURTHER ORDERED that a hearing on the issuance of an Extended Order is set in Department ____ at ____ ___.m. on the ______ day of _______________, 20_____. THIS TEMPORARY ORDER REMAINS IN EFFECT UNTIL THE HEARING ON THE EXTENDED ORDER HAS BEEN HELD. (NOTE: THIS HEARING WILL BE HELD WITHIN TEN (10) JUDICIAL DAYS PURSUANT TO NRS 33.270(6)(c), UNLESS COMPELLING REASONS REQUIRE OTHERWISE.) 20 21 22 23 YOU and YOUR witnesses may approach and enter the Courthouse to attend the hearing but must stay away from Applicant and Applicant’s witnesses while approaching, leaving, and within the Courthouse. IF AN EARLIER HEARING DATE IS REQUIRED, THE ADVERSE PARTY MAY APPLY TO THE ABOVE COURT FOR RELIEF. 24 25 Form B-8 Temporary Order for Protection Against Harassment in the Workplace Page 4 of 5 ©2007 Nevada Supreme Court Revised July 27, 2007 NOTICE TO LAW ENFORCEMENT 1 2 Any law enforcement officer, with or without a warrant, and whether or not a 3 violation occurs in the presence of the officer, may arrest and take into custody the 4 Adverse Party, when the law enforcement officer has probable cause to believe that (a) 5 an Order has been issued pursuant to NRS 33.270 against the Adverse Party; (b) the 6 Adverse Party has been served with a copy of the Order; and (c) the Adverse Party is 7 acting or has acted in violation of the Order. 8 9 Any law enforcement agency in Nevada may enforce a Court Order issued pursuant to NRS 33.270 without regard to the county in which the Order was issued. 10 If a law enforcement officer cannot verify that the Adverse Party was served with 11 a copy of this Order, the officer shall serve the Adverse Party with a copy of the Order if 12 a copy is available. 13 IT IS SO ORDERED this ________________ day of ________________________, 20___. 14 _______________________________________ JUDGE 15 PROOF OF SERVICE UPON THE ADVERSE PARTY 16 17 18 19 20 21 22 23 I, the undersigned, personally served the Adverse Party named above with a copy of this Temporary Order for Protection Against Harassment in the Workplace, together with a copy of the Application. ___________________________________________ Signature ___________________________________________ Print Name ___________________________________________ Date of Service ___________________________________________ Time of Service 24 25 Form B-8 Temporary Order for Protection Against Harassment in the Workplace Page 5 of 5 ©2007 Nevada Supreme Court Revised July 27, 2007