Superior Court of Washington County of State of Washington, Plaintiff, v. , Defendant. SID: If no SID, use DOB: No. Sexual Assault Protection Order (Criminal/Felony) (ORSXP) (JIS order code: SXP) Pretrial Post conviction Clerk's action required 1. The court finds that the defendant has been charged with, arrested for, or convicted of a sex offense as defined in RCW 9.94A.030, a violation of RCW 9A.44.096, a violation of RCW 9.68A.090, or a gross misdemeanor that is, under chapter 9A.28 RCW, a criminal attempt, criminal solicitation, or criminal conspiracy to commit an offense that is classified as a sex offense under RCW 9.94A.030. Additional findings on page two. 2. This Sexual Assault Protection Order is entered pursuant to RCW 7.90.150. This order protects: . (Write protected person's name or if minor you may use initials and DOB. RCW 7.69A.030, 10.52.100, 10.97.130.) It Is Ordered: This Pretrial Sexual Assault Protection Order Expires on . This Post Conviction Sexual Assault Protection Order Expires on . (A final sexual assault protection order entered in conjunction with a criminal prosecution shall remain in effect for a period of two years following the expiration of any sentence of imprisonment and subsequent period of community supervision, conditional release, probation, or parole.) Defendant: A. do not contact the protected person(s) directly, indirectly, in person or through others whether or not the others know of the order. B. do not knowingly come within or stay within (distance) of the protected person'(s) residence school place of employment other: ___________ . do not obtain, own, possess or control a firearm. (Pretrial: crimes defined as serious offenses) do not obtain, own, possess or control a firearm. (Post-conviction) Additional orders on page two. C. Sexual Assault Protection Order (ORSXP) - Page 1 of 2 WPF CR 84.0440 (06/2014) ­ RCW 7.90.150 American LegalNet, Inc. www.FormsWorkFlow.com Cause No.:_________________________ Warning: Violation of this order is a criminal offense under chapter 26.50 RCW and will subject a violator to arrest. You can be arrested even if any person protected by the order invites or allows you to violate the order's prohibitions. You have the sole responsibility to avoid or refrain from violating the order's provisions. Only the court can change the order. (Pretrial order for crimes not defined as serious offenses in RCW 9.41.010) It Is Further Ordered: Defendant is prohibited from obtaining or possessing a firearm, other dangerous weapon or concealed pistol license. The defendant shall immediately surrender all firearms and other dangerous weapons within the defendant's possession or control and any concealed pistol license to: (name/law enforcement agency). The the pretrial orders for crimes not defined as serious offenses in RCW 9.41.010 are based upon the court's finding that possession of a firearm or other dangerous weapon by the defendant presents a serious and imminent threat to public health or safety, or to the health or safety of any individual. RCW 9.41.800(4). The court finds that the defendant's relationship to a person protected by this order is: spouse or former spouse current or former domestic partner parent of a child in common current or former cohabitant as part of a dating relationship. (It is unclear whether the court can order under RCW 7.90.150 the restraints necessary to qualify for mandatory surrender of weapons under RCW 9.41.800(3). If the court determines it can make the necessary findings, additional findings and orders may be attached.) This order is issued in accordance with Full Faith and Credit provisions of Violence Against Women Act. Federal penalties may apply. WACIC Data Entry It is further ordered that the clerk of the court shall forward a copy of this order on or before the next judicial day to:_____________________________________________ County Sheriff's Office Police Department where the case is filed, which shall enter it into the Washington Crime Information Center. Done in Open Court in the presence of the defendant this date: . Judge/Print or Type Name ________________________ Deputy Prosecuting Attorney WSBA No. Print or Type Name: _____________________ Attorney for Defendant WSBA No. Print or Type Name: _________________________ Defendant Print or Type Name: A Law Enforcement Information Sheet (LEIS) must be completed. Sexual Assault Protection Order (ORSXP) - Page 2 of 2 WPF CR 84.0440 (06/2014) ­ RCW 7.90.150 American LegalNet, Inc. www.FormsWorkFlow.com