PETICIONES PARA
ORDENES DE PROTECCIÓN
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PETICIONES PARA ORDENES DE PROTECCIÓN |
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You may be eligible for this Order if you believe you are in immediate danger of physical violence from a CURRENT or FORMER household member.
This information we have provided is necessary to file a PETITION for ORDER of PROTECTION. It is only to be used as a GUIDELINE when filing a Petition.
To file a PETITION for ORDER OF PROTECTION you will need to come to the: 4th Judicial District - Washington County Prosecutor’s Office Washington County Courthouse 280 North College, Suite #301 Fayetteville, AR
Please have the following information with you (the Petitioner): Ø Your name Ø Date of Birth Ø Driver’s License Number
The identity of your offender (Respondent) must be confirmed by the Sheriff’s Office. For this reason, you must provide an exact DATE OF BIRTH or DRIVER’S LICENSE. If the number you provide is incorrect, it is likely your Temporary Order will not be served or enforced.
The information needed for your Offender (the Respondent) is:
Ø Respondent’s First, Middle and Last Name Ø Race Sex Ø Weight Height Ø Hair Color Eye Color Ø Date of Birth -or- Driver’s License Number Ø Physical Address Work Address and Hours Worked Ø Vehicle Description Vehicle Tag Number
v You were referred for a Protective Order by: _________________________ v You are at least 18 years of age (or have been emancipated by a Court). v The Respondent is at least 18 years of age (or has been emancipated by a Court) v I am filing this PETITION because (You must be eligible for at least one of these): Ø I believe I am in immediate danger of Domestic Abuse OR, Ø The Respondent will be released from Jail/Prison within 30 days of today, at which time I believe I will be in danger of Domestic Abuse OR, Ø I am the Parent/Guardian of a child who I believe is in danger of Domestic Abuse OR, Ø I am responsible for a person adjudicated incompetent who I believe is in danger of Domestic Abuse. v I have filed a PETITION for a PROTECTIVE ORDER against this Respondent in the past. If a PETITION has been previously filed, please be able to provide When, Where, and What resulted and the reasons if dismissed.
You must qualify for at least one of the following:
v The Victim / Petitioner and the Respondent: Ø Are Spouses OR, {You need to provide the Date and Place of Marriage} Ø Have a divorce case pending OR, {You need to provide who the divorce was filed by} Ø Are former Spouses OR, {You need to provide the Date and Place of Divorce} Ø Are Parent and Child OR, {Respondent is Victim/Petitioner’s: (relationship) } Ø Are related by blood OR, {Respondent is Victim/Petitioner’s: (relationship) } Ø Currently reside together OR, {You have lived together since _________ Ø Formerly resided together OR, {You lived together from _____ to _____} Ø Never shared a household, but have a child together.
It is necessary that you describe the REASON or EVENTS to file for the Petition:
v I believe I am (or the Victim is) in immediate danger of physical violence because: {Please describe the events in detail, including dates and time periods.}
v I (or the Victim) have had the following contact with Law Enforcement regarding this Respondent: {List reports, arrests, pending cases, etc.}
The following are REQUESTS that can be made by the JUDGE and ordered, as part of the PROTECTION ORDER
v I request the Respondent be removed from our shared home. Ø Address of the home. o This address is ____ My home or ____ Our shared home o The home is Owned by: __________ or Leased by: ________
v I request the Respondent be restrained from making contact with me at any time or any place pending the Protective Order hearing.
v I request the Respondent be restrained from making contact with the following minors pending a Protective Order hearing: Ø Child’s Name Ø Date of Birth / Race / Sex Ø Legal Custodian Ø Child is currently living with:
v Please be prepared to initial the following statements confirming you have read them and understand them.
Ø I understand that once I complete this PETITION I must take it to the CIRCUIT CLERK’S OFFICE where I will be assigned to a JUDGE who will review my PETITION and determine my eligibility. The Judge may schedule a hearing in his/her Court to be held within 30 days and may issue a TEMPORARY PROTECTIVE ORDER to in effect until the hearing. ____
Ø I understand if the Judge awards a TEMPORARY ORDER OF PROTECTION, I must have the ORDER filed in the CIRCUIT CLERK’S OFFICE and take a copy to the appropriate SHERIFF’S DEPARTMENT so that the Respondent may be served notice of the Hearing and / or TEMPORARY ORDER. The order will not be in effect until the Respondent has been served with a copy of the PETITION and ORDER. ____
Ø I understand that if the Respondent violates this ORDER I should contact Law Enforcement immediately. To ensure proper enforcement, I should not initiate contact with the Respondent. If I feel I no longer need the ORDER, I should contact the VICTIM ASSISTANCE PROGRAM AT (479) 444-1570 for instructions. ____
Ø I understand that I am required to attend the Hearing. I understand that if I do not appear, the Judge has the option to issue an ORDER to have me brought to Court by a Deputy Sheriff and / or to charge me a filing fee. ____
Ø I understand I am not required to have an attorney at the Hearing, but that without legal representation I must be prepared to provide testimony and possible cross examination. ____
Ø I understand that the Respondent has a right to attend the Hearing and protest the allegations listed in this report. Based on testimony presented, the Judge may dismiss the PETITION, amend it, or issue a full ORDER of PROTECTION for a minimum of 90 days. ____
Ø I understand that his is not a criminal proceeding and that if I am interested in pursuing criminal charges, I may contact the VICTIM ASSISTANCE PROGRAM, a local Law Enforcement Agency, or the Prosecuting Attorney’s Office. ____
Ø I understand that once signed, this PETITION acts as a sworn AFFIDAVIT and that if I intentionally provide any false information, I may be held liable financially and / or criminally. ____
AFFIDAVIT
The Petitioner, under oath, swears that the facts listed above are true and correct according to the Petitioner’s best knowledge and belief.
____________________________________ __________________ PETITIONER’S SIGNATURE DATE |
