COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. IN THE COURT OF COMMON PLEAS OF CARBON COUNTY, PENNSYLVANIA : Calendar No. CIVIL ACTION - LAW _________________________________________ : Plaintiff Plaintiff(s) AND/OR (please circle one, if applicable) ON BEHALF OF : : : JUDICIAL SUBPOENA : : NO. -against- _________________________________________ vs. Defendant(s) _________________________________________ :: :: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Defendant. . . . . . . . . . . . . . . . . ........ PETITION TO AMEND PROTECTION FROM ABUSE ORDER AND NOW COMES, Petitioner, ___________________________________________________, Plaintiff in the above referenced matter and respectfully offers the following: TO 1. The Petitioner mostly has a Protection from Abuse order, issued against the above-noted defendant on ___________________________________________, entered under the above referenced docket GREETINGS: number. WE the existing Protection from Abuse and is attached hereto. 2. A copy of COMMAND YOU, that all businessorderexcuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of seeks to modify his/her Protection from Abuse order in the following manner: 3. Petitioner in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the THE PEOPLE OF THE STATE OF NEW YORK _________________________________________________________________________________ _________________________________________________________________________________ Your failure that the with this act(s) merit the Court's modification/withdrawal of the existing 4. Petitioner alleges to comply followingsubpoena is punishable as a contempt of court and will make you liable to the Protection from behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a party on whose Abuse order: result of your failure to comply. _________________________________________________________________________________ _________________________________________________________________________________ Witness, Honorable , one of the Justices of the ________________________________________________________________________________________ Court in County, day of , 20 Wherefore, the Petitioner respectfully requests the Court to set a date for the hearing on the merits of the instant petition. Respectfully submitted, ____________________________________ Dated (Attorney must sign above and type name below) _______________________________________________________ Plaintiff's Signature ORDER OF HEARING for Attorney(s) The Plaintiff(s) and Defendant(s) is/are ordered to attend a hearing on the Petition to amend the Protection from Abuse Order scheduled below: ____________________, ______, 20_____ at ______________ AM/PM, in Courtroom #____, Carbon County Courthouse. Office and P.O. Address Month Day Year Time Telephone No.: BY THE COURT Facsimile No.: ________________________________________________ E-Mail Address: J. Mobile Tel. No.: Dated _________________________ Revised 10/27/03 American LegalNet, Inc. www.USCourtForms.com