IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF LINN
_____________________________________
Petitioner (your nam e) Gua rdian Petitioner,
vs. _____________________________________ Respondent (person to be restrained)
) ) ) ) ) ) ) ) )
CASE NO :__________________________ PETITIONER'S MOTION AND ORDER OF DISMISSAL [Elderly Persons and Person s with Disabilities Abus e Prevention A ct]
MOTION Comes now Petitioner Guardian Petitioner, _________________________, and moves this court for an order allowing the voluntary withdrawal and dismissal of the Restraining Order to Prevent Abuse of Elderly Person or Person with Disabilities on file herein. __________________________ Signature of Petitioner/Guardian Petitioner _________________________ Print or Type Name of Petitioner/ Guardian Petitioner SUBSCRIBED AND SWORN TO before me this __________ day of ________________, 200____, by _____________________________. __________________________ NOTARY PUBLIC FOR OREGON/COURT CLERK My Commission Expires: ______________________ /// /// /// /// /// /// /// /// ///
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ORDER
Motion Granted.
Motion Denied.
IT IS SO ORDERED this _____ day of ____________________, 20____
__________________________________________ JUDGE (Signature) __________________________________________ Print, Type or Stamp Name of Judge
Submitted by: __________________________________________________________________ Print Name Address or Contact Address Petitioner Guardian Petitioner _____________________________________________ Attorney for Petitioner/Guardian Petitioner OSB No: Telephone or Contact:___________________________________________ Telephone Number(s)_____________________________________________
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