FAMILY PROTECTION REGISTRY ADDENDUM TO INFORMATION SHEET Use this form for Vacates, Dismisses, Seals, Extensions, Violations, Warrants and Service. A copy of the original order of protection is not required. ******ASTERISKED AREAS ARE REQ UIRED ***** ORIGINAL ORDER INFORMATION: **COURT ORI No: **ORDER NO: NY0 __ __ __ __ ____ __ J 20____ - __ __ __ __ __ __ **COURT: **COUNTY: Court Contact: Name Tel: **DOCKET/INDEX NO: **Enjoined Party's Name: **Applying Party's Name: Law Enforcement Agency at which Copy of Order is Filed: **NAME: ORDER SERVED **POLICE ORI: NY __ __ __ __ __ __ __ Service Date: Police Agency _______________________________ Other: ___________________________ ORDER VACATED Date: Judge: CASE DISMISSED * Date: Judge: CASE SEALED * Date: Judge: Seal Section _________________ ORDER EXTENDED **Date of Extension: **New expiration date: Police to Serve Order Order served in Court (Date: Notification by Mail (Mail date: ) **SERVICE OF EXTENDED ORDER: Other (later service) **Judge: Order Previously Served (Date: (Family Court orders only) ) (no new service to be done) VIOLATION **Date of Filing: **Date of Disposition: **Disposition: Dismissed Gun license revoked **Judge: Resentence Convicted New OP WARRANT **Issue Date: Warrant Executed Return on Warrant Warrant Vacated (date: (date: (date: ) **Name: ) ) Revised 8/2013 American LegalNet, Inc. www.FormsWorkFlow.com