Affidavit In Support Of Request For Order Against Stalking Or Sexual Assault
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Affidavit In Support Of Request For Order Against Stalking Or Sexual Assault Form. This is a Vermont form and can be use in Superior Court Statewide.
Tags: Affidavit In Support Of Request For Order Against Stalking Or Sexual Assault, 248, Vermont Statewide, Superior Court
Docket Number
Form 248
STATE OF VERMONT
AFFIDAVIT IN SUPPORT OF REQUEST FOR ORDER AGAINST STALKING OR SEXUAL ASSAULT
Pursuant to 12 V.S.A. 5133(a)
Plaintiff
Defendant
VS.
In support of my request for a protection order, 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: (Specifically describe the facts
that support your complaint)
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 Order
Against Stalking or Sexual Assault.
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. §2904.
7/06 SML
Distribution: Original ~ Court; 1 Copy ~ Plaintiff; 1 Copy ~ Defendant; 1 Copy ~ File
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