IN THE CIRCUIT COURT OF THE STATE OF OREGON COUNTY OF _________________ ) ) ) ) ) ) ) ) ) )
Case No.
Petitioner (your full name),
(date of birth)
v.
ORDER RENEWING RESTRAINING ORDER (Family Abuse Prevention Act)
Respondent (full name),
(date of birth).
TO THE RESPONDENT: This order continues the original or modified restraining order and becomes effective immediately. Violation of the continued restraining order may result in your arrest or in civil and/or criminal penalties. This order is enforceable in every state, the District of Columbia, and all tribal lands and territories of the United States. If you wish to contest the continuation of this order, see your rights to a hearing in the "Notice to Respondent/Request for Hearing" form attached to this Order. The court, having reviewed the Petition to Renew Restraining Order, makes the following findings: A person in the Petitioner's situation reasonably would fear further acts of abuse by the Respondent if the Restraining Order in this matter is not renewed. No further service is necessary because the Respondent appeared in person before the court.
This matter coming before the court on the petition of the Petitioner, IT IS HEREBY ORDERED that: The Restraining Order in this matter is renewed for a period of one year, expiring on: (date). Other:
THE SECURITY AMOUNT FOR VIOLATION OF ANY PROVISION OF THIS ORDER OR THE ORIGINAL RESTRAINING ORDER IS $5,000 unless otherwise specified here: $ The Petition to Renew Restraining Order is dismissed.
ORDER RENEWING RESTRAINING ORDER - PAGE 1 OF 3
(FAPA.6/08)
FIREARMS PROHIBITIONS MAY APPLY TO YOU! As a result of this Order, or any Order continuing or changing this Order, it may be unlawful for you to possess or purchase a firearm, including, a rifle, pistol, or revolver, or ammunition pursuant to federal law under 18 U.S.C. ยง 992(g)(8), as well as state and local law. If you have any questions whether these laws make it illegal for you to possess or purchase a firearm, you should consult an attorney. CERTIFICATE OF COMPLIANCE WITH THE VIOLENCE AGAINST WOMEN ACT This protective Order meets all full faith and credit requirements of the Violence Against Women Act, 18 U.S.C. 2265 (1994). This court has jurisdiction over the parties and the subject matter. The Respondent was afforded notice and timely opportunity to be heard as provided by the law of the jurisdiction. This Order is valid and entitled to enforcement in this and all other jurisdictions.
DATED this _____ day of ____________, 20______.
JUDGE (Signature) Print, Type or Stamp Name of Judge Submitted by: Print Name, Petitioner Attorney for Petitioner OSB No. (if applicable)
Address or Contact Address
City, State, Zip
Telephone or Contact Telephone Number
ORDER RENEWING RESTRAINING ORDER - PAGE 2 OF 3
(FAPA.6/08)
RELEVANT DATA PETITIONER (you)_______________________________________________ Female Male Name ***Residence/Contact Address ________________________________________________________________ Number, Street and Apt. Number (if applicable) City County State Zip Telephone/Contact Telephone Number __________________________________________________________ Birthdate____________________ Age _______ Race/Ethnicity Height _____________ Weight_____________ Eye Color_____________ Hair Color
***If you wish to have your residential address or telephone number withheld from Respondent, use a contact address or telephone number so the Court and the Sheriff can reach you if necessary.
RESPONDENT ___________________________________________________ Female Male Name Residence Address __________________________________________________________________________ Number, Street and Apt. Number (if applicable) City County State Zip
Telephone Number Birthdate_________________ Age ______ Race/Ethnicity Height_____________ Weight_____________ Eye Color _____________ Hair Color ______________ -----------------------------------------------------------------------------------------------------------------------------PLEASE FILL OUT THIS INFORMATION TO AID IN SERVICE OF THE RESTRAINING ORDER Where is Respondent most likely to be located? Residence Hours _________________ Employment Hours _________________ Address: ___________________________________________ ___________________________________________________ Other Hours _________________ Address: __________________________________________ ___________________________________________________ Description of Vehicle ______________________________________________________________________ Is there anything about the Respondent's character, past behavior, or the present situation that indicates that the Respondent may be a danger to others? to him/herself? EXPLAIN: __________________________________ __________________________________________________________________________________________ Does the Respondent have any weapons, or access to weapons? EXPLAIN: __________________________ __________________________________________________________________________________________ Has the Respondent ever been arrested for or convicted of a violent crime? EXPLAIN: __________________ __________________________________________________________________________________________
ORDER RENEWING RESTRAINING ORDER - PAGE 3 OF 3
(FAPA.6/08)