Petition for Injunction for Protection Against Domestic Violence · Step 4 of 6

Children

Name Write the full name of your first minor child. Birth date Write your first child's date of birth. Name Write the full name of your second minor child, if you have one. Birth date Write your second child's date of birth, if you have one. Name Write the full name of your third minor child, if you have one. Birth date Write your third child's date of birth, if you have one. saw the domestic violence described in this petition happen. Check this box if the children actually watched the abuse happen. Pick only one option from this list. were at the place where the domestic violence happened but did not see it. Check this box if the children were nearby when the abuse happened but did not actually see it. Pick only one option from this list. were not there when the domestic violence happened this time but have seen previous acts of domestic violence by Respondent. Check this box if the children were not present this time but have seen the Respondent be violent before. Pick only one option from this list. have not witnessed domestic violence by Respondent. Check this box if the children have never seen the Respondent be violent. Pick only one option from this list. Name any other minor children who were there when the domestic violence happened. Include children's name, age, and parents' names. List any other children who were there during the abuse. Give each child's name, age, and the names of their parents.

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