Free Order to Modify Prior Protective Order - Georgia

ORI ___________________ THE SUPERIOR COURT FOR THE COUNTY OF________________ STATE OF GEORGIA

________________, Petitioner, v. _________________, Respondent.

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Civil Action File

No._____________________

ORDER TO MODIFY PRIOR PROTECTIVE ORDER IT IS HEREBY ORDERED, ADJUDGED and DECREED that the prior Family Violence Protective Order issued _______________________, 20____ is modified as follows: ______________________________________________________________________________ ______________________________________________________________________________ _________________________________________________________________________ the remaining parts of the Protective Order issued ____________________, 20_____ remains unmodified and in full effect. This _______ day of _______________, 20___.

___________________________ JUDGE, SUPERIOR COURT __________________ County ___________________________ Print or stamp Judge's name

TRANSMITTED TO GEORGIA PROTECTIVE ORDER REGISTRY

DATE _______ CLERK _______
Rev'd 1/10/03

* REMOVE THIS PAGE FROM ORDER *

Pursuant to O.C.G.A. Section 19-13-3, Petitioner assisted by: Name: _________________________ Address: _______________________ _______________________ Telephone: _____________________