STATE OF NORTH CAROLINA County Name nd ddress Of Petitioner File No. In The General Court Of Justice District Court Division VERSUS Name nd ddress Of Respondent NOTICE OF HEARING ON NO-CONTACT ORDER PURSUANT TO THE WORKPLACE VIOLENCE PREVENTION ACT TEMPORARY ORDER PERMANENT ORDER G.S. 95-263; -266 To The Respondent Named Above The attached Complaint has been filed alleging that you have committed unlawful conduct upon an employee of the petitioner. 1. A hearing will be held before a district court judge at the date, time and location indicated below. At that time it will be determined whether a temporary order should be granted. 2. A hearing will be held before a district court judge at the date, time and location indicated below. At that hearing it will be determined whether a permanent no-contact order should be granted. Date Of Hearing Time Of Hearing Date AM Location Of Hearing PM Signature Deputy CSC Assistant CSC Clerk Of Superior Court NOTE TO CLERK: If this notice of hearing is for a temporary order, attach it with the complaint and summons to be served by the sheriff. If a temporary no-contact order has been issued that order includes a notice of hearing for a permanent order and this separate notice of hearing should not be used unless the hearing date set in the temporary order is being changed. If the complaint and summons have already been served and this notice is issued at a later date you are responsible for mailing a copy of this Notice of Hearing to the respondent. In that situation only, you must mail a copy of the notice by first class mail and complete the "Certificate Of Service" set out below. NOTE TO PETITIONER: CERTIFICATE OF SERVICE I certify that on the date of mailing shown below a copy of this Notice was served on the respondent at the address listed above by depositing a copy in a post-paid, properly addressed envelope in a post office or official depository under the exclusive care and custody of the United States Postal Service. Date Of Mailing Date Of Certification Signature Of Petitioner AOC-CV-532, New 7/11 © 2011 Administrative Office of the Courts American LegalNet, Inc. www.FormsWorkFlow.com