Affidavit In Support Of Request For Emergency Relief From Abuse
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Affidavit In Support Of Request For Emergency Relief From Abuse Form. This is a Vermont form and can be use in Family Court Statewide.
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Tags: Affidavit In Support Of Request For Emergency Relief From Abuse, 151, Vermont Statewide, Family Court
Form 151
Affidavit: Relief From Abuse
Docket Number
STATE OF VERMONT
AFFIDAVIT IN SUPPORT OF REQUEST FOR EMERGENCY RELIEF FROM ABUSE
Pursuant to 15 V.S.A. Chapter 21
Plaintiff
Defendant
VS.
In support of the claims made in my request for relief from abuse, subject to the penalties for perjury,
I state the following facts to be true to the best of my knowledge and belief about the present situation. The
compelling reasons for relief from abuse by me are: (Specifically describe the facts that support your
claim(s) of abuse)
Signature of Plaintiff
Date
Subscribed and sworn to before me.
Signature of Notary Public
Date
Expiration Date
NOTICE!
This affidavit will be served on Defendant with the Complaint for Relief from Abuse.
WARNING:
MAKING FALSE STATEMENTS IN THIS AFFIDAVIT IS A CRIME SUBJECT TO A TERM OF
IMPRISONMENT OR A FINE, OR BOTH AS PROVIDED BY 13 V.S.A. ยง2904.
9/06 SML
Distribution: 1 Copy ~ Court 1 Copy ~ Plaintiff 1 Copy ~ Defendant 1 Copy ~ File
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