PETITION FOR ORDER OF PROTECTION
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PETITION FOR ORDER OF PROTECTION
(A.R.S.
Section 13-3602)
Petitioner
alleges as follows:
1.
Petitioner’s name is:
2.
Petitioner’s address, if subject to disclosure, is:
3. The
name and address, if known, of the defendant are:
4. The
conduct constituting domestic violence, including the dates of its
commission is as follows:
A. The
relationship between petitioner and respondent is:
B.
Whether there is pending between the parties an action for annulment,
legal separation or dissolution of marriage:
C. The
name of the court in which any prior or pending proceeding or order
was sought or issued concerning the conduct which is sought to be
restrained is:
WHEREFORE, petitioner prays for relief as follows:
1. For the
immediate issuance of an ex parte order of protection granting the
following relief:
a. Enjoining the
respondent from committing the conduct known as domestic violence and
defined in A.R.S. Section 13-3601, as amended;
b. Enjoining and
restraining the respondent from coming near the residence and place of
employment of the petitioner;
c. Enjoining and
restraining the respondent from coming near the Petitioner at the
following designated locations:
2. For an
order requiring respondent to pay the reasonable attorney's fees and
costs of petitioner, through the Clerk of the Court, within thirty (30)
days of the issuance of the order;
3. For
such other and further relief as the Court deems just.
Dated this ____ day of
_______, 200__.
_____________________________
(Signature of Petitioner)
V E R I F I C A T I O N
STATE OF ARIZONA )
) ss.
County of Yavapai )
I, the undersigned, being
first duly sworn, depose and say:
That I am the petitioner in
the foregoing proceedings; that I have read the foregoing petition for
order of protection and know the contents thereof; that the foregoing is
true and correct except as to those matters stated upon information and
belief, and as to those matters, I believe them to be true.
_______________________________ (Signature of Petitioner)
Subscribed, sworn to and
acknowledged before me this __ day of ______, 200__.
______________________________
My commission expires: _________________ |
