Fillable CIVIL DIVISION Docket No. ON TO MODIFY/EXTEND/VACATE/ORDER MOTI (Vermont Judiciary)

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CIVIL DIVISION Docket No. ON TO MODIFY/EXTEND/VACATE/ORDER MOTI (Vermont Judiciary)

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100-00254 – Motion to Modify/Extend/Vacate/Order Against Stalking or Sexual Assault (09/2006) Page 1 of 1
STATE
OF
VERMONT
SUPERIOR COURT
Unit
CIVIL DIVISION
Docket No.
Plaintiff Name
DOB
V.
Defendant Name
DOB
MOTI
ON TO MODIFY/EXTEND/VACATE/ORDER
AGAINST STALKING OR SEXUAL ASSAULT
An Order against stalking or sexual assault was entered in the above case on (date) _______________.
☐ Plaintiff ☐ Defendant requests that this Order of the Court be:
☐ Modified as follows: _______________________________________________________________
_______________________________________________________________
_______________________________________________________________
☐ Extended until (date) _______________
☐ Vacated
Affidavit in Support of Request
In support of this request, subject to the penalties for perjury, I state the following facts to be true to the best
of my knowledge and belief. Specifically describe the facts that support your request.
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
________________________________ ______________________________________
Date Signature of Petitioner
Sig
ned and sworn to before me:
NOTICE!
This affidavit will be served on opposing party with the motion to modify/extend/vacate the Order against
Stalking or Sexual Assault
WARNING
MAKING FALSE STATEMENTS IN THIS AFFIDAVIT IS A CRIME SUBJECT TO A TERM OR IMPRISONMENT OR A
FINE, OR BOTH AS PROVIDED BY 13 V.S.A. § 2904.
Date Signature of Notary Public Expiration Date
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CIVIL DIVISION Docket No. ON TO MODIFYEXTENDVACATEORDER MOTI (Vermont Judiciary)

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Completed 30 July 2020

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