COURT OF WASHINGTON FOR NO. Petitioner vs. Respondent ORDER TO SURRENDER WEAPON (HARASSMENT) (ORWPN) (Clerk's Action Required) THIS MATTER CAME ON regularly before the court on a Petition for Surrender of Weapon. Based upon the petition, testimony, and the case record, the court finds: By clear and convincing evidence that Petitioner Respondent has used, displayed, or threatened to use a firearm or other dangerous weapon in a felony, or previously committed any offense making him or her ineligible to possess a firearm under RCW 9.41.040, AND IT IS THEREFORE ORDERED that said party: Surrender any firearm or other dangerous weapon to the sheriff of _______________________________________________County. chief of police of city of _____________________________________. that party's counsel. other __________________________________________________________________________; Surrender any concealed pistol license issued under RCW 9.41.070; and Is prohibited from obtaining or possessing a firearm or other dangerous weapon or concealed pistol license. ORD TO SURRENDER WEAPON (HARASSMENT) (ORWPN) - Page 1 of 2 WPF UH-04.0400 (9/2000) - RCW 9.41.800 2001 © American LegalNet, Inc. By a preponderance of the evidence that Petitioner Respondent has used, displayed, or threatened to use a firearm or other dangerous weapon in a felony, or previously committed any offense making him or her ineligible to possess a pistol under RCW 9.41.040, OR That possession of a firearm or other dangerous weapon by the nonmoving party presents a serious and imminent threat to public health or safety, or to the health or safety of any individual, AND IT IS THEREFORE ORDERED that said party: Surrender any firearm or other dangerous weapon to the sheriff of ____________________________________________ County. chief of police of city of __________________________________. that party's counsel. other_________________________________________________________________________ Surrender any concealed pistol license issued under RCW 9.41.070. Is prohibited from obtaining or possessing a firearm or other dangerous weapon or concealed pistol license. This order expires on . (date) The clerk of the court shall forward a copy of this order on or before the next judicial day to: ________________________________ County Sheriff's Office or ____________________________ Police Department where petitioner lives which shall enter this order in any computer-based criminal intelligence system available in this state used by law enforcement to list outstanding warrants. ________________________________ County Sheriff's Office or ____________________________ Police Department where respondent lives which shall personally serve the respondent with a copy of this order, the Temporary Order, and the Petition, and shall promptly complete and return to this court proof of service. DATED at a.m./p.m. JUDGE/COMMISSIONER Presented by: Moving Party I acknowledge receipt of a copy of this Order. Date Receiving Party Date ORD TO SURRENDER WEAPON (HARASSMENT) (ORWPN) - Page 2 of 2 WPF UH-04.0400 (9/2000) - RCW 9.41.800 2001 © American LegalNet, Inc.