Form 251 INTENTION TO PURSUE OR WITHDRAW COMPLAINT FOR PROTECTION ORDER AGAINST STALKING OR SEXUAL ASSAULT PURSUANT TO 12 V.S.A. §5133 County VERMONT SUPERIOR COURT Plaintiff's Name Docket Number Date of Birth / Defendant's Name Date of Birth / / / City, State, Zip Defendant's Street Address I understand my request for emergency relief has been denied. I hereby withdraw my request for a final order against stalking or sexual assault sought under 12 V.S.A. §5133. OR In spite of the fact that my request for emergency relief was denied, I intend to pursue my request for a final order against stalking or sexual assault order under 12 V.S.A. §5133. I request a hearing be set. Plaintiff's Signature Date **************************************************************************** A hearing will be held at: Name and Street Address of Court Time Date on: at: AM PM Clerk **************************************************************************** RETURN OF SERVICE Vermont Superior Court Docket Number County Plaintiff VS. On (date) AM PM at Name of Person I personally served this Denial, Complaint & Affidavit upon: by Name, Title, & Agency of Serving Officer - PLEASE PRINT Service = $ =$ Name of Defendant (printed or typed) I, hereby accept service of this Order. Defendant's Signature Total = 8/06 SML Date Signature Acceptance of Service: Fees: miles at Defendant Date ALSO SEE "IMPORTANT NOTICES" ON THE BACK OF THIS PAGE. Time AM PM American LegalNet, Inc. www.FormsWorkflow.com Form 251 INTENTION TO PURSUE OR WITHDRAW COMPLAINT FOR PROTECTION ORDER AGAINST STALKING OR SEXUAL ASSAULT Back of Page 1 "IMPORTANT NOTICES" INFORMATION FOR PLAINTIFF AND DEFENDANT ABOUT REPRESENTATION BY AN ATTORNEY Although you may represent yourself at any hearing during these proceedings, you may wish to consult with or be represented by an attorney. If you hire an attorney to represent you, your attorney is required to tell the court and the other party that they will be representing you. Both parties have the right to receive "notice" before any hearing that the opposing party will be represented by an attorney. The Vermont Rules of Civil Procedure require that such notice must be given to the opposing party or their attorney in person, by telephone, or in writing and it must be given far enough in advance of the hearing to permit them to hire an attorney too. If you do not provide such notice to the opposing party, and if the party without an attorney asks, the court will postpone the hearing for a reasonable time to allow the unrepresented party to obtain an attorney. IMPORTANT INFORMATION FOR DEFENDANT At the hearing to be held on the date and time specified on the face of this notice, the court will decide on whether to issue or deny a final order. After the hearing, an order may be issued, which may remain in effect for a defined period of time, which will be stated on the order. If you fail to appear at the hearing, an order may be issued against you granting the plaintiff's requests for relief as the court deems appropriate. 8/06 SML American LegalNet, Inc. www.FormsWorkflow.com