Criminal Form 2 8/2010 ORI No: _____________ At a term of the _________________ Court County of _______________________ Order No: _____________ at the Courthouse at (address)_____________________________State of New York NYSID No: _____________ CJTN No. ________________ ORDER OF PROTECTION Present: Hon ______________________________, Non-Family Offense – C.P.L. 530.13 1 ________________________________________ (Not involving victims of domestic violence) People of the State of New York ‘ Youthful Offender (check if applicable) -againstPart_____ Index/Docket No.________________ Indictment No., if any: ____________________ _________________________________________ Charges ________________________________ Defendant (Check one): ‘ Ex parte Date of Birth: ‘ Defendant Present in Court NOTICE: YOUR FAILURE TO OBEY THIS ORDER M AY SUBJECT YOU TO M ANDATORY ARREST AND CRIM INAL PROSECUTION, W HICH M AY RESULT IN YOUR INCARCERATION FOR UP TO SEVEN YEARS FOR CONTEM PT OF COURT. IF THIS IS A TEM PORARY ORDER OF PROTECTION AND YOU FAIL TO APPEAR IN COURT W HEN YOU ARE REQUIRED TO DO SO, THIS ORDER M AY BE EXTENDED IN YOUR ABSENCE AND THEN CONTINUES IN EFFECT UNTIL A NEW DATE SET BY THE COURT. ------------------------------------------------------------------------------------------------------------------------------------------------------------‘ TEM PORARY ORDER OF PROTECTION. W hereas good cause has been shown for the issuance of a temporary order of protection [as a condition of ‘ recognizance ‘ release on bail ‘ adjournment in contemplation of dismissal], ‘ ORDER OF PROTECTION. W hereas defendant has been convicted of [specify crime or violation]: _______________________________________________________________________________________________ And the Court having made a determination in accordance with section 530.13 of the Criminal Procedure Law, IT IS HEREBY ORDERED that the above-named defendant observe the following conditions of behavior: (Check applicable paragraphs and subparagraphs): ‘ Stay away from “ [name(s) of protected person(s) or witness(es)]:________________________________ and/or from the “ home of _______________________________________________________________ “ school of ______________________________________________________________ “ business of ____________________________________________________________ “ place of employment of __________________________________________________ “ other__________________________________________________________________ ; ‘ Refrain from communication or any other contact by mail, telephone, e-mail, voice-mail or other electronic or any other means with [specify protected person(s)]: ; ‘ Refrain from assault, stalking, harassment, aggravated harassment, menacing, reckless endangerment, strangulation, criminal obstruction of breathing or circulation, disorderly conduct, criminal mischief, sexual abuse, sexual misconduct, forcible touching, intimidation, threats or any criminal offense or interference with the victim or victims of , or designated witnesses to, the alleged offense and such members of the family or household of such victim(s) or witness(es) as shall be specifically named [specify]: ; ‘ Refrain from intentionally injuring or killing without justification the following companion animal(s) (pet(s)) [specify type(s) and, if available, name(s)]: ; ‘ Surrender any and all handguns, pistols, revolvers, rifles, shotguns and other firearms owned or possessed, including, but not limited to, the following: ________________________________________and do not obtain any further guns or other firearms. Such surrender shall take place immediately, but no later than [specify date/time]:___________________________ at:__________________________________________________________________________________________________ ‘ Specify other conditions defendant must observe for the purposes of protection: ; IT IS FURTHER ORDERED that the above-named Defendant's license to carry, possess, repair, sell or otherwise dispose of a firearm or firearms, if any, pursuant to Penal Law §400.00, is hereby “ suspended or “ revoked (note: final order only), and/or “ the Defendant shall remain ineligible to receive a firearm license during the period of this order. (Check all applicable boxes). NOTE: If this paragraph is checked, a copy of this form must be sent to: New York State Police, Pistol Permit Section, State Campus Building #22, 1220 W ashington Avenue, Albany, New York 12226-2252. IT IS FURTHER ORDERED that this order of protection shall remain in force until and including [specify date]: but if you fail to appear in court on this date, the order may be extended and continue in effect until a new date set by the Court. DATED:________________ ________________________________________________ JUDGE / JUSTICE COURT (COURT SEAL) ‘ Defendant advised in Court of issuance and contents of Order. ‘ Order personally served on Defendant in Court ____________________________________________ (Defendant’s signature) ‘ Order to be served by other means [specify]:_ _____ ‘ W arrant issued for Defendant ‘ ADDITIONAL SERVICE INFORMATION: [specify]: _________________________________________ , The Criminal Procedure Law provides that presentation of a copy of this order of protection to any police officer or peace officer acting pursuant to his or her special duties shall authorize, and in some situations may require, such officer to arrest a defendant who has violated its terms and to bring him or her before the Court to face penalties authorized by law. Federal law requires that this order must be honored and enforced by state and tribal courts, including courts of a state, the District of Columbia, a commonwealth, territory or possession of the United States, if the person against whom the order is sought is an intimate partner of the protected party and has been or will be afforded reasonable notice and opportunity to be heard in accordance with state law sufficient to protect that person's rights (18 U.S.C. §§2265, 2266). It is a federal crime to: • cross state lines to violate this order or to stalk, harass or commit domestic violence against an intimate partner or family member; • buy, possess or transfer a handgun, rifle, shotgun or other firearm or ammunition while this Order remains in effect (Note: there is a limited exception for military or law enforcement officers but only while they are on duty); and • buy, possess or transfer a handgun, rifle, shotgun or other firearm or ammunition after a conviction of a domestic violence-related crime involving the use or attempted use of physical force or a deadly weapon against an intimate partner or family member, even after this Order has expired. (18 U.S.C. ''922(g)(8), 922(g)(9), 2261, 2261A, 2262). 1 Use this form for non-family offense orders of protection, issued pursuant to CPL §530.13, that are not issued to protect victims of family offenses, intimate partners and family and household members and are not entered onto the statewide domestic violence registry. See Exec. L. §221-a(1); CPL §§530.11(1), 530.12(1), 530.13. American LegalNet, Inc. www.FormsWorkFlow.com