PROTECTIVE ORDER TO PREVENT SEXUAL ABUSE - Page 1 of 5 (SAPO 08/2019) IN THE CIRCUIT COURT OF THE STATE OF OREGON COUNTY OF Petitioner Case No: (Parent/Guardian of Minor Petitioner) (use full names) PROTECTIVE ORDER TO PREVENT SEXUAL ABUSE v. Respondent (full name of person restrained) The Court, having reviewed the Petition and heard testimony, makes the following findings: Judge222s Initials 1A. Petitioner is an adult and Respondent is at least 18 years of age 1A. 1B. Petitioner is a minor and Respondent is at least 18 years of age 1B. 1B(1).Petitioner is a minor, and Respondent represents a credible threat to the physical safety of Petitioner or Petitioner222s children 1B(1). 2. Petitioner is an adult, and Petitioner and Respondent are not family or household members under ORS 107.705. 2. They are not husband, wife, or Registered Domestic Partners (current or former); They are not adults related by blood, marriage, or adoption; They have never cohabited (lived together in a sexually intimate relationship); They have not been involved in a sexually intimate relationship in the last two years; They are not the unmarried parents of a child; and NOTICE TO RESPONDENT: You must obey all of parts of this Sexual Abuse Protective Order, even if Petitioner contacts you or gives you permission to contact them. Violation of this Sexual Abuse Protective Order may result in your arrest and in civil and/or criminal penalties. . This Order is enforceable in every county in Oregon, all 50 states, the District of Columbia, and all tribal lands and territories of the United States. Review this Order carefully. See the attached 223NOTICE TO RESPONDENT/REQUEST FOR HEARING224 for more information about your rights to a hearing. American LegalNet, Inc. www.FormsWorkFlow.com PROTECTIVE ORDER TO PREVENT SEXUAL ABUSE - Page 2 of 5 (SAPO 08/2019) Judge222s Initials 3. Respondent has subjected Petitioner to sexual abuse as defined by ORS163.760; the abuse occurred WITHIN THE LAST 180 DAYS. It is objectively reasonable for a person in Petitioner222s situation to fear for their physical safety if an order is not entered. 3. 4. Respondent is not prohibited from contacting Petitioner by a foreign restraining order as defined in ORS 24.190, an order issued under ORS 30.866, 124.015, 124.020, 163.738, or 419B.845, or an order entered in a criminal action. 4. IT IS HEREBY ORDERED THAT: Petitioner222s Request (check all that apply): 1. Respondent is restrained (prohibited) from contacting Petitioner and from intimidating, molesting, interfering with or menacing Petitioner, or attempting to contact, intimidate, molest, interfere with or menace Petitioner. 1. 2. Respondent is restrained (prohibited) from contacting Petitioner222s children or family or household members. 2. 3. Respondent is restrained (prohibited) from intimidating, molesting, interfering with or menacing any children or family or household members of Petitioner, or attempting to intimidate, molest, interfere with or menace any children or family or household members of Petitioner. 3. 4. Respondent is restrained from entering or attempting to enter, or remaining in, the area within 150 feet unless otherwise specified here: Other Distance: feet of the building and land at the following locations: (include names/addresses unless withheld for safety reasons) 4. a. Petitioner222s current or future residence: b. Petitioner222s current or future business or place of employment: c. Petitioner222s current or future school: d. Other locations: 5. Respondent shall not knowingly be or stay within 150 feet unless 5. otherwise specified here: Other Distance: feet of Petitioner unless otherwise ordered by the Court as follows: American LegalNet, Inc. www.FormsWorkFlow.com PROTECTIVE ORDER TO PREVENT SEXUAL ABUSE - Page 3 of 5 (SAPO 08/2019) Judge222s Initials 6. Except as otherwise set out in this Order, Respondent is restrained (prohibited) from: 6. a. Contacting, or attempting to contact, Petitioner in person directly or through third parties. b. Contacting, or attempting to contact, Petitioner by mail, or e-mail, any other electronic transmission, or delivery service. c. Contacting, or attempting to contact, Petitioner by telephone, including cell phone or text messaging directly or through third parties. 7. Other Relief necessary to provide for the safety and welfare of Petitioner or Petitioner222s children or family or household members: 7. 7A. Respondent shall not purchase or possess any firearms or ammunition because: 7A. Other orders regarding firearms (for court use only): 7B. Other relief necessary for safety and welfare: 7B. IT IS FURTHER ORDERED that the SECURITY AMOUNT for violation of any provision of this Order is $5,000 unless otherwise specified here: Other Amount: $ Nothing in this Order prevents Respondent from appearing at or participating in a court (or administrative) hearing or other related legal process as a party or witness in a case involving Petitioner. At these times, Respondent must stay at least feet away from Petitioner and follow any additional protective terms ordered in that case. Further, nothing in this Order prevents Respondent from serving or providing documents related to a court (or administrative) case to Petitioner in a manner permitted by law. However, Respondent may not personally deliver legal documents to Petitioner. FIREARMS NOTIFICATION If the firearms prohibition in Paragraph 7A is initialed by the judge, it is not lawful for Respondent to possess or purchase a FIREARM, including a rifle, pistol, or revolver, and AMMUNITION. (ORS 163.765(1)(b)(E)). Talk to a lawyer if you have questions about this. American LegalNet, Inc. www.FormsWorkFlow.com PROTECTIVE ORDER TO PREVENT SEXUAL ABUSE - Page 4 of 5 (SAPO 08/2019) CERTIFICATE OF COMPLIANCE WITH VIOLENCE AGAINST WOMEN ACT (This is not a Brady Certificate) FULL FAITH AND CREDIT PROVISIONS: This Sexual Abuse Protective Order meets all full faith and credit requirements of the Violence Against Women Act. (18 USC 247 2265). This court has jurisdiction over the parties and the subject matter. The Respondent is being afforded notice and timely opportunity to be heard as provided by the law of this jurisdiction. This Order is valid and entitled to enforcement in this and all other jurisdictions. IT IS HEREBY ORDERED that: The Petition for Sexual Abuse Protective Order is GRANTED as set forth above. The Petition for Sexual Abuse Protective Order is DENIED and DISMISSED because: Petitioner did not establish a claim for relief. Other: The Petition for Sexual Abuse Protective Order is DISMISSED because Petitioner did not appear at the time set for the ex parte hearing on their petition. Judge Signature: Certificate of Readiness for Judicial Signature. The proposed order is ready for judicial signature under UTCR 5.100 because service of this order is not required by statute, rule, or otherwise. Submitted by: Date Signature of Petitioner, Parent or Guardian of Minor Petitioner Print Name, Petitioner, Parent or Guardian of Minor Petitioner Attorney for Petitioner OSB No. (if applicable) Contact Address City, State, Zip Contact Telephone Number Use Safe Contact Address Use Safe Contact Number The above provisions of this Sexual Abuse Protective Order are in effect for a period of one (1) year from the date of the judge222s signature or until the Order is terminated, modified, or renewed, whichever occurs first. American LegalNet, Inc. www.FormsWorkFlow.com RELEVANT DATA PETITIONER: Female Male Name ***Residence/Contact Address (Use a safe address***): Number, Street and Apt. Number (if applicable) City County State Zip Telephone/Contact Telephone Number (Use safe contact number) Birth Date (see CIF) Age Race/Ethnicity Height Weight Eye Color Hair Color RESPONDENT: Female Male Name Residence Address Telephone Number Birth Date (see CIF) Age Race/Ethnicity Height Weight Eye Color Hair Color PLEASE FILL OUT THIS INFORMATION TO AID IN SERVICE OF THE SEXUAL ABUSE PROTECTIVE ORDER Where is the Other Party most likely to be located? Residence Hours Address Employment Hours Address (see CIF) Other Hours Address Description of Vehicle Is there a