Petition
For Temporary Restraining Order And/Or Injunction
Respondent.
)
Respondent's
DOB:
Sex:
Race:
Height:
Weight:
Hair:
Eye:
Under oath, I petition the court for a
temporary restraining order and injunction against the respondent under the
Stockbridge-Munsee Domestic Abuse Restraining Order and Injunction Ordinance,
based upon the following:
Our residences/premises are as stated as
above.
The respondent is (mark one):
a. a spouse, former spouse, parent, child, or a person related by blood to
the petitioner.
b. a
person currently or formerly residing in a place of abode with the
petitioner.
c. a
person currently or formerly dating the petitioner.
d. a
person with whom the petitioner has engaged in a sexual relationship.
e. a
person currently or formerly related tot he petitioner by marriage.
f.
a person with whom I have a child in common.
(Mark any of the following boxes that apply.)
a. We
are not married.
b.
Respondent owns the property on which I am living.
c. I
have no legal interest in this property.
I
am
am
not in imminent danger of physical harm.
Attached as a part of this petition is a statement of facts
indicating that respondent has engaged in or might engage in domestic abuse
to me.
I REQUEST THAT THE COURT:
Immediately issue a temporary restraining order and set a time for a hearing
on an injunction requiring the respondent to:
a. avoid my residence and any premises temporarily occupied by me.
b. avoid contacting me and causing any other person to have contact with me
in any way.
c. refrain from committing acts of domestic abuse against me.
d. Other:
Set a
time for a hearing on the petition for an injunction.
Grant
an award in a reasonable amount for the costs of maintaining this action and
attorney fees, if deemed appropriate, and such other relieve as may be just
and equitable.
Direct Stockbridge-Munsee law enforcement to assist in placing me in
physical possession of my residence.
Enter
an order reducing the time before the hearing to serve the respondent
because:
a.
Because of
the seriousness of the matter, I am in imminent danger.
Enter
an injunction for five years or the following shorter period.
Subscribed and sworn to before me
This day
of ,
20
NOTARY PUBLIC
COUNTY OF
My Commission Expires: