PETITION TO RENEW RESTRAINING ORDER - Page 1 of 2 (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) ) PETITION TO RENEW RESTRAINING ORDER ) (Elderly Persons / Persons w/Disabilities by and through his/her Guardian Petitioner: ) Abuse Prevention Act) ) (name of Guardian Petitioner) ) ) Case No. v. ) (See CIF) ) Respondent (date of birth) ) (person to be restrained) ) NOTICE TO PETITIONER You must provide complete and truthful information. If you do not, the court may dismiss your restraining order and may also hold you in contempt of court. I am the Petitioner Guardian Petitioner and I state the following information is true: There is an Elderly Persons / Persons with Disabilities Abuse Prevention Act restraining order in this case. I have good cause to renew the restraining order because: American LegalNet, Inc. www.FormsWorkFlow.com PETITION TO RENEW RESTRAINING ORDER - Page 2 of 2 (EPPDAPA 8/2016) I hereby ask the court to issue an Order renewing the Restraining Order in this matter that was signed on , 20 (date), for a period of one year, and continuing the security amount set forth in the original restraining order or in such other amount, as the court deems appropriate. I hereby declare that the above statement is true to the best of my knowledge and belief, and that I understand it is made for use as evidence in court and subject to penalty for perjury. Signature of Petitioner Print or Type Name of Petitioner 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, Petitioner Attorney for Petitioner OSB No. (if applicable) Address or Contact Address City, State, Zip Telephone or Contact Telephone Number Use a Safe Contact address Use a Safe Contact number American LegalNet, Inc. www.FormsWorkFlow.com