Petition for Injunction for Protection Against Domestic Violence — What You Are Asking For

a. General Information

Yes Check this if you have asked any court for a protection order against this person before. No Check this if you have never asked a court for a protection order against this person. If yes, what happened in that case? {Include case number, if known} Explain what happened with that earlier case and include the case number if you know it.

b. Possession & Access

Petitioner needs the exclusive use and possession of the home that the parties share at {street address} Check this box if you want to live in the shared home and have the Respondent stay out. Petitioner needs the exclusive use and possession of the home that the parties share at {street address} Write the street address of the home you and the Respondent share. {city, state, zip code} Write the city, state, and ZIP code for that shared home. Petitioner cannot get another safe place to live because: Check this box if you have no other safe place to stay. Petitioner cannot get another safe place to live because: Explain why you cannot find another safe place to live, such as no money or no family nearby. If kept out of the home, Respondent has the money to get other housing or may live without money at {street address} Check this box if the Respondent could afford other housing or has another place to live. If kept out of the home, Respondent has the money to get other housing or may live without money at {street address} Write the street address where the Respondent could live instead, if you know it. {city, state, zip code} Write the city, state, and ZIP code for the Respondent's other housing option. owned or rented by Petitioner and Respondent jointly. Check this if both you and the Respondent own or rent the home together. solely owned or rented by Petitioner. Check this if only you own or rent the home. solely owned or rented by Respondent. Check this if only the Respondent owns or rents the home. Petitioner requests that the Court provide a temporary parenting plan, including a temporary time-sharing schedule, with regard to the minor child or children of the parties, as follows: Check this box if you want the court to set up a temporary plan for who cares for the children and when. You can check more than one option in this section. as follows: Describe the parenting plan and schedule you want, such as who the children live with and when each parent sees them. Petitioner requests that the Court order supervised exchange of the minor children or exchange through a responsible person designated by the Court. The following person is suggested as a responsible person for purposes of such exchange. {Explain}: Check this box if you want another person to be present when the children are handed off between parents, to keep it safe. {Explain}: Name the person you suggest to oversee the hand-off of the children, and explain why this is needed. Petitioner requests that the Court limit time-sharing by Respondent with the minor children. {Explain}: Check this box if you want the court to reduce how much time the Respondent spends with the children. {Explain}: Explain why the Respondent's time with the children should be limited. Petitioner requests that the Court prohibit time-sharing by Respondent with the minor children because Petitioner genuinely fears that Respondent imminently will abuse, remove, or hide the minor children from Petitioner. {Explain}: Check this box if you want the court to stop the Respondent from spending any time with the children because you fear they may hurt, take, or hide them. {Explain}: Explain why you fear the Respondent will harm, take, or hide the children if allowed to see them. Petitioner requests that the Court allow only supervised time-sharing by Respondent with the minor children. {Explain}: Check this box if you want the Respondent to see the children only while another person is watching. {Explain}: Explain why the Respondent should only see the children with someone else present. Supervision should be provided by a Family Visitation Center, or other (specify): Name who should supervise the visits, such as a Family Visitation Center or another specific person or place. Petitioner requests to have exclusive care, possession, and control of the following animal(s) which are owned, possessed, harbored, kept, or held by Petitioner, Respondent, or a minor child residing in Petitioner's or Respondent's residence or household: Check this box if you want to be the only person in charge of caring for and keeping certain pets. Use the next line to list those pets. Petitioner requests to have exclusive care, possession, and control of the following animal(s) which are owned, possessed, harbored, kept, or held by Petitioner, Respondent, or a minor child residing in Petitioner's or Respondent's residence or household: Describe the pets you want full care of. Include the type of animal, name, breed, or color so the court knows which ones you mean. Petitioner requests that Respondent have no contact with the following animal(s) and be prohibited from taking, transferring, encumbering, concealing, harming, or otherwise disposing of them: Check this box if you want the court to order the Respondent to stay away from certain pets and not harm or move them. List those pets on the next line. Petitioner requests that Respondent have no contact with the following animal(s) and be prohibited from taking, transferring, encumbering, concealing, harming, or otherwise disposing of them: Describe the pets you want the Respondent to have no contact with. Include the type of animal, name, breed, or color. Petitioner claims a need for the money he or she is asking the Court to make Respondent pay, and that Respondent has the ability to pay that money. Check this box if you need money from the Respondent and believe the Respondent can afford to pay it. Petitioner requests that the Court order Respondent to pay the following temporary alimony to Petitioner. Check this box if you want the court to order the Respondent to give you spousal support payments for now. You must be married to ask for this. Temporary Alimony Requested $ Enter the dollar amount of spousal support you are asking the Respondent to pay you. every: week Check this box if you want the spousal support paid once every week. other week Check this box if you want the spousal support paid once every two weeks. month Check this box if you want the spousal support paid once every month.

c. Child Support

Petitioner requests that the Court order Respondent to pay the following temporary child support to Petitioner. Check this box if you want the court to order the Respondent to pay money to help support your children for now. The Respondent must be the children's parent or legal guardian. Temporary child support is requested in the amount of $ Enter the dollar amount of child support you are asking the Respondent to pay. every: week Check this box if you want the child support paid once every week. other week Check this box if you want the child support paid once every two weeks. month Check this box if you want the child support paid once every month. the address of Petitioner's place(s) of employment or school is: Write the full street address of where you work or go to school. This lets the court keep the other person away from those places. f. prohibiting Respondent from going to or within 500 feet of the following place(s) Petitioner or Petitioner's minor children must go often {include address}: Check this box if you want the other person to stay at least 500 feet away from other places you or your children visit often. You will list those places below. prohibiting Respondent from going to or within 500 feet of the following place(s) Petitioner or Petitioner's minor children must go often {include address}: List the addresses of places you or your children go often, like a church, gym, or relative's home. Include the full address for each one.

d. Possession & Access

g. granting Petitioner temporary exclusive use and possession of the home Petitioner and Respondent share; Check this box if you want to be the only one allowed to live in the home you share with the other person. h. granting Petitioner on a temporary basis 100% of the time sharing with the parties' minor children; Check this box if you want to have your children with you all of the time for now. i. establishing a temporary parenting plan including a temporary time-sharing schedule for the parties' minor children; Check this box if you want the court to set up a temporary schedule for who has the children and when. j. granting Petitioner exclusive care, possession, or control of the animal(s) identified in paragraph 1 of Section VI which are owned, possessed, harbored, kept or held by Petitioner, Respondent, or a minor child residing in Petitioner or Respondent's residence or household; Check this box if you want to be the only one to care for and keep the pet(s) you listed in Section VI. k. prohibiting Respondent from having any contact with the animal(s) identified in paragraph 2 of Section VI or from taking, transferring, encumbering, concealing, harming, or otherwise disposing of them; Check this box if you want to stop the other person from going near, taking, or harming the pet(s) you listed in Section VI. l. granting temporary alimony for Petitioner; Check this box if you want the other person to pay you money for support for now.

e. Child Support

m. granting temporary child support for the minor children; Check this box if you want the other person to pay money to help support your children for now. n. ordering Respondent to participate in treatment, intervention, and/or counseling services; Check this box if you want the court to order the other person to attend treatment or counseling. o. referring Petitioner to a certified domestic violence center Check this box if you want the court to send you to a domestic violence help center and add any other protection terms.