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Verified Petition For Protective Order Form. This is a Utah form and can be use in Protective Orders And Civil Stalking Statewide.
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Tags: Verified Petition For Protective Order, Utah Statewide, Protective Orders And Civil Stalking
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
:
Index No.
Calendar No.
: CASE NO.____________________
JUDICIAL SUBPOENA
Plaintiff(s)
INFORMATION SHEET
:
(This information must be attached to the Protective Order)
:
(Fill out information as completely as possible. Please write clearly)
-against-
:
**********
Defendant(s)
:
......................................................
Respondent's name: ____________________________________________________________
Date of birth: __________________________
SSN: _______________________________
THE PEOPLE OF THE STATE OF NEW YORK
Address for service: ____________________________________________________________
TO
Best times to reach at address: ____________________________________________________
Alias/nicknames: _______________________________________________________________
Respondent's Employer's name/address: ____________________________________________
GREETINGS:
______________________________________________________________________________
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
Other addresses (hangouts): ______________________________________________________
,
the Honorable
at the
Court
located at
County of
Race: ________________________________
Height: _____________________________
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
orWeight: ______________________________witnessAge: _______________________________
adjourned date, to testify and give evidence as a
in this action on the part of the
Hair: ________________________________
Eyes: ______________________________
Special Characteristics/Tattoos/Scars/etc: ___________________________________________
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party Year. License No.. and Color was issued for a maximum penalty of $50 and all damages sustained as a
Make, on whose behalf this subpoena of Vehicles: ____________________________________
result of your failure to comply.
Weapons/Violent History: _______________________________________________________
Witness, Honorable
, one of the Justices of the
Additional Information: _________________________________________________________
Court in
County,
day of
, 20
______________________________________________________________________________
______________________________________________________________________________
(Attorney must sign
Law enforcement agencies to which the Protective Orders and this sheet above and be name below)
should type
delivered:_____________________________________________________________________
Attorney(s) for
______________________________________________________________________________
______________________________________________________________________________
Office and P.O. Address
8/2003
1 of 9
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
8/03
American LegalNet, Inc.
www.USCourtForms.com
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
Index No.
:
______________________________
Petitioner’s Name
-against______________________________
Address (may be omitted for privacy)
______________________________
City, State, ZIP
______________________________
Telephone (may be omitted)
Plaintiff(s)
Calendar No.
:
JUDICIAL SUBPOENA
:
:
:
Defendant(s)
:
......................................................
IN THE _____________________ JUDICIAL DISTRICT COURT
_____________________
THE PEOPLE OF THE STATE OF NEW YORK COUNTY, STATE OF UTAH
TO
)
)
)
VERIFIED PETITION FOR
GREETINGS: Petitioner,
)
PROTECTIVE ORDER
)
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
vs.
)
,
the Honorable
at the
Court
)
Civil No.
located at
County of
____________________________,
)
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
Judge
or adjourned date, to testify and give evidence as a witness)in this action on the part of the
Respondent.
)
____________________________,
Your failure to comply THAT subpoena is FALSIFICATION OF of court and will make
PETITIONER IS ADVISED with thisKNOWINGpunishable as a contempt ANY STATEMENT you liable to
the party on whose behalf this subpoena was THE PURPOSE OF OBTAINING A PROTECTIVE
OR INFORMATION PROVIDED FOR issued for a maximum penalty of $50 and all damages sustained as a
result of your failure to comply.
ORDER MAY SUBJECT THE PETITIONER TO FELONY PROSECUTION (Utah Code Ann.
Section 30-6-4(1)(b)(i)).
Witness, Honorable
, one of the Justices of the
Court in
County,
day of
20
The Petitioner alleges against the Respondent and,states as follows:
1.
Either Petitioner or Respondent resides, or the acts occurred, in this County.
2.
Neither party is the minor child (step, adoptive, or natural) of the other party.
(Attorney must sign above and type have the
3.
Petitioner is 16 or older, or emancipated. Petitioner and Respondent name below)
following relationship (check and circle all that apply):
[]
currently married
[]
formerly married; divorced on:____________
Attorney(s) for
Office and P.O. Address
2 of 9
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
8/03
American LegalNet, Inc.
www.USCourtForms.com
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
Index No.
:
[]
currently living as if married
Plaintiff(s)
Calendar No.
:
JUDICIAL SUBPOENA
[]
-againsthave lived as if married;
[]
:
related by blood or marriage; [describe relationship:
_________________________________________________________]
:
:
[]
have one or more children together;
[]
have an unborn child together;
[]
currently residing in the same residence
[]
have resided in the same residence.
4.
Petitioner and Respondent are the parents of the following minor children:
Defendant(s)
:
......................................................
THE PEOPLE OF THE STATE OF NEW YORK
TO
GREETINGS:
NAME
BIRTH DATE
ADDRESS
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court
located at
County of
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
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result of your failure to comply.
Witness, Honorable
, one of the Justices of the
Court in minor children subject to a court order in this or another jurisdiction? If so, please
County,
day of
, 20
Are the
describe the type of order and where it was issued.
______________________________________________________________________________
(Attorney must sign above and type name below)
______________________________________________________________________________
______________________________________________________________________________
Attorney(s) for
______________________________________________________________________________
Office and P.O. Address
3 of 9
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
8/03
American LegalNet, Inc.
www.USCourtForms.com
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
:
Index No.
Calendar No.
:
JUDICIAL SUBPOENA
Plaintiff(s)
5.
On or about __________________, at_______________________, the
Respondent threatened, -against- or caused the following acts of abuse or domestic violence.
attempted,
:
[Describe in detail what happened, where, who was involved (including the minor children
:
and family and household members), if weapons were involved, and if injuries resulted.
Attach more sheets if necessary but only write on one side.]
:
______________________________________________________________________________
Defendant(s)
:
......................................................
______________________________________________________________________________
______________________________________________________________________________
THE PEOPLE OF THE STATE OF NEW YORK
______________________________________________________________________________
______________________________________________________________________________
TO
______________________________________________________________________________
______________________________________________________________________________
GREETINGS:
______________________________________________________________________________
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend
______________________________________________________________________________ before
,
the Honorable
at the
Court
______________________________________________________________________________
located at
County of
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
______________________________________________________________________________
______________________________________________________________________________
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
6.
The comply.
result of your failure tofollowing is a description of other acts of abuse or domestic violence by
Respondent. (Describe with the same detail as in paragraph 5. Attach more sheets if necessary
but only write on one side.)
Witness, Honorable
, one of the Justices of the
______________________________________________________________________________
Court in
County,
day of
, 20
______________________________________________________________________________
______________________________________________________________________________
(Attorney must sign above and type name below)
______________________________________________________________________________
______________________________________________________________________________
Attorney(s) for
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Office and P.O. Address
______________________________________________________________________________
______________________________________________________________________________
Telephone No.:
4 of 9
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
8/03
American LegalNet, Inc.
www.USCourtForms.com
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
:
Index No.
Calendar No.
______________________________________________________________________________
:
JUDICIAL SUBPOENA
Plaintiff(s)
______________________________________________________________________________
-against-
:
:
7.
The following cases which involve Petitioner, Respondent and/or the others
named in this petition have been filed: (List all cases that have been filed in any court, at any
:
time)
Defendant(s)
:
......................................................
Party
Date of filing or
judgment
Court or County
where case filed
Type of Case and
Case number if
known
Has a judge
signed an order?
THE PEOPLE OF THE STATE OF NEW YORK
TO
GREETINGS:
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court
located atthe following family and household members:
County of8.
I also request relief for
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
______________________________________________________________________________
______________________________________________________________________________
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
WHEREFORE: I respectfully request that this Court:
result of your failure to comply.
1.
Order the Respondent to appear at a hearing.
2.
Immediately issue an Ex Parte Protective Order and, after the hearing, issue a
Witness, Honorable
, one of the Justices of the
Protective Order containing the following relief (Check boxes of relief that you are
Court in
day of
, 20
requesting):County,
[]
Restrain the Respondent from attempting, threatening or committing abuse or
domestic violence against the Petitioner and from (Attorney must sign above and threatening or
stalking, harassing, or type name below)
using or attempting to use physical force that would reasonably be expected to cause
physical injury to the Petitioner.
Attorney(s) for
Office and P.O. Address
5 of 9
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
8/03
American LegalNet, Inc.
www.USCourtForms.com
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
:
Index No.
Calendar No.
[]
Restrain the Respondent from attempting, threatening or committing abuse or
:
JUDICIAL SUBPOENA
Plaintiff(s)
domestic violence against the minor children and the designated family and household
-againstmembers and from stalking, harassing, or threatening or using or attempting to use
:
physical force that would reasonably be expected to cause physical injury to the
:
designated family or household members.
:
[]
Prohibit the Respondent from directly or indirectly contacting, harassing,
telephoning, e-mailing, or otherwise communicating with the Petitioner.
Defendant(s)
:
......................................................
[]
Order the Respondent to vacate and stay away from the residence located at:
_____________________________________________________________, and any
subsequent residence of NEW YORK
THE PEOPLE OF THE STATE OF Petitioner known to the Respondent, and prohibit the Respondent
from terminating or interfering with the utility services to the residence.
TO
[]
Order the Respondent to stay away from Petitioner’s school, place of employment,
and other places frequented by Petitioner, the minor children and designated family or
household members and any subsequent school, place of employment or other places
GREETINGS: to the Respondent, which are frequented by the Petitioner, the minor children and
known
designated family or household members. These places are identified by the following
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
address(es):
,
the Honorable
at the
Court
located at
County of
________________________________________________________________________
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
________________________________________________________________________
________________________________________________________________________
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
[]
Prohibit the subpoena was issued for a maximum penalty of $50 and all damages sustained as a
the party on whose behalf this Respondent from purchasing, using, or possessing a firearm or other
weapon asto comply. by the court.
result of your failure designated
Note: if this section is checked, please describe any weapons owned by the
Witness, Honorable
, one of the Justices of the
RespondentCounty, they have been used , 20
and how
against you.
Court in
day of
________________________________________________________________________
________________________________________________________________________
(Attorney must sign above and type name below)
________________________________________________________________________
________________________________________________________________________
Attorney(s) for
________________________________________________________________________
________________________________________________________________________
Office and P.O. Address
6 of 9
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
8/03
American LegalNet, Inc.
www.USCourtForms.com
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
:
Index No.
Calendar No.
[]
Award possession of the following residence, automobile and/or other essential
:
JUDICIAL SUBPOENA
Plaintiff(s)
personal effects:
-against________________________________________________________________________
:
________________________________________________________________________
:
________________________________________________________________________
:
________________________________________________________________________
Defendant(s)
:
. . . . . . . . ________________________________________________________________________
..............................................
________________________________________________________________________
________________________________________________________________________
THE PEOPLE OF THE STATE OF NEW YORK
________________________________________________________________________
TO
[]
Order a law enforcement officer to accompany Petitioner to the residence to ensure
that Petitioner is safely restored to possession of the listed items.
GREETINGS:
[]
Order a law enforcement officer to supervise Respondent’s removal of essential
WE COMMAND YOU, thatthe business and excuses being laid aside, you and each of you attend before
personal belongings from all residence.
,
the Honorable
at the
Court
located at
County of[]
Order Respondent to participate in an electronic monitoring program.
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
[]
Order the Department of Child and Family Services to conduct an investigation
into the possibilities of child abuse.
Your failure to comply with this subpoena is punishable asbest interests of the and will make you liable to
[]
Appoint a Guardian ad Litem to represent the a contempt of court children.
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result of your failure to comply. Protective Order the following temporary relief which should be in
3.
Include in the
effect for up to 150 days (explain in writing and attach if additional time will be
Witness, Honorable
, one of the Justices of the
necessary).
Court in
County,
day of
, 20
[]
Grant Petitioner custody of the minor child/ren.
[]
Order the following visitation arrangement (if requesting above and type name below)
(Attorney must sign visitation arranged
through, or supervised by, another person, state the name and phone number of that
person):
Attorney(s) for
________________________________________________________________________
________________________________________________________________________
Office and P.O. Address
________________________________________________________________________
________________________________________________________________________
Telephone No.:
________________________________________________________________________
Facsimile No.:
________________________________________________________________________
E-Mail Address:
7 of 9
Mobile Tel. No.:
8/03
American LegalNet, Inc.
www.USCourtForms.com
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
Index No.
:
Calendar No.
________________________________________________________________________
:
________________________________________________________________________
JUDICIAL SUBPOENA
Plaintiff(s)
-against-
[]
:
Restrain Respondent from using drugs and/or alcohol prior to or during visitation.
:
[]
Restrain Respondent from removing the minor child/ren from the state.
[]
Order Respondent to pay child support in the amount of _____________
:
Defendant(s)
:
. . . . . . . . pursuant. to .the .Utah . . . . . . . . . . . . . .Support. Guidelines.
. . . . . . . . . . . . . . . Uniform Child . . . . . . . . . . . . .
[]
Order Respondent to participate in mandatory income withholding pursuant to
Utah Code Annotated § NEW YORK
THE PEOPLE OF THE STATE OF62A-11, Parts 4 and 5.
TO
[]
Order Respondent to pay one-half of the minor child/ren’s day care expenses.
[]
Order Respondent to pay one-half of the minor child/ren’s medical expenses
including premiums, deductibles and co-payments.
GREETINGS:
[]
Order Respondent to pay spousal support in the amount of $_______________.
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable Order Respondent to pay Petitioner’s medical expenses suffered as a result of
at the
Court
[]
located at
County of
abuse in the amount of $_____________________.
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
[]
Order Respondent to pay the minor children’s medical expenses suffered as a
result of abuse in the amount of $_____________________.
Your failure to comply with this that the court considers necessary for the safetywill make you liable to
[]
Order any other relief subpoena is punishable as a contempt of court and and welfare
the party on Petitioner, the children andwas issued for a maximum penalty of $50 and all damages sustained as a
whose behalf this subpoena designated household and family members, including:
of
result of your failure to comply.
________________________________________________________________________
________________________________________________________________________
Witness, Honorable
, one of the Justices of the
Court in ________________________________________________________________________
County,
day of
, 20
________________________________________________________________________
________________________________________________________________________
(Attorney must sign above and type name below)
Attorney(s) for
Office and P.O. Address
8 of 9
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
8/03
American LegalNet, Inc.
www.USCourtForms.com
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
:
DATED: _____________________________.
Plaintiff(s)
State of Utah
-against)
____________ County
Index No.
Calendar No.
:
JUDICIAL SUBPOENA
:
) ss:
)
:
:
Being sworn, I state that I am the Petitioner; that I have read this Petition and the
statements in it are true and correct to the best of my knowledge; that I believe I am entitled to the
Defendant(s)
:
. .relief.requested,. and. that .this . . . . . . . .is .not. being . . . . .to. harass or to abuse process.
. . . . . . . . . . . . . . . . . . . . . Petition . . . . . . . . used . . .
THE PEOPLE OF THE STATE OF NEW YORK _______________________________________
Petitioner
TO
GREETINGS:
Subscribed and sworn to before me on ______________________________.
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court
_______________________________________
located at
County of
Clerk or Notary Public
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
Residing at:
or adjourned date, to testify and give evidence as a witness in this action on the part of the
My Commission Expires:
Serve Respondent at:
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
Street: ______________________
result of your failure to comply.
City/Town: ______________________
State, Zip:
______________________
Witness, Honorable
Court in
County,
, one of the Justices of the
day of
, 20
(Attorney must sign above and type name below)
Attorney(s) for
Office and P.O. Address
9 of 9
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
8/03
American LegalNet, Inc.
www.USCourtForms.com
