Motion to Modify/Extend Order of Protection And Order Extending Order of Protection Until Hearing PETITIONER/PLAINTIFF First Middle Last Case No. Court _____________________________ County Tennessee PETITIONER/PLAINTIFF IDENTIFIERS Date of Birth of Petitioner Minor Children Protected Under this Order: ________________________________________________ ________________________________________________ V. RESPONDENT SEX First Middle Last HAIR SOCIAL SECURITY # RESPONDENT IDENTIFIERS RACE DOB HT WT EYES Relationship to Petitioner _________________________________ Address & Phone No. ____________________________________ ________________________________________________________ Respondent's Employer __________________________________ Distinguishing Features ____________________________ _______________________ NOTICE: PURSUANT TO T.C.A. §36-3-608 AND THE ATTACHED ORDER, THE ORDER OF PROTECTION ENTERED ON _______________ REMAINS IN FULL FORCE AND EFFECT PENDING THIS HEARING AND FURTHER ORDERS OF THE COURT. Comes now the Petitioner, ____________________, and swears and affirms pursuant to T.C.A. §36-3-605(d), and T.C.A. §36-3-608, and moves this court to modify/extend the Order of Protection entered by this court on ___________________________ for: One year, and Petitioner, upon notice to Respondent, may request a continuation of the Order. This is requested because: ________________________________________________________ 11-24-08 American LegalNet, Inc. www.FormsWorkFlow.com Five years based on an initial violation of the Order of Protection. This is requested because: Ten years based on a second or subsequent violation of the Order of Protection. This is requested because: ______________________________________________________________ ______________________________________________________________________________ Other relief requested. STATE OF TENNESSEE COUNTY OF _________ ) ) , Petitioner, being first duly sworn, has read the foregoing Motion, knows the contents thereof, and states that the same is true and correct to the best of Petitioner's knowledge, information and belief. ____________________________________ PETITIONER Sworn to and subscribed before me this day of _______________, 20___. ____________________________________ NOTARY PUBLIC/CLERK My Commission Expires:_____________________ TEMPORARY ORDER EXTENDING ORDER OF PROTECTION It appears to the Court from the sworn motion to extend the order of protection that such an order should issue pursuant to Tennessee Code Annotated, title 36, chapter 3, part 6. IT IS, THEREFORE, ORDERED, ADJUDGED, AND DECREED: 1. That this court's Order of Protection entered on the ___ day of ___________, 20__ shall remain in effect until the hearing on the Motion to Extend the Order of Protection is heard. 2. That a copy of the Motion to Extend the Order of Protection, this Temporary Order Extending Order of Protection and the attached Notice of Hearing, shall be served upon the Respondent. ______________________________ _____________________________________ DATE JUDGE/MAGISTRATE 11-24-08 American LegalNet, Inc. www.FormsWorkFlow.com NOTICE OF HEARING To the Respondent: Notice is hereby given to you that the above named Petitioner shall appear requesting the Court to modify and/or extend the Order of Protection previously entered in this cause and to award the relief prayed for in the Motion to Modify/Extend Order of Protection. IF YOU WANT TO TELL YOUR SIDE TO THE JUDGE, YOU MUST BE AT THE HEARING. IF YOU DO NOT COME TO THE HEARING, THE JUDGE WILL DECIDE BASED ONLY ON THE PETITIONER'S TESTIMONY. DATE OF HEARING ________________________ AT ____________________ A.M./P.M. PLACE OF HEARING ________________________________________________________ CERTIFICATE OF SERVICE I hereby certify that I have sent a copy of the foregoing motion, notice of hearing and temporary order extending order of protection by fax to the ______________County Sheriff's Department and by U.S. mail postage pre-paid, to the respondent at his or her last known address: _________________________________________. This ___ day of ______________, 2____. , CLERK By: __________________________ Deputy Clerk 11-24-08 American LegalNet, Inc. www.FormsWorkFlow.com