NOTICE TO RESPONDENT/REQUEST FOR HEARING - Page 1 of 4 (EPPDAPA 8/2016) IN THE CIRCUIT COURT OF THE STATE OF OREGON COUNTY OF (See CIF) ) Petitioner (date of birth) ) (name of person to be protected) ) NOTICE TO RESPONDENT/ ) REQUEST FOR HEARING ) (Elderly Persons / Persons w/Disabilities by and through his/her Guardian Petitioner: ) Abuse Prevention Act- Renewal) ) (name of Guardian Petitioner) ) ) Case No. v. ) (See CIF) ) Respondent (date of birth) ) (person to be restrained) THIS FORM MUST BE ATTACHED TO SERVICE COPY OF ORDER RENEWING RESTRAINING ORDER. To Respondent: The restraining order previously issued by the court has been renewed (continued) and remains in effect. The court has found that a person in the Petitioner222s situation would reasonably fear further acts of abuse by you if the order was not renewed. This renewed order becomes effective immediately. Requests for hearing must be made within 30 days after you receive the order. You must include your address and telephone number with your request for a hearing. The hearing will be held within 21 days. At the hearing, a judge will decide whether the order should be renewed. The only issue that will be considered at the hearing is the reason for the renewal unless the Petitioner agrees with your written request to hear other issues involving the restraining order. Keep in mind that the order you have received is in effect and remains in effect until the court that issued the order modifies or dismisses it or until it expires. If you are arrested for violating this order, the security amount (bail) is $5,000, unless a different amount is ordered by the court. This order, or any order continuing or changing this order, is enforceable in every county in Oregon. It is also enforceable in all 50 states, the District of Columbia, tribal lands, and territories of the United States. Violation of this order, or any order changing this order, constitutes contempt of court, punishable by a fine of up to $500 or one percent of your annual gross income, whichever is greater, or a jail term of up to six months, or both. Other sanctions may also be imposed for contempt. If you wish to contest the renewal of this order, you must com plete page 3 and mail or deliver it to (Name and Address of Court) American LegalNet, Inc. www.FormsWorkFlow.com NOTICE TO RESPONDENT/REQUEST FOR HEARING - Page 2 of 4 (EPPDAPA 8/2016) FIREARMS PROHIBITIONS MAY APPLY TO YOU If the original Restraining Order to Prevent Abuse ordered you not to possess or purchase firearms and has not been changed, it is unlawful for you to possess or purchase a FIREARM, including a rifle, pistol, or revolver, and AMMUNITION. ORS 124.020(1)(f). As a result of this Order, or any Order continuing or changing this Order, it may be unlawful for you to possess or purchase a firearm, including, a rifle, pistol, or revolver, or ammunition under federal law. 18 U.S.C. 247 922(g)(8). In addition, state law or local laws may prohibit you from such possession or purchase as a result of this Order or any Order continuing or changing this Order. ORS 166.250 to 166.270; and local law. This Order also may negatively affect your ability to serve in the Armed Forces of the United States or to be employed in law enforcement. If you have any questions whether these laws make it illegal for you to possess or purchase a firearm, you should consult an attorney. You may also be subject to further restrictions and prohibited from: 225 Traveling across state lines or tribal land lines with the intent to violate this Order and then violating this Order. 225 Causing the Petitioner to cross state lines or tribal land lines for the purpose of violating the order 225 Possessing, receiving, shipping or transporting any firearm or firearm ammunition. Other Laws May Also Apply To You Whether or not a Restraining Order is in effect, federal law may prohibit you from: 225 Traveling across state lines or tribal land lines with the intent to injure the Petitioner and then intentionally committing a crime of violence causing bodily injury to the Petitioner. 225 Causing the Petitioner to travel across state lines or tribal land lines if your intent is to cause bodily injury to the Petitioner or if the travel results in your causing bodily injury to the Petitioner. American LegalNet, Inc. www.FormsWorkFlow.com NOTICE TO RESPONDENT/REQUEST FOR HEARING - Page 3 of 4 (EPPDAPA 8/2016) REQUEST FOR HEARING (To Be Completed By Respondent Only) IN THE CIRCUIT COURT OF THE STATE OF OREGON COUNTY OF (See CIF) ) Petitioner (date of birth) ) (name of person to be protected) ) RESPONDENT222S REQUEST ) FOR HEARING by and through his/her Guardian Petitioner: ) (Elderly Persons and Persons With Disabilities ) Abuse Prevention Act) (name of Guardian Petitioner) ) ) v. ) Case No. (See CIF) ) Respondent (date of birth) ) (person to be restrained) I am the Respondent in the above-referenced action and I request a hearing to contest all or part of the Order Renewing Restraining Order as follows (mark one or more): The basis for the renewal. Other term(s) of the Order (please be specific): I will will not be represented by an attorney at the hearing. The name and Bar Number of the attorney (if known) are: I will need language interpretation services at the hearing. I will need Americans with Disabilities Act accommodations at the hearing. Notice of the time and place of the hearing can be mailed to me at the address below. Respondent222s Signature American LegalNet, Inc. www.FormsWorkFlow.com NOTICE TO RESPONDENT/REQUEST FOR HEARING - Page 4 of 4 (EPPDAPA 8/2016) Certificate of Document Preparation You are required to truthfully complete this certificate regarding the document you are filing with the court. Check all boxes and complete all blanks that apply: I selected this document for myself and I completed it without paid assistance. I paid or will pay money to for assistance in preparing this form. Submitted by: Print Name, Respondent Attorney for Respondent OSB No. (if applicable) Address or Contact Address City, State, Zip Telephone or Contact Telephone Number Use Safe Contact Address Use Safe Contact Number American LegalNet, Inc. www.FormsWorkFlow.com