COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Plaintiff(s) -against- Calendar No. : JUDICIAL SUBPOENA : WASHINGTON SUPREME COURT PATTERN FORMS COMMITTEE : : INSTRUCTIONS ON HOW TO FILL OUT Defendant(s) THE FORMS FOR : ...................................................... ANTIHARASSMENT THE PEOPLE OF THE STATE OF NEW YORK Prepared by the Office of the Administrator for the Courts Olympia, Washington Tentatively Approved November 1998 TO GREETINGS: FOLLOW THESE INSTRUCTIONS CAREFULLY. PLEASE PRINTyou and each of you attend before WE COMMAND YOU, that all business and excuses being laid aside, ALL , the Honorable at any INFORMATION REQUESTED. If you have the questions orCourt problems the clerk has sample located at County of to assist you. forms 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 Before you begin working on these forms read the following paragraph. The unlawful harassment statute does not allow an order for protection from civil harassment to Your in any action covered by subpoena is violence laws contempt 10.99 and 26.50 be issuedfailure to comply with this the domesticpunishable as a (Chapters 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 RCW). Domestic violence is defined as physical harm, bodily injury, assault, or the infliction of result of your failure to comply. fear of imminent physical harm, bodily injury or assault between family or household members; or sexual assault of one family or household member by another. “Family or household of the Witness, Honorable , one of the Justices members” include adults or juveniles who are spouses, former spouses, persons related by Court in County, day of , 20 blood or marriage, persons who are presently residing together, or who have resided together in the past, and persons who have a child in common regardless of whether they have been married or have lived together at any time. (Attorney must sign above and type name below) IF YOU ARE A VICTIM OF DOMESTIC VIOLENCE, DO NOT Attorney(s) for FILL OUT THESE FORMS. INSTEAD, YOU SHOULD FILL OUT A SET OF DOMESTIC VIOLENCE FORMS. DOMESTIC VIOLENCE FORMS ARE AVAILABLE FROM THE CLERK OF THE COURT. Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Instructions for Antiharassment Forms (11/98) FORMS NEEDED Plaintiff(s) Index No. : Calendar No. : JUDICIAL SUBPOENA -against- : To begin an action for an order for protection from civil harassment, you will need the following 7 : forms: : (1) Motion for Waiver of Fees (Unlawful Harassment) (1 page)-- WPF UH-02.0100; (2) Order to Proceed Without Payment of Fees (Unlawful Harassment) Defendant(s) : . . . . . . . . . . . .(1 .page)--WPF. UH-02.0110;. . . . . . . . . . . . . . . . . . . . . ......... .......... (3) Petition For An Order For Protection (Unlawful Harassment) (2 pages)--WPF UH-02.0200; (4) Law Enforcement Information Sheet (Unlawful Harassment) THE PEOPLE OF THE STATE OF NEW YORK (5) Temporary Protection Order and Notice of Hearing (2 pages)--WPF UH-03.0200; TO (6) Return of Service (Unlawful Harassment) FORMS (1 page)--WPF UH-04.0110; and NEEDED (7) Order for Protection from Civil Harassment (2 GREETINGS: pages)--WPF UH-04.0500. 4 These forms should beYOU, that all business and you are missing any forms or pages informyou attend before WE COMMAND included in this packet. If excuses being laid aside, you and each of the clerk. , the Honorable at the Court located at County of Complete steps 1 the below. in room , on through 8day 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 ________________________________________________________________________ STEP 1 - FILL IN THE HEADING OF EACH FORM. ________________________________________________________________________ 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 You are failure to comply. The person who is harassing you is the RESPONDENT. Your of your the PETITIONER. name and the respondent’s name should be filled in the heading of each form. When you file your papers with the clerk of the court you will be given a case number. That number should be Witness, Honorable , one of the Justices of the included in the upper right hand corner of every form you complete. Court ________________________________________________________________________ in County, day of , 20 STEP 2 - MOTION FOR WAIVER OF FEES (UNLAWFUL HARASSMENT) (WPF (Attorney must sign OF FEES UH-02.0100); and ORDER TO PROCEED WITHOUT PAYMENTabove and type name below) (UNLAWFUL HARASSMENT) (WPF UH-02.0110). ________________________________________________________________________ Attorney(s) for The Motion for Waiver of Fees is used to tell the court that you do not have the funds to pay the fees for filing and serving your papers. If the court determines that you do not have the necessary funds, the court will issue an order that will allow you to proceed without paying these fees. IF YOU HAVE THE FUNDS TO PAY THESE FEES, SKIP THEand P.O. Address THIS Office REMAINDER OF STEP AND GO TO STEP 3. If you do not have the funds to pay these fees, follow the instructions in the next two paragraphs. Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: 2 American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Instructions for Antiharassment Forms (11/98) : Index No. Calendar No. : JUDICIAL SUBPOENA Plaintiff(s) Provide all the information requested in the Motion for Waiver of Fees. In paragraph 1.3, you -against: should designate the law enforcement agency that will serve the respondent. If you do not know where the respondent resides or if you are unsure which law enforcement agency to fill in, leave : this paragraph blank. When you present your papers to the judge, tell the judge why you were unable to complete this paragraph. Provide the financial information requested in Part II : (Declaration) to the best of your ability. In paragraph 2.5, you should estimate what your total monthly living expenses are. Make sureDefendant(s) both the motion and the declaration. that you sign : ...................................................... The Order to Proceed Without Payment of Fees will allow you to proceed without payment of fees once the judge signs it. In paragraph 2.3, insert the name of the law enforcement agency that will serve the respondent if you have this information. If you do not know where the THE PEOPLE OF THE STATE OF NEW YORK respondent resides or if you are unsure which law enforcement agency to fill in, leave paragraph 2.3 blank. When you present your papers to the judge, tell the judge why you were unable to TO complete paragraph 2.3. You must also sign the Order to Proceed Without Payment of Fees in the bottom left hand corner where the signature of the petitioner is requested. The judge or court commissioner who reviews your application will complete the rest of the order and sign and date it. 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 STEP 3 - PETITION FOR AN ORDER FOR PROTECTION (UNLAWFUL of in roomHARASSMENT) (WPF day of , on the , 20 , at o'clock in the noon, and at any recessed UH-02.0200). or adjourned date, to testify and give evidence as a witness in this action on the part of the ________________________________________________________________________ Your request for an order for protection is initiated by the filing of a petition with the court. Provide the information requested in paragraphs 1 through 7 of the petition. In paragraph 2, check Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the on that applies this subpoena are issued for a unlawful penalty of $50 and all the parent the party boxwhose behalfto you. If you wasthe victim of maximumharassment and you are damages sustained as a result of a child underto comply. is in need of protection, you may check both boxes. The questions in of your failure age 18, who paragraph 3 are to help the court determine whether it has jurisdiction to proceed with your petition. If none of the boxes apply to your situation, leave all of the boxes in paragraph 3 blank. Witness, Honorable , one of the Justices of the Paragraph 4 asks for the petitioner’s name, date of birth and driver’s license, or identicard, Court number and state. Your identification information20 needed to help the court avoid issuing a in County, day of , is protection order that contradicts another protection order. Paragraph 5, asks for the respondent’s name, date of birth and driver’s license, or identicard, number and state, or, if unavailable, home (Attorney avoid issuing a protection order address. The respondent’s information is needed to help the court must sign above and type name below) that contradicts another protection order. Paragraph 6 asks for information about minors needing protection. The name, date of birth, age and sex of the child is needed to help the court avoid issuing a protection order that contradicts another protection order. for Attorney(s) Paragraph 7 asks for other court cases or protection orders involving you and the respondent. This information is also required to help the court avoid issuing a protection order that contradicts another protection order. If you have concerns about your safety by disclosing your identification information, tell the court clerk. Office and P.O. Address In the next section, you may ask for the relief you need. If an emergency exists and you might suffer great and irreparable harm if a temporary restraining order is not issued immediately, you Telephone No.: may request a temporary order that will last fourteen (14) days. To request a temporary order, Facsimile No.: E-Mail Address: Mobile Tel. No.: 3 American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Instructions for Antiharassment Forms (11/98) : Index No. Calendar No. : JUDICIAL SUBPOENA Plaintiff(s) check the box next to the protection you are requesting, in the left-hand column. If you request a -against: temporary order, you must tell the court in a statement the reasons why you feel that you might suffer great and irreparable harm if a temporary restraining order is not issued immediately. To : request an order for protection, check the box in the second column for the type of protection you are requesting. For both orders you may check more than one box. : In the STATEMENT section, you are asked to tell the court why you are requesting an order for Defendant(s) : . . . . . protection. . Enough.information .should. be .provided. in. the. declaration to allow the judge or ........ ...... ......... .... .. ...... . .. ... commissioner to decide whether an order for protection should be issued. You can assist the judge or commissioner in making this determination by listing the approximate dates and places the harassment occurred and by briefly describing how the respondent harassed you. Remember, if THE PEOPLE OF THE STATE OF NEW YORK you requested a 14-day temporary protection order, you must also tell the court in your statement the reasons why you feel that you might suffer great and irreparable harm if a temporary TO protection order is not issued immediately. When you finish your statement, complete the certification at the bottom of page 2 of the petition. You must GREETINGS: fill in the city and state where you are signing the petition. ________________________________________________________________________ WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable 4 - LAW ENFORCEMENT INFORMATION SHEET FOR UNLAWFUL at the Court STEP located County HARASSMENT (UH-01.0400). at 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 The purpose of the Law Enforcement Information Sheet is to furnish law enforcement officials with information that will assist them in serving your papers and enforcing your order. THIS FORM IS CONFIDENTIAL AND WILL NOT punishable as a contempt of court and will This you liable to BE SERVED ON THE RESPONDENT. make Your failure to comply with this subpoena is form must be behalf this subpoena was the party on whose completed in every case. issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. The Law Enforcement Information Sheet is to provide law enforcement officials with detailed information about the respondent. The Law Enforcement Information Sheet goes out to the law Witness, Honorable , one of the Justices of the enforcement agency serving the Order of Protection on the respondent. THE INFORMATION Court in County, day of , 20 CONTAINED ON THE FORM IS FOR LAW ENFORCEMENT AND COURT OFFICIALS ONLY. Your address and phone number will not be shown or given to the respondent. (Attorney must sign law enforcement Provide as much information as possible about the respondent. If you wantabove and type name below) officials to serve your papers you must list the respondent’s current address. Law enforcement personnel cannot enter your order on the statewide law enforcement computer system unless you include at least the year of the respondent’s birth where the respondent’s date of birth is Attorney(s) for requested. BE SURE YOU COMPLETE THE HAZARD INFORMATION SECTION OF THE LAW ENFORCEMENT INFORMATION SHEET. This information is forP.O. safety of law Office and the Address enforcement officials while enforcing your order for protection. ________________________________________________________________________ Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: 4 American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Instructions for Antiharassment Forms (11/98) : Index No. Calendar No. : JUDICIAL SUBPOENA Plaintiff(s) STEP 5 - TEMPORARY PROTECTION ORDER AND NOTICE OF HEARING -against: (WPF UH-03.0200). ________________________________________________________________________ : This form should be completed if you requested an ex parte temporary antiharassment protection : order in the Petition for an Order for Protection (WPF UH-02.0200). IF YOU DID NOT REQUEST AN EX PARTE TEMPORARY ANTIHARASSMENT PROTECTION ORDER Defendant(s) : . . . . . IN .YOUR. PETITION,. SKIP. THE .REMAINDER. OF. THIS. STEP AND GO TO STEP 6. .. ..... ......... .... .... ........... .. .... In paragraph 1, check the box that applies to the manner in which the respondent was served notice of the hearing. Paragraph 2 asks for identification information about the minors addressed THE PEOPLE OF THE STATE OF NEW YORK in the order. TO You should fill in the next section to the best of your ability. Check the box or boxes that correspond(s) with the temporary restraints you requested in the Petition for an Order for Protection. In the next section, regarding the Clerk of Court, be careful to make sure the correct law enforcement agency is listed. In the same section, check the appropria te box regarding GREETINGS: service of the temporary order upon the respondent. If you want law enforcement officials to serve the respondent with your papers, be careful excuses beingthe correct law enforcementyou attend before WE COMMAND YOU, that all business and to make sure laid aside, you and each of , the Honorable listed in the blank. If you are unsureat the h law enforcement agency to fill in, do not fill Court agency is whic located papers to the judge, tell the judge that you would like a law County of blank. When you present yourat in the in room , on the day of , 20 , why you o'clock in theto fill noon, and at any recessed enforcement agency to serve the respondent and explainat were unable in the blank. or adjournedneed help or have questions about this section, askthis action on the part of the If you date, to testify and give evidence as a witness in the clerk. The next section tells the respondent to appear at the next hearing. You must also appear, or the court willfailure to comply with this subpoena is punishable as a contempt of court and will make you liable to not grant the relief you are requesting. Your the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result Immediately below the section directing the respondent to appear, is a sentence stating “This of your failure to comply. Temporary Order for Protection is effective until the next hearing date, shown below the caption on page 1.” Remember to fill in the date, time and place of the next hearing on the Justices of the Witness, Honorable , one of page 1. The clerk will provide you with the hearing information. Court in County, day of , 20 Once you have finished filling in the order, sign the Order for Protection in the lower left corner of page 2, on the line for the petitioner. (Attorney must sign above and type name below) ________________________________________________________________________ STEP 6 - RETURN OF SERVICE (UNLAWFUL HARASSMENT) (WPF UH-04.0110). Attorney(s) for ________________________________________________________________________ This form is to be completed by the person who serves your papers. IF AT ALL POSSIBLE, HAVE LAW ENFORCEMENT OFFICIALS SERVE YOUR PAPERS ON YOUR HARASSER. YOU CANNOT SERVE YOUR PAPERS YOURSELF. Address Office and P.O. If someone other than a law enforcement official serves your papers, you must make sure the respondent is personally served not less than 5 court days prior to the scheduled hearing. The Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: 5 American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Instructions for Antiharassment Forms (11/98) : Index No. Calendar No. : JUDICIAL SUBPOENA Plaintiff(s) person serving your papers must be over 18 years of age and a Washington resident. After -against: serving your papers, this person must complete the return of service. : You should contact the law enforcement official or other person who is serving your papers several days prior to your hearing to make sure your papers were served. : If the respondent is not served at least 5Defendant(s) court days prior to your hearing, the judge or court : . . . . . commissioner .cannot . . . . . your. Order. for. Protection .unless. the respondent appears at the . . . . . . . . . . . . . . . . issue . . . . . . . . . . . . . . . . . . . . . . hearing. If the respondent was not properly served, go to your hearing so that a new hearing date can be set. At this time you can request that your temporary protection order be reissued. If you want your temporary protection order reissued, you need to present an Order Reissuing Ex Parte THE PEOPLE OF THE STATE OF NEW YORK Temporary Protection Order (WPF UH-03.0240) to the court. Once the court signs the Order Reissuing Ex Parte Temporary Protection Order, a copy of the Order Reissuing TO Ex Parte Temporary Protection Order, the Temporary Protection Order and a Notice of Hearing (WPF UH-3.0200) must be served on the respondent prior to your hearing. Copies of the Order Reissuing Ex Parte Temporary Protection Order and Notice of Hearing forms are available from the clerk. GREETINGS: There is no filing fee for the reissuance of a temporary protection order since your case is already open. 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 roomSTEP 7 - ORDER FORday of , on the 20 at o'clock in the noon, PROTECTION ,FROM, CIVIL HARASSMENT (WPF and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the UH-04.0500). ________________________________________________________________________ The Order for Protection is the paper that legally restrains the respondent from further harassing Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to you. 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. In paragraph 1, check the box that applies to the manner in which the respondent was served notice of the hearing. Paragraph 2 asks for identification information about the minors addressed Witness, Honorable , one of the Justices of the in the order. Court in County, day of , 20 You should fill in the next section to the best of your ability. Check the box or boxes that correspond(s) with the temporary restraints you requested in the Petition for an Order for (Attorney must sign make sure the correct Protection. In the next section, regarding the Clerk of Court, be careful to above and type name below) law enforcement agency is listed. In the same section, check the appropriate box regarding service of the temporary order upon the respondent. If you want law enforcement officials to serve the respondent with your papers, be careful to makeAttorney(s) for law enforcement sure the correct agency is listed in the blank. If you are unsure which law enforcement agency to fill in, do not fill in the blank. When you present your papers to the judge, tell the judge that you would like a law enforcement agency to serve the respondent and explain why you were unable to fill in the blank. If you need help or have questions about this section, ask the clerk. P.O. Address Office and The last paragraph has a blank for the expiration date of the order. You do not need to fill in the blank. If the Order for Protection is granted, the judge will fill in the blank. Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: 6 American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Instructions for Antiharassment Forms (11/98) : Index No. Calendar No. : JUDICIAL SUBPOENA Plaintiff(s) Once you have finished filling in the order, sign the Order for Protection in the lower left corner of : page 2, on the line for -againstthe petitioner. : : Defendant(s) : ...................................................... ________________________________________________________________________ STEP 8 - WHAT TO DO WITH THE COMPLETED FORMS. THE PEOPLE OF THE STATE OF NEW YORK ________________________________________________________________________ TO Give your completed forms to the clerk. You should ask for photocopies of all the forms you complete. If someone other than a law enforcement official will be serving your papers you will need to get certified copies of your forms for that person to serve. GREETINGS: ________________________________________________________________________ WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable 9 - GO TO YOUR HEARING. at the Court STEP 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 andon your scheduledahearing date. Ifaction on the part of the hearing, You must appear in court give evidence as witness in this you do not appear at your an Order for Protection will not be issued. 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 GENERAL INFORMATION Court in County, day of , 20 ________________________________________________________________________ If you decide that your Order for Protection is no longer necessary or that its conditions should be modified, you may request a hearing to change your order.(Attorney mustthe conditions of your below) To modify sign above and type name Order for Protection, complete the Motion to Modify Order for Protection and Notice of Hearing (WPF UH-09.0100). To terminate your Order for Protection, complete the Motion to Terminate Order for Protection and Notice of Hearing (WPF UH-09.0300). Both of these forms are Attorney(s) for available from the clerk. The clerk will also provide you with hearing information for paragraph 2 of the Notice. Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: 7 American LegalNet, Inc. www.USCourtForms.com