American LegalNet, Inc. www.FormsWorkFlow.com 24-971. Stipulated order of protection against petitioner. ADDITIONAL PAGES1 OFSTIPULATED ORDER OF PROTECTIONAGAINSTThe court further FINDS, CONCLUDES AND ORDERS: (check only applicable paragraphs) 1.NOTICE, APPEARANCES AND STATUS This order was entered on stipulation of the parties.[ ]The relationship of the parties is that of an "intimate partner" as defined in18 USC Section 921(a)(32). (See 2 below)2.EFFECT OF STIPULATION TO ORDER OF PROTECTION Violation of this order can have serious consequences, including: A.If you violate the terms of this order, you may be charged with amisdemeanor, which is punishable by imprisonment of up to three hundredsixty-four (364) days and a fine of up to one thousand dollars ($1,000) orboth. You may be found to be in contempt of court. B.If you are the spouse or former spouse of the other party, an individual whocohabitates with or has cohabitated with the other party, or if you and theother party have had a child together, federal law prohibits you frompossessing or transporting firearms or ammunition while this order is ineffect. If you have a firearm or ammunition, you should immediately disposeof the firearm or ammunition. Violation of this law is a federal crimepunishable by imprisonment for up to ten (10) years and a fine of up to twohundred fifty-thousand dollars ($250,000). C.If you are not a citizen of the United States, violation of this order may havea negative effect on your application for residency or citizenship. 3.DOMESTIC ABUSE PROHIBITED The petitioner shall not abuse the respondent or members of the respondent'shousehold. "Abuse" means any incident by petitioner against the respondent orrespondent's household member resulting in (1) physical harm; (2) severe emotionaldistress; (3) bodily injury or assault; (4) a threat by petitioner causing imminent fearof bodily injury to respondent's or respondent's household members; (5) criminaltrespass; (6) criminal damage to property; (7) repeatedly driving by respondent's or American LegalNet, Inc. www.FormsWorkFlow.com 3respondent's household members' residence or workplace; (8) telephone harassment;(9) stalking; (10) harassment; or (11) harm or threatened harm to children in anymanner set forth above. Petitioner shall not ask or cause other persons to abuse the respondent orrespondent's household members. 4.CONTACT PROHIBITIONS Petitioner shall stay yards away from the respondent and therespondent's home and workplace at all times, unless at a public place, where thepetitioner shall remain yards away from the respondent except asspecifically permitted by this order. Petitioner shall not telephone, talk to, visit or contact respondent in any way exceptas follows: [ ]The parties may contact each other by telephone regarding medicalemergencies of minor children; [ ].[ ]The parties may attend joint counseling sessions at the counselor'sdiscretion. (Unless the court has entered an order sealing the protected party222s address, include itbelow.) Protected party222s addresses (home address) (work address) (city) (if applicable, tribe or pueblo) (state and zip code) 5.COUNSELING [ ]Petitioner shall attend and complete counseling at ,contacting that office within five (5) days. The petitioner shall participate in,attend and complete counseling as recommended by the named agency. [ ]Respondent shall attend and complete counseling at ,contacting that office within five (5) days. The respondent shall participatein, attend and complete counseling as recommended by the named agency.[ ]Petitioner shall report to for a [ ] drug [and] [ ] alcoholscreen by , (date) with the results returned tothis court. American LegalNet, Inc. www.FormsWorkFlow.com 4[ ]Respondent shall report to for a [ ] drug [and] [ ]alcohol screen by , (date) with the resultsreturned to this court. [ ]Other counseling requirements: .6.CUSTODY2 [ ]The court's orders regarding the minor [child] [children] of the parties arefound in the Custody, Support and Division of Property Attachment of thisorder of protection. 7.PROVISIONS RELATING TO SUPPORT2 [ ]The court's orders regarding support issues for the parties are found in theCustody, Support and Division of Property Attachment of this order ofprotection. 8.PROPERTY, DEBTS, PAYMENTS OF MONEY2 [ ]The court's orders regarding property, debts and payment of money areaddressed in the Custody, Support and Division of Property Attachment ofthis order of protection. 9.ADDITIONAL ORDERS [ ]Review hearing. The parties are ordered to appear for a review hearing on the day of , , at (a.m.) (p.m). Failure to appear may result in the issuance of a bench warrantfor your arrest or dismissal of this order.Any party ordered to attend counseling shall bring proof of counseling to the reviewhearing. IT IS FURTHER ORDERED3: .10.RESPONDENT SHALL NOT CAUSE VIOLATION While this order of protection is in effect, the respondent should refrain from any actthat would cause the petitioner to violate this order. This provision is not intended to anddoes not create a mutual order of protection. Under Section 40-13-6(D) NMSA 1978, onlythe restrained party can be arrested for violation of this order. American LegalNet, Inc. www.FormsWorkFlow.com 511.NOTICE TO LAW ENFORCEMENT AGENCIES ANY LAW ENFORCEMENT OFFICER SHALL USE ANY LAWFUL MEANSTO ENFORCE THIS ORDER. [ ]Petitioner is ordered to surrender all keys to the residence to law enforcementofficers. [ ]Law enforcement officers or shall be present during any propertyexchange. [ ]This order supersedes prior orders in County, State of, Cause No. to the extent thatthere are contradictory provisions. 12.NOTICE TO PETITIONER AND RESPONDENT This order does not serve as a divorce and does not permanently resolve childcustody or support issues. 13.AGREEMENT OF PARTIES Without admitting that domestic abuse has occurred, the parties stipulate to the entryof this order and affirm that they have read and do understand the effects of this order asstated in Paragraph 2. Petitioner's signature Respondent's signature Petitioner's counsel, if any Respondent's counsel, if any Date Date 14.RECOMMENDATIONS I have: [ ]reviewed the pleading for order of protection; [ ]prepared this order as my recommendation to the district court judgeregarding disposition of requests for order of protection. Signed American LegalNet, Inc. www.FormsWorkFlow.com 6Domestic Violence Commissioner Court's telephone number: SO ORDERED. District Judge [ ]A copy of this order was [ ] hand delivered [ ] faxed [ ] mailed to [ ] respondent [ ]respondent's counsel on (date).4 [ ]A copy of this order was [ ] hand delivered [ ] faxed [ ] mailed to [ ] petitioner [ ]petitioner's counsel on (date). Signed USE NOTES 1. The first page of this stipulated order of protection form shall be in the uniformformat preceding the heading for additional pages of the order.2. See Form 4-967 NMRA, "Custody, Support and Division of Property Attachment".3. If appropriate, an order providing for restitution may be included in this paragraph.4. Petitioner may be served at the time this order is issued. If petitioner is not presentat the time this order is issued, service upon petitioner shall be made by deliveringa copy to the party. See Section 40-13-6(A) NMSA 1978. [Approved, effective April 9, 2002; as amended by Supreme Court Order 07-8300-20,effective September 17, 2007; as amended by Supreme Court Order No. 08-8300-40,effective December 15, 2008.] American LegalNet, Inc. www.FormsWorkFlow.com