Court of Washington For No. Petitioner, vs. Respondent. Petition for an Order for Protection Harassment (PTORAH) and/or Stalking (PTORSTK) This is a Petition for an Order for Protection against Harassment and/or Stalking as checked in the caption. I believe: I am a victim of stalking. _________________________ (name) is the victim of stalking and he/she is a minor or vulnerable adult. The respondent has been - stalking the victim either in person or cyber stalking, and - repeatedly contacting the victim or attempting to contact or monitor the victim for no lawful purpose and his/her actions caused the victim to feel intimidated, frightened or threatened. I am a victim of unlawful harassment. _____________________________ (name) is a victim of unlawful harassment and he/she is a minor. The respondent's actions toward the victim have seriously alarmed, annoyed or harassed the victim, or are detrimental to the victim and serve no legitimate or lawful purpose. The respondent's actions have caused substantial emotional distress to the victim or caused me to fear for the well-being of my child. How do the victim and respondent know each other? _______________________-__ I have given a detailed explanation below. 1. Who is the petitioner? My name is (please print) _________________________________. I am the petitioner. Pt for an Or for Protection ­ Harassment/Stalking (PTORAH, PTORSTK) ­ Page 1 of 7 WPF UHST-02.0200 (07/2015) ­ RCW 10.14.040, .800, RCW 7.92.030 American LegalNet, Inc. www.FormsWorkFlow.com I am 18 or older and I am petitioning on my own behalf. I am 16 or 17 and I am petitioning on my own behalf. I am the parent or guardian of child/ren under age 18 and I am petitioning on their behalf: Children's Name/s (First, Middle Initial, Last) Age I am not the parent or guardian, but the child/ren live/s with me; and I am petitioning on their behalf; and the respondent is not a parent. Children's Name/s (First, Middle Initial, Last) Age I am filing this petition on behalf of petitioner, (name) ________________________, a vulnerable adult as defined in RCW 74.34.020, who is a victim of stalking. I am an interested person as defined in RCW 74.34.020(10). My relationship to this petitioner is _____________________. 2. Is the respondent 18 years of age or older? Yes No (If no, use the Petition for Order for Protection Harassment/Stalking Respondent Under Age 18, instead of this petition.) 3. Where do the parties live? Petitioner lives in ____________________________________ county. Did the petitioner leave their residence because of stalking conduct and that is the county of their new residence? Yes No Children named above live in __________________________ county. Respondent lives in ___________________________________ county. 4. Where did the Conduct take place? The conduct took place in ____________________ county. Pt for an Or for Protection ­ Harassment/Stalking (PTORAH, PTORSTK) ­ Page 2 of 7 WPF UHST-02.0200 (07/2015) ­ RCW 10.14.040, .800, RCW 7.92.030 American LegalNet, Inc. www.FormsWorkFlow.com  Statement describing the victim/s need for protection from the respondent Write clearly. If you need more space below, attach additional page/s. Do not write on the back. 5. Describe what the Respondent did or said that you think is harassment or stalking. You must describe what the respondent actually said. You must describe what the respondent actually did. The respondent has committed acts of harassment or stalking as follows: A. Describe the most recent incident of harassment or stalking. Date and time (on or around): __________________________________________________ Location: __________________________________________________________________ What did the respondent do or say that you believe to be harassing or stalking behavior? . Pt for an Or for Protection ­ Harassment/Stalking (PTORAH, PTORSTK) ­ Page 3 of 7 WPF UHST-02.0200 (07/2015) ­ RCW 10.14.040, .800, RCW 7.92.030 American LegalNet, Inc. www.FormsWorkFlow.com How did the respondent make these statements? in person mail/written notes e-mail text phone social media (such as facebook and twitter) other (describe): _________________________________________________________. B. Describe other incidents of harassment or stalking. For each incident, include the date, time (on or about), location, what was said, how statements were made, and what was done to a victim. . 6. How did the incidents you describe above make you, the minor, or the vulnerable adult feel? . Pt for an Or for Protection ­ Harassment/Stalking (PTORAH, PTORSTK) ­ Page 4 of 7 WPF UHST-02.0200 (07/2015) ­ RCW 10.14.040, .800, RCW 7.92.030 American LegalNet, Inc. www.FormsWorkFlow.com 7. Has the respondent used, displayed, or threatened to use a firearm or other dangerous weapon in a felony? Please describe: . 8. Has the respondent previously committed an offense that makes him or her ineligible to possess a firearm under the provisions of RCW 9.41.040? Please describe: . 9. Does possession of a firearm or other dangerous weapon by the respondent present a serious and imminent threat to public health or safety, or to the health or safety of a victim? Please describe: . 10. Do you have any evidence of the harassment or stalking conduct other than testimony? No Yes. I have attached the following evidence: Copy of mail or written notes Copy of text messages Copy of emailed messages Copy of social media messages Police report Declaration or Affidavit from the following witness: ___________________ Other (describe): _____________________________________________ 11. Has/have the victim/s or the respondent ever requested or obtained protection from the other person in a restraining order, civil protection order, or criminal no-contact order? If yes, list the type of order, the name of the court and the approximate date, and whether the request was granted: . Pt for an Or for Protection ­ Harassment/Stalking (PTORAH, PTORSTK) ­ Page 5 of 7 WPF UHST-02.0200 (07/2015) ­ RCW 10.14.040, .800, RCW 7.92.030 American LegalNet, Inc. www.FormsWorkFlow.com 12. Is there any other litigation between the victim/s and the respondent? This includes all matters - pending or past - such as parenting plans, landlord-tenant disputes, employment disputes, or property disputes. If yes, provide case number/s if known, type of case, and name of court: . Requests 13. I ask the Court for an order approving the following requests for protection: I Request an Order for Protection follo