Sexual Assault Order of Protection Page 1 of 5 Revised July 31, 2018 Circuit Court of the Judicial District, County of , State of Wyoming Case Number Court Address Court Phone Number 307- SEXUAL ASSAULT ORDER OF PROTECTION 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. THIS MATTER was heard on , 20 . These parties were present: 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 Sexual Assault Order of Protection Page 2 of 5 Revised July 31, 2018 PETITIONER RESPONDENT Appeared in person Appeared in person Did not appear and was given proper notice Attorney Attorney THE COURT FINDS: This Court has jurisdiction over the parties and subject matter of this action. The parties stipulate to the Court exercising jurisdiction in this case and the subject matter of this action. After hearing the testimony of the parties and their witnesses, the Court finds that the Respondent222s conduct constitutes sexual assault as defined by W.S. 2476-2-302, 6-2-303, 6-2-314 through 6-2-318 and that an Order of Protection should be entered. IT IS ORDERED, ADJUDGED AND DECREED AS FOLLOWS: 1. Respondent shall not have contact with Petitioner, or with any of the persons listed in Paragraph 3 below, 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. 2. 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 THAT the Respondent shall comply with this Order as checked below: 3. Respondent shall not personally, or through any other person or means, contact, harass, threaten, intimidate, or otherwise interfere with Petitioner, or any of the following people: American LegalNet, Inc. www.FormsWorkFlow.com Sexual Assault Order of Protection Page 3 of 5 Revised July 31, 2018 4. Respondent shall not stop at, enter into, or place under surveillance any of the following locations: Home School Business Place of Employment Other Location (describe) 5. Respondent shall not be at the Petitioner222s place of employment or residence. In addition, the Respondent shall not be at any other location where Petitioner may be found. The Respondent shall not place the Petitioner under surveillance. 6. Respondent is restrained from attending classes that are also attended by the Petitioner at school. 7. Other Requirements: 8. Respondent shall not use or possess firearms: American LegalNet, Inc. www.FormsWorkFlow.com Sexual Assault Order of Protection Page 4 of 5 Revised July 31, 2018 Case Number A copy of this Order shall be sent by the Clerk to the County Sheriff, who shall notify the local law enforcement agencies within the county of the existence of this Order. 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 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 will be filed with one or more local law enforcement agencies. 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 lands and U.S. territories, and is issued to prevent violent or threatening acts by the Respondent against the Petitioner. 18 U.S.C. 247 2265. WARNING: The Petitioner cannot give you legal permission to violate this order. If you go near the Petitioner or other protected persons, even with their consent, you may be arrested. You act at your own risk if you disregard this WARNING. If you want to modify or dismiss the order you must ask the Court. Only the Court can change this Order. Willful violation of any provision of this Order of Protection constitutes a crime as defined by Wyo. Stat. Ann. 247 7-3-510(c) and can result in immediate arrest. A violation of this Order of Protection that constitutes the offense of stalking as defined by W.S. 247 6-2-506(b), may subject the Respondent to enhanced penalties for felony stalking under W.S. 6-2-506(e). DATED this day of , 20 . BY THE COURT: JUDGE OR MAGISTRATE American LegalNet, Inc. www.FormsWorkFlow.com Sexual Assault Order of Protection Page 5 of 5 Revised July 31, 2018 ACCEPTANCE OF SERVICE I, , Respondent in this action, voluntarily accept service of the within Order of Protection, and acknowledge that I have received a true copy thereof. Respondent's Signature Date CERTIFICATE OF SERVICE Petitioner Sheriff222s Office Petitioner222s Attorney Police Department Respondent Victim-Witness Coordinator Respondent222s Attorney American LegalNet, Inc. www.FormsWorkFlow.com