Order of Protection Page 1 of 6 Revised July 31, 2018 Circuit Court of the Judicial District, County of , State of Wyoming Case Number Court Address Court Phone Number (307) ORDER OF PROTECTION THIS ORDER EXPIRES ON: This Order shall be in effect and will expire at 12:01 a.m. on the day of , 20 , unless extended by order of the Court. PETITIONER First Middle Last PETITIONER IDENTIFIERS Date of Birth of Petitioner Race Sex RESPONDENT First Middle Last Respondent222s Physical Address: Respondent222s Mailing Address: CAUTION: Firearms Involved Firearms on Property RESPONDENT IDENTIFIERS SEX RACE DOB HT WT EYES HAIR DRIVERS LICENSE# STATE EXP DATE VEH. MAKE/MODEL COLOR PLATE# EMPLOYMENT Additional Information (i.e. other names used, tattoos, scars): American LegalNet, Inc. www.FormsWorkFlow.com Order of Protection Page 2 of 6 Revised July 31, 2018 THIS MATTER was heard on , . These parties were present: PETITIONER RESPONDENT Appeared in person Appeared in person Did not appear and was given proper notice Attorney Attorney THE COURT FINDS: Petitioner and Respondent are married to each other Petitioner and Respondent are living together as if married Petitioner and Respondent were formerly married to each other Petitioner and Respondent formerly lived together as if married Petitioner is the parent of Respondent Petitioner is an adult sharing common living quarters with the Respondent Petitioner and Respondent are parents of a child(ren) and are not living together Petitioner is an adult child of Respondent Petitioner and Respondent are in a dating relationship Petitioner and Respondent have previously been in a dating relationship Petitioner has requested that the sole right to use and sole financial responsibility for a mobile phone number or numbers be transferred to Petitioner. THE COURT FURTHER FINDS: The Respondent has stipulated that an act of domestic abuse as defined by WYO. STAT. ANN. 247 35-21-102 (a)(iii) has occurred. Based upon the foregoing stipulation, the Court finds that the Respondent has committed an act of domestic abuse as defined by WYO. STAT. ANN. 247 35-21-102 (a)(iii). The Respondent stipulates that the Court may exercise jurisdiction over him/her under the Domestic Violence Protection Act even though the Respondent may dispute that he/she has committed an act of domestic abuse against the Petitioner. WYO. STAT. ANN. 247247 35-21-101 to 112. After having heard the evidence, the Court finds that an act of domestic abuse as defined by WYO. STAT. ANN. 247 35-21-102(a)(iii) has occurred. This Court has jurisdiction over the parties and subject matter of this action. IT IS ORDERED, ADJUDGED, AND DECREED AS FOLLOWS: 1. Respondent shall not commit any of the following acts: (A) Physically abusing, threatening to physically abuse, attempting to cause or causing physical harm or acts which unreasonably restrain the personal liberty of the Petitioner; (B) Placing the American LegalNet, Inc. www.FormsWorkFlow.com Order of Protection Page 3 of 6 Revised July 31, 2018 Petitioner in reasonable fear of imminent physical harm; or (C) Causing the Petitioner to engage involuntarily in sexual activity by force, threat of force or duress. 2. Respondent shall not initiate contact with Petitioner anywhere either directly or indirectly, including, but not limited to, communication verbally in person, communication by telephone or other electronic means, written communication in any form, communication through third persons, and nonverbal communication and gestures. Prohibited contact under this paragraph includes telephone calls, mail, e-mail, texting, fax, contacting through social media using the internet or similar technology and any other form of communication. 3. Respondent shall not be at the Petitioner222s place of employment or residence or so near the same as to upset the life of Petitioner under any circumstances. The Respondent shall not place the Petitioner under surveillance. 4. Respondent shall provide the Court with a current mailing address. While this Order is in effect, the Respondent shall promptly inform the Court in writing if that mailing address changes. Mailing of appropriate documents (for example: modification, termination or extension of this Order) to the most recent mailing address provided to the Court by the Respondent shall be considered service upon the Respondent. IT IS FURTHER ORDERED: 5. Petitioner is granted sole possession of the following residence during the period this order is in effect. Respondent shall immediately vacate and is restrained and enjoined from entering or being at Petitioner222s premises at: 6. Petitioner is awarded temporary custody of the following child(ren). Respondent is restrained from abducting, removing or concealing any child(ren) from Petitioner222s custody. 7. Respondent is provided reasonable visitation rights with the above-named child(ren) as follows: American LegalNet, Inc. www.FormsWorkFlow.com Order of Protection Page 4 of 6 Revised July 31, 2018 8. If custody/visitation in this order modifies the previous order, it shall remain effective only until the parties revisit the issue in the original court. 9. Respondent is ordered to pay to Petitioner temporary child support in the amount of $ per month, commencing on and on the day of each month thereafter. Payments are to be made to the Circuit Court. 10. Respondent is ordered to pay medical costs incurred by Petitioner as a result of the abuse inflicted herein in the amount of $ . Payment shall be made as follows: 11. Respondent is restrained from transferring, concealing, encumbering or otherwise disposing of Petitioner222s property or the joint property of the parties. This order shall not affect title to any property nor allow the Petitioner to transfer, conceal, encumber or otherwise dispose of Respondent222s property or the joint property of the parties. 12. Respondent may retrieve personal belongings from the residence located at: . This retrieval shall occur on , 20 between a.m./p.m. and a.m./p.m. Respondent shall be accompanied by law enforcement. Respondent222s belongings may be retrieved from the residence located at: by a 3 rd party (name) on , 20, between a.m./p.m. and a.m./p.m. The 3rd party shall be accompanied by law enforcement. 13. Respondent shall undergo appropriate counseling as follows: 14. Respondent shall not possess firearms: American LegalNet, Inc. www.FormsWorkFlow.com Order of Protection Page 5 of 6 Revised July 31, 2018 15. A separate "Order for Transfer of Mobile Number Use and Financial Responsibility224 shall be signed and appended hereto, which orders the Respondent222s commercial mobile services provider (as defined in 47 U.S.C. sec. 332 (d)) to transfer to the Petitioner the sole right to use and sole financial responsibility for the mobile telephone number(s) used by the Petitioner or a minor child in the Petitioner222s custody, and to terminate in the provider222s system the Respondent222s ability to use and to access any data associated with the mobile telephone number(s). 16. Other: The Court Orders the Parties to Take Notice of the Following: Certain provisions of the Federal Violent Crime Control and Law Enforcement Act of 1994 make it unlawful for persons subject to domestic violence protection orders to possess, ship, use or transfer any firearms or ammunition. Gun Control Act, 18 U.S.C. Section 922(g)(8). This order shall be filed with the clerk of court and a copy shall be sent by the clerk to the county sheriff who shall, after service, notify the local law enforcement agency within the county in which the Petitioner resides. The order shall be personally served upon the Respondent, unless the Respondent or the Respondent's attorney was present when the order was issued. This order applies immediately to the Respondent and shall remain in full force and effect until the expiration date of the order or until it is modified or terminated by this court. Interstate violation of this order may subject the Respondent to federal criminal penalties. 18 U.S.C. 247247 2261, 2261 (A) and 2262. This protection order is enforceable in all fifty states, the District of Columbia, tribal la