Page 3 of 5 – Motion to Extend Protection Order
Grant the adverse party visitation with our minor child(ren) on the
following terms: (suggest when visitation should happen, when and where
exchanges should happen, and if visitation should be supervised)
Order the adverse party to pay child support. (you may need to file a
Financial Disclosure Form before the hearing)
Order the adverse party to pay the rent or mortgage or make payments for
my own support in the amount of $________ per month.
Order that custody, visitation, and child support remain as already ordered
in the Divorce or Custody Order in case number _________________
which is filed in the _____________Court in the State of __________.
Keep the adverse party at least 100 yards away from the following
schools/daycares:
School/Day Care Name _________________________________
Address ______________________________________________
City __________________ State _______ County ____________
School/Day Care Name _________________________________
Address ______________________________________________
City __________________ State _______ County ____________
Keep the adverse party at least 100 yards away from my work:
Employer Name _______________________________________
Address ______________________________________________
City __________________ State _______ County ____________
Employer Name _______________________________________
Address ______________________________________________
City __________________ State _______ County ____________