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Petition For Order Of Protection Form. This is a South Carolina form and can be use in Charleston Local County.
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Tags: Petition For Order Of Protection, South Carolina Local County, Charleston
STATE OF SOUTH CAROLINA
COUNTY OF SOUTH CAROLINA
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)
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__________________________________ )
Petitioner
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VS.
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__________________________________ )
Respondent
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IN THE FAMILY COURT
NINTH JUDICIAL CIRCUIT
FILE #: 20_____DR-10- _________
RESPONDENTS SSN: _______________________
DOB/RACE/SEX:__________/________/________
PETITION FOR ORDER OF PROTECTION
I ask this court to issue an Order of Protection, because:
1.
This is the county where this case should be handled, since (check all that apply):
a. The alleged act of abuse occurred in this county; or,
b. The person who caused the abuse lives in this county; or,
c. The person who caused the abuse and I last lived together in this county.
2.
The person who caused the abuse lives at _____________________________________
in or near the town or city of ______________________________________ which is in
__________________________ County, and the State of ________________________.
3.
The person who was abused was (check one or both and supply information):
______ a. ___________________________, who is the person asking for an Order of Protection; or,
______ b. ___________________________, who is a child under 18 years old who lives with me.
4.
That the abuser and the victim (check all that apply):
______ are husband and wife
______ were formerly husband and wife
______ are living together
______ were formerly living together
______ have a child/children in common, who is/are___________________________
5.
The abuse happened at (address) _____________________________________________
on ________________________, 20______, at ____________o clock, _____m when
_______________________________________ did this:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
6.
Have there been any prior convictions of domestic violence or prior orders of protection?
______ yes ______ no. If yes, please state date ________________________________.
7.
I ask this court to grant the following temporary relief (check as many as apply and supply information)
______ a. issue an Order of Protection which prohibits and forbids ______________________________
from abusing threatening to abuse, or molesting, or engaging in any other conduct that would place
Petitioner in reasonable fear of bodily injury.
______ b. issue an Order of Protection which restrains and prohibits _____________________________
from using, attempting to use, or threatening to use physical force against Petitioner that would reasonably
be expected to cause bodily injury.
______ c. issue an Order of Protection which restrains, prohibits, and forbids ______________________
______________ from communicating or attempting to communicate with petitioner in any way, and from
entering or attempting to enter the home of the victim, place of employment, education, or other location as
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the Court may order.
______ d. issue an order granting _____________________________ temporary custody of the following
minor child(ren):
Name
DOB
Address
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
______ grant reasonable visitation or ______ deny visitation.
______ e. issue an order granting Petitioner temporary child support (Financial declaration must be
completed and attached).
______ f. issue an order granting Petitioner temporary alimony (Financial declaration must be completed
and attached).
______ g. issue and order granting Petitioner temporary exclusive use and possession of the home and
furnishings.
______ h. issue and order which forbids ______________________ from transferring, selling, destroying,
encumbering, or otherwise disposing of real or personal property belonging to petitioner or jointly owned.
______ i. issue an order which gives the petitioner assistance from law enforcment in that petitioner will be
accompined:
______ (1) in removing personal property from _______________________________________________
(Street address) in ___________________________(city) ____________________________(county), SC.
______ (2) in placing the petitioner in possession of the home and furnishings at
____________________________________(Street address)
_________________________(city)________________(county), SC.
______ j. issue an order reimbursing petitioner for costs and attorney s fees.
______ k. hold a hearing within 15 days of the date of filing these papers.
______ l. hold an emergency hearing within 24 hours.
______ m. issue an order granting petitioner the following additional requests:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Sworn to and Subscribed before me
this _______ day of _____________, 200____
______________________________________
Notary Public for South Carolina
My Commission expires: __________________
___________________________________
Signature of Petitioner or
Person on behalf of Petitioner under 18 years old
NOTICE TO RESPONDENT: YOU HAVE THE RIGHT TO EMPLOY COUNSEL TO
REPRESENT YOU.
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PETITIONER
RESPONDENT
NAME ____________________________ NAME _____________________________
ADDRESS _________________________ ADDRESS __________________________
CITY, ZIP CODE ____________________ CITY, ZIP CODE ____________________
SEX_______RACE_______DOB________ SEX_______RACE_______DOB________
SSN_______________________________ SSN________________________________
HGT___________ WGT______________ HGT_____________WGT______________
EYES__________HAIR_______________ EYES_____________HAIR_____________
EMPLOYMENT_____________________ EMPLOYMENT _____________________
___________________________________ ____________________________________
HOME # ___________________________ HOME #____________________________
WORK # ___________________________ WORK #____________________________
CELL # ____________________________ CELL # _____________________________
VEHICLE MAKE & MODEL __________ VEHICLE MAKE & MODEL __________
___________________________________ ____________________________________
TAG # ____________STATE___________ TAG # ______________STATE _________
DO YOU HAVE ANY PENDING CASES IN FAMILY COURT? ____ YES ____ NO
*FOR COURT USE ONLY*
FILE # _______________________________
MUTUAL ORDER YES / NO
DATE GRANTED ______________________
EXPIRATION DATE ____________________
ISSUING JUDGE________________________
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