NOTICE TO RESPONDENT & REQUEST FOR HEARING - Page 1 of 3 (EPPDAPA 8 /2016) THIS FORM MUST BE ATTACHED TO ALL COPIES OF THE RESTRAINING ORDER IN THE CIRCUIT COURT OF THE STATE OF OREGON COUNTY OF (See CIF) ) Petitioner (name of person to be protected) (date of birth) ) ) NOTICE TO RESPONDENT/ ) REQUEST FOR HEARING by and through his/her Guardian Petitioner: ) (Elderly Persons and Persons With Disabilities ) Abuse Prevention Act) (name of Guardian Petitioner) ) ) Case No. v. ) (See CIF) ) Respondent (person to be restrained) (date of birth) ) ) TO RESPONDENT : A RESTRAINING ORDER HAS BEEN ISSUED BY THE COURT WHICH AFFECTS YOUR RIGHTS. THIS ORDER IS NOW IN EFFECT. You have the right to contest this Restraining Order as set out below. If you wish to contest the continuation of this order, you must complete this form and mail or deliver it to (address of court): Enforceability of the Restraining Order The Restraining Order you have received is in effect and remains in effect until the court modifies or dismisses it or until it expires. The order may also be renewed upon a finding that a person in the Petitioner222s situation would reasonably fear further acts of abuse by you if the order is not renewed. 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 Restraining 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. Requests for hearing must be filed within 30 days after you receive the order. You must include a contact address and contact telephone number with your request for hearing. The hearing will be held within 21 days. The only purpose of this hearing will be to determine if the terms of the order should be canceled, changed, or extended. American LegalNet, Inc. www.FormsWorkFlow.com NOTICE TO RESPONDENT & REQUEST FOR HEARING - Page 2 of 3 (EPPDAPA 8 /2016) Violation of the Restraining Order Violation of any part of this restraining order, or any order continuing or 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 consequences may also be imposed for contempt. FIREARMS PROHIBITIONS MAY APPLY TO YOU! If the judge has specifically ordered in the Restraining Order to Prevent Abuse that you are not to possess firearms or ammunition, it is unlawful for you to possess or purchase a FIREARM, including a rifle, pistol, or revolver, and AMMUNITION. ORS 124.020(1)(f). Additionally, 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 3 (EPPDAPA 8 /2016) IN THE CIRCUIT COURT OF THE STATE OF OREGON COUNTY OF (See CIF) ) Petitioner (name of person to be protected) (date of birth) ) ) 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 (person to be restrained) (date of birth) ) ) I am the Respondent in the above-referenced action and I request a hearing to contest all or part of the Order as follows (check one or more): The Order restraining me from contacting or attempting to contact the petitioner. Other: I will will not be represented by an attorney at the hearing. Notice of the time and place of the hearing can be mailed to me at the address below my signature. 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 below: 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. Date: Submitted by: Signature Print Name OSB No. (if applicable) Address or Contact Address City, State, Zip Telephone or Contact Telephone Number Use safe contact address Use safe contact number If you wish to have your residential address or telephone number withheld from Petitioner, use a contact address or telephone number so the Court and the Sheriff can reach you if necessary. American LegalNet, Inc. www.FormsWorkFlow.com