COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Plaintiff(s) -against- Calendar No. : JUDICIAL SUBPOENA : : : Defendant(s) : ...................................................... IN THE DISTRICT COURT OF SPOKANE COUNTY WASHINGTON THE PEOPLE OF THE STATE OF NEW YORK ________________________________________ Petitioner TO vs. GREETINGS: NO. PETITION FOR AN ORDER FOR PROTECTION (Unlawful Harassment) ________________________________________ WE COMMAND YOU, that allRespondent excuses being laid aside, you and each of you attend before business and , the Honorable at the Court ________________________________________ located at County of Respondent’s Address 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 ____________________Respondent’s Date of Birth _____________________________________________________________________________________________ Your failure to I. PETITIONER’S AFFIDAVIT (STATEMENT) court and will make you liable to comply with this subpoena is punishable as a contempt of 1.1 partyI,on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages for ______________________________________________________, am petitioning sustained as a the result of An Order for Protection from Unlawful Harassment. your failure to comply. 1.2 The alleged acts of unlawful harassment occurred in ______________________County. 1.3 I Witness, Honorable am the victim of unlawful harassment committed by the respondent as set forth of the , one of the Justices on page Court in 2 of this petition. County, day of , 20 II. REQUEST FOR ORDER FOR PROTECTION FROM CIVIL HARASSMENT AND TEMPORARY ANTIHARASSMENT PROTECTION (Attorney must sign above and type name below) ORDER 2.1 I request that an Order for Protection from Civil Harassment be issued that will: (a) [ ] Restrain the respondent from attempting to contact me. Attorney(s) for (b) [ ] Restrain the respondent from making any attempts to keep my under surveillance. (c) [ ] Requiring the respondent to stay away from my residence and workplace. (d) [ ] Other: Office and P.O. Address PETITION FOR AN ORDER OF PROTECTION (Unlawful Harassment) RCW 10.14.080/.120/.180 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: PAGE 1 OF 3 American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. 2.2 [ ] An emergency exists, and I request that a temporary antiharassment restraining : Plaintiff(s) order, granting the relief requested in Paragraph 2.1 above JUDICIAL SUBPOENA be issued immediately without notice to the Respondent to avoid irreparable harm. : -against- 2.3 Other court cases or any other protection order or no-contact order involving me and the : respondent are: : CASE NAME Defendant(s) : CASE. NUMBER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........ ......... COURT/COUNTY THE PEOPLE OF THE STATE OF NEW YORK III. CERTIFICATION OF STATEMENTS IN THE PETITION TO I certify that I have not previously obtained two (2) temporary antiharassment protection orders against the respondent above without obtaining an Order for Protection from Civil Harassment. I certify under penalty of perjury under the laws of the State of Washington that I have read the above statement, know the contents thereof, and believe them to be true and correct. GREETINGS: (R.C.W.91A.72.095). WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court Dated of located at County ___________ 20___ at Spokane, Washington Petitioner__________________________ in room , on the day of , 20 , at o'clock in the noon, and at any recessed STATEMENT OF PETITIONER or adjourned date, to testify and give evidence as a witness in this action on the part of the I am the victim of unlawful harassment committed by the respondent as follows: (Describe specific acts and approximate dates of unlawful harassment. Unlawful harassment means a knowingYour failure to course of conduct directedpunishable as a contemptwhich seriously make you liable to and willful comply with this subpoena is at a specific person of court and will alarms, the party or harasses such person, and was issued for ano legitimate or lawful purpose. Course of on whose behalf this subpoena which serves maximum penalty of $50 and all damages sustained as a annoys, result of your failure to comply. conduct means a pattern of conduct composed of a series of acts, except constitutionally protected activities, over a period of time, however short, evidencing a continuity of purpose.) 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 PETITION FOR AN ORDER OF PROTECTION (Unlawful Harassment) RCW 10.14.080/.120/.180 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: PAGE 2 OF 3 American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : STATEMENT (Continued) Plaintiff(s) Calendar No. : JUDICIAL SUBPOENA ______________________________________________________________________________ -against- : ______________________________________________________________________________ : ______________________________________________________________________________ : ______________________________________________________________________________ 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 I certify under penalty of perjury under the laws of the State of Washington that I have read the Your failure to comply with this subpoena is punishable as a contempt be court and correct. you liable to above statement, know the contents thereof, and believe them to of true and will make 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. DATED _________________ 20___ at Spokane, Washington Witness, Honorable Court in County, , one of the Justices of the day of , 20 _____________________________________________ Signature of Petitioner (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address District Court complies with Americans with Disabilities Act (ADA). Persons with disabilities that would require accommodation should call the Court (509) 477-3661, TDD available. PETITION FOR AN ORDER OF PROTECTION (Unlawful Harassment) RCW 10.14.080/.120/.180 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: PAGE 3 OF 3 American LegalNet, Inc. www.USCourtForms.com