STATE OF NORTH CAROLINA County Name Of Plaintiff File No. In The General Court Of Justice District Court Division VERSUS Name And Address Of Defendant MOTION FOR RETURN OF WEAPONS SURRENDERED UNDER DOMESTIC VIOLENCE PROTECTIVE ORDER AND NOTICE OF HEARING G.S. 50B-3.1(f), (g) MOTION BY DEFENDANT FOR RETURN As required by the Court in the domestic violence protective order in this case, I surrendered the following property to the County: (check all that apply) Sheriff of firearms. ammunition. permit to purchase firearms. permit to carry a concealed weapon. The domestic violence protective order that required the surrender of the property listed above expired on the date listed below and has not been renewed. There is is not a pending motion to renew. As indicated by the affidavit on Pages 2 and 3, I am not precluded by any state or federal law from owning or possessing a firearm and I have no pending criminal charges in state or federal court alleged to have been committed against the person who is protected by the domestic violence protective order. I request the court to order the sheriff to return the items I surrendered. Date Protective Order Expired Date Signature Of Defendant MOTION BY THIRD-PARTY OWNER FOR RETURN Pursuant to the domestic violence protective order entered in this case, the defendant surrendered to the Sheriff of County the firearms, ammunition, and gun permits on the date listed below. I, and not the defendant, am the owner of the surrendered property described below. I request the Court to return this property to me. I am not precluded by any state or federal law from owning or possessing a firearm as indicated by the affidavit on Pages 2 and 3. This motion is filed not later than 30 days after the surrender of the items. (Describe firearms, ammunition, gun permits that belong to person filing motion) Name And Address Of Third-Party Owner (Type Or Print) Date Weapons Surrendered Date Signature Of Third-Party Owner (See Reverse) AOC-CV-319, Page 1 of 4, Rev. 2/06 © 2006 Administrative Office of the Courts AFFIDAVIT WARNING: This affidavit must be filled out completely and truthfully. False statements may result in criminal prosecution. Name (Last, First, Middle) Street Current Residence Maiden Name, Nickname, Alias Apartment No. Apartment No. Previous Residence Street City, State, Zip Code City, State, Zip Code Other States Of Residence Are You A U.S. Citizen? If No, List Country Of Citizenship Work Telephone Yes No Home Telephone Social Security Number Employer Drivers License/ID No. Occupation State Employer Address (Street, City, State, Zip Code) Sex Date Of Birth Place Of Birth Race Height Weight Hair Color Eye Color Distinguishing Scars, Piercings, Tattoos, Etc. (describe): 1. Do you have any criminal charges in state or federal court, including traffic offenses, pending against you? What type of charge and where is it pending? Name alleged victim and relationship to you Have you ever been convicted of a misdemeanor crime of violence (including domestic violence) in either a state or federal court? What was the crime? When and where were you convicted? Who was the victim of the crime? Have you ever been convicted of a felony in either a state or federal court? What was the crime? When and where were you convicted? Have you ever been convicted of driving while impaired in either a state or federal court? When and where were you convicted? Are there any outstanding warrants for your arrest? Where and for what reason? Are you under indictment for a crime at this time? Where and for what reason? Are you currently subject to a domestic violence protective order or any other order that restrains you from harassing, stalking, threatening or engaging in any conduct that would place anyone in reasonable fear of bodily injury? What court issued the order? Yes No 2. Yes No 3. Yes No 4. Yes No 5. 6. 7. Yes No Yes No Yes No IMPORTANT: You must attach a copy of the protective/restraining order to this affidavit. 8. 9. Were you ever a member of the military? If yes, what kind of discharge did you receive? Are you currently using or are you addicted to any controlled substance, including marijuana, cocaine, methamphetamine or heroin? Yes Yes No No AOC-CV-319, Page 2 of 4, Rev. 2/06 © 2006 Administrative Office of the Courts Name Of Defendant File No. 10. Have you ever been a patient in any mental institution or hospital? When and where? Have you ever been adjudicated incompetent by a court? When and where? Yes No 11. Yes No VERIFICATION I, the undersigned being duly sworn, verify that the information submitted above is true, correct and complete to the best of my knowledge and belief. SWORN/AFFIRMED AND SUBSCRIBED TO BEFORE ME Date Signature Of Person Authorized To Administer Oaths Signature Of Applicant Name Of Person Authorized To Administer Oaths Name Of Applicant Type Or Print) Deputy CSC Notary County Where Notarized Assistant CSC Clerk Of Superior Court Date Date My Commission Expires SEAL NOTICE OF HEARING Pursuant to a motion made by the defendant a third-party a hearing will be held before a district court judge at the date, time and location indicated below to determine whether to return the weapons surrendered to the defendant. the third-party claiming the weapons surrendered is the owner of the items listed in the motion and is entitled to have the items returned to him/her. The plaintiff has a right to appear and be heard at this hearing. Date Of Hearing Time Of Hearing Location Of Hearing AM Date Signature Of Clerk PM Deputy CSC Clerk Of Superior Court Assistant CSC NOTE TO CLERK: You must give a copy of this notice of hearing to the defendant or third-party when the motion is filed and you must mail a copy by first class mail to the plaintiff and give a copy to the sheriff. If the motion is filed by a third person, you must also mail notice of the hearing to the defendant. CERTIFICATION I certify that on the date of mailing shown below a copy of this Motion And Notice Of Hearing was served on the plaintiff at the address listed below by depositing a copy in a postpaid properly addressed envelope in a post office or official depository under the exclusive care and custody of the United States Postal Service. On the same date a copy was served on the defendant at the address listed on this motion by the same method. Address Of Plaintiff (Type Or Print) Date Of Mailing Date Of Certification Signature Of Clerk Deputy CSC Clerk Of Superior Court Assistant