Free Request for Modification to Domestic Abuse Protection Order, DC 19:19 - Nebraska

STATE OF NEBRASKA FORM NO. DC19:19 NEW 10/08 Neb. Rev. Stat. § 42-924

REQUEST FOR MODIFICATION TO DOMESTIC ABUSE PROTECTION ORDER

CASE NUMBER: DOCUMENT No.:

IN THE DISTRICT COURT OF

COUNTY, NEBRASKA

Petitioner

vs.
Respondent 1.

REQUEST FOR MODIFICATION TO DOMESTIC ABUSE PROTECTION ORDER

I am the petitioner in this case. I am requesting a modification to the existing domestic abuse protection order issued on, _____________________________, pursuant to Neb. Rev. Stat. § 42-924. If petitioner is less than nineteen (19) years old, state age: . I am filing this request for a modification on behalf of the minor child(ren) whose name(s) is/are shown after mine in the caption of this petition.



2.

The modification(s) requested is/are detailed below:

3.

Reasons for modification are stated below:

1

I hereby swear, or affirm, under penalty of perjury, the forgoing is true

Signature of Petitioner Subscribed and sworn on oath before me on Clerk of the District Court/Notary Public (Seal) ,

2