STATE OF NORTH CAROLINA County Name And Address Of Plaintiff File No. In The General Court Of Justice District Court Division Name And Address Of Defendant VERSUS TEMPORARY NO-CONTACT ORDER FOR STALKING OR NONCONSENSUAL SEXUAL CONDUCT Ex Parte G.S. 50C-6 FINDINGS The Court hereby finds that: 1. The Court has jurisdiction over the subject matter. 2. This Order is entered ex parte. Immediate and irreparable injury, loss, or damage will result to the plaintiff before notice can be served and defendant heard in opposition because (define injury and state why it is irreparable) the efforts that have been made to give notice and reasons supporting the and it appears by certificate of the plaintiff plaintiff's claim that notice should not be required. that there is good cause to hear the matter ex parte because the harm that is intended to be prevented would likely occur if defendant were given prior notice of the plaintiff's efforts to obtain judicial relief. 3. This Order is entered after notice has been provided to the defendant. Present at the hearing were: the plaintiff, represented by the defendant, represented by 4. The plaintiff has suffered unlawful conduct by the defendant in that: . . 5. Other: CONCLUSIONS 1. The defendant committed acts of unlawful conduct against the plaintiff. 2. The plaintiff has failed to prove grounds for issuance of a temporary no-contact order. (Over) AOC-CV-523, Rev. 10/15 © 2015 Administrative Office of the Courts American LegalNet, Inc. www.FormsWorkFlow.com ORDER It is ORDERED that: 1. The defendant shall not visit, assault, molest, or otherwise interfere with the plaintiff. 2. The defendant cease stalking the plaintiff. 3. The defendant cease harassment of the plaintiff. 4. The defendant not abuse or injure the plaintiff. 5. The defendant not contact the plaintiff by telephone, written communication, or electronic means. 6. The defendant not enter or remain present at the plaintiff's residence, school, place of employment, and other places listed below at times when the plaintiff is present. List Other Places Where Defendant Ordered Not To Be 7. Other: (specify) 8. The terms of this Order shall be effective than 10 days) for ten (10) days from the date of this Order. . until (specify date and time if less 9. It is ordered that the parties appear at the time and date set out below for a hearing on whether a permanent no-contact order should be entered. Date Of Hearing Date Time Of Hearing Time AM PM AM PM Location Of Hearing Name Of District Court Judge Or Designated Magistrate (type or print) Signature Of District Court Judge Or Designated Magistrate NOTICE TO DEFENDANT: A KNOWING VIOLATION OF A CIVIL NO-CONTACT ORDER SHALL BE PUNISHABLE AS CONTEMPT OF COURT WHICH MAY RESULT IN A FINE OR IMPRISONMENT. THE COURT MAY FIND YOU IN CIVIL OR CRIMINAL CONTEMPT. CERTIFICATION I certify this Order is a true copy. Date Signature Of Clerk Deputy CSC Clerk Of Superior Court Assistant CSC NOTE TO CLERK: G.S. 50C-9 provides: "The clerk of court shall deliver on the same day that a civil no-contact order is issued, a certified copy of that order to the sheriff." The statute also provides that a copy of the order shall be issued promptly to the police department of the municipality of the victim's residence, or the sheriff and any county police department if the victim does not live within a municipality with a police department. AOC-CV-523, Side Two, Rev. 10/15 © 2015 Administrative Office of the Courts American LegalNet, Inc. www.FormsWorkFlow.com