Fill - Free fillable IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT, (Florida) PDF form

IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,

IN AND FOR ___________ COUNTY, FLORIDA

Case No.:

Division:

__________________,

Petitioner,

and

__________________,

Respondent.

TEMPORARY INJUNCTION FOR PROTECTION AGAINST STALKING

The Petition for Injunction for Protection Against Stalking under Section 784.0485, Florida Statutes, and

other papers filed in this Court have been reviewed. Under the laws of Florida, the Court has jurisdiction

of the Petitioner and the subject matter, and has jurisdiction of the Respondent upon service of the

temporary injunction. The term Petitioner as used in this injunction includes the person on whose

behalf this injunction is entered.

It is intended that this protection order meet the requirements of 18 U.S.C. Section 2265 and

therefore intended that it be accorded full faith and credit by the court of another state or Indian tribe

and enforced as if it were the order of the enforcing state or of the Indian tribe.

SECTION I. NOTICE OF HEARING

Because this Temporary Injunction for Protection Against Stalking has been issued without notice to

Respondent, Petitioner and Respondent are instructed that they are scheduled to appear and testify at a

hearing regarding this matter on {date} _______________________, at ________ a.m./p.m., when the

Court will consider whether it should issue a Final Judgment of Injunction for Protection Against Stalking,

which shall remain in effect until modified or dissolved by the Court, and whether other things should be

ordered. The hearing will be before The Honorable {name} ____________________________, at the

following address: _________________________________________________________, Florida. If

Petitioner and/or Respondent do not appear, this temporary injunction may be continued in force,

extended, or dismissed, and/or additional orders may be granted, including entry of a permanent

injunction and the imposition of court costs. All witnesses and evidence, if any, must be presented at

this time. Petitioner and Respondent will be bound by the terms of any injunction or order issued at

the final hearing.

IF EITHER PETITIONER OR RESPONDENT DO NOT APPEAR AT THE FINAL HEARING, HE OR SHE WILL BE

BOUND BY THE TERMS OF ANY INJUNCTION OR ORDER ISSUED IN THIS MATTER.

Florida Supreme Court Approved Family Law Form 12.980(u), Temporary Injunction for Protection Against Stalking

(03/15)

__________________________________________________________________

NOTICE: Because this is a civil case, there is no requirement that these proceedings be transcribed at

public expense.

YOU ARE ADVISED THAT IN THIS COURT:

a.____ a court reporter is provided by the court.

b.____ electronic recording only is provided by the court. A party may arrange in advance for the

services of and provide for a court reporter to prepare a written transcript of the proceedings at that

party’s expense.

A RECORD, WHICH INCLUDES A TRANSCRIPT, MAY BE REQUIRED TO SUPPORT AN APPEAL. THE PARTY

SEEKING THE APPEAL IS RESPONSIBLE FOR HAVING THE TRANSCRIPT PREPARED BY A COURT REPORTER.

THE TRANSCRIPT MUST BE FILED WITH THE REVIEWING COURT OR THE APPEAL MAY BE DENIED.

If you are a person with a disability who needs any accommodation in order

to participate in this proceeding, you are entitled, at no cost to you, to the

provision of certain assistance. Please contact __________________________

{identify applicable court personnel by name, address, and telephone number} at

least 7 days before your scheduled court appearance, or immediately upon

receiving this notification if the time before the scheduled appearance is less

than 7 days; if you are hearing or voice impaired, call 711.

SECTION II. FINDINGS

The statements made under oath by Petitioner make it appear that Section 784.0485, Florida Statutes,

applies to the parties, and that stalking exists.

SECTION III. TEMPORARY INJUNCTION AND TERMS

This injunction shall be in effect until the hearing set above and in no event for longer than 15 days,

unless extended by court order. If a final order of injunction is issued, the terms of this temporary

injunction will be extended until service of the final injunction is effected upon Respondent. This

injunction is valid and enforceable in all counties of the State of Florida. The terms of this injunction

may not be changed by either party alone or by both parties together. Only the Court may modify the

terms of this injunction. Either party may ask the Court to change or end this injunction.

Willful violation of the terms of this injunction, such as: committing an act of stalking against

Petitioner; going to or being within 500 feet of Petitioner's residence, place of employment, school, or

other place prohibited in this injunction; knowingly and intentionally coming within 100 feet of

Petitioner’s motor vehicle, whether or not that vehicle is occupied; committing any other violation of

this injunction through an intentional unlawful threat, word or act to do violence to Petitioner;

telephoning, contacting or communicating with Petitioner, unless indirect contact through a third

Florida Supreme Court Approved Family Law Form 12.980(u), Temporary Injunction for Protection Against Stalking

(03/15)

________________________________________________________________________

______________________________________________________________________________

party is specifically allowed by this injunction; defacing or destroying Petitioner’s personal property,

including Petitioner’s motor vehicle; or refusing to surrender firearms or ammunition if ordered to so

by the Court, constitutes a misdemeanor of the first degree punishable as provided by Sections

775.082 and 775.083, Florida Statutes.

Any party violating this injunction may be subject to civil or indirect criminal contempt proceedings,

including the imposition of a fine or imprisonment, and also may be charged with a crime punishable

by a fine, jail, or both, as provided by Florida Statutes.

ORDERED and ADJUDGED:

1. Prohibited Actions. Respondent shall not commit, or cause any other person to commit, any

acts of stalking against Petitioner, including stalking, cyberstalking, aggravated stalking, or any

criminal offense resulting in physical injury or death. Respondent shall not commit any other

violation of this injunction through an intentional unlawful threat, word, or act to do violence to

Petitioner.

2. No Contact. Respondent shall have no contact with the Petitioner unless otherwise provided

in this section.

a. Unless otherwise provided herein, Respondent shall have no contact with Petitioner.

Respondent shall not directly or indirectly contact Petitioner in person, by mail, e-mail, fax,

telephone, through another person, or in any other manner, including any electronic means or

use of social media. Further, Respondent shall not contact or have any third party contact

anyone connected with Petitioner's employment or school to inquire about Petitioner or to send

any messages to Petitioner. Unless otherwise provided herein, Respondent shall not go to, in,

or within 500 feet of:

b. Petitioner’s current residence {list address}

or any residence to which Petitioner may move;

c. Petitioner’s current or any subsequent place of employment {list address of current

employment}

d. where Petitioner attends school {list address of school}

______________________________________________________________________; or

e. the following other places (if requested by Petitioner) where Petitioner, specific members of

Petitioner’s family, or individuals closely associated with Petitioner, regularly frequent:

______________________________________________________________________________.

Florida Supreme Court Approved Family Law Form 12.980(u), Temporary Injunction for Protection Against Stalking

(03/15)

____________________________________________________________________________

_________________________________________________________________________

____________________________________________________________________________

_____________________________________________________________________________

3.

4.

5.

6.

f. Respondent shall not knowingly and intentionally come within 100 feet of Petitioner’s motor

vehicle at any time, whether or not that vehicle is occupied;

g. Other provisions regarding contact:_________________________________________

____________________________________________________________________________.

Firearms.

{Initial all that apply; write N/A if not applicable}

a. ____Respondent is a state or local officer, as defined in section 943.10(14), Florida Statutes,

who holds an active certification, who receives or possesses a firearm or ammunition for use in

performing official duties on behalf of the officer’s employing agency, and is not prohibited by

the court from having in his or her care, possession, or control any firearm or ammunition.

b. ____Respondent shall not use or possess a firearm or ammunition.

c. ____Respondent shall surrender any firearms and ammunition in the Respondent's

possession to the___________________ County Sheriff's Department.

d. _____Other directives relating to firearms and ammunition:_________________________

____________________________________________________________________________.

Mailing Address or Designated E-Mail Address(es). Respondent shall notify the Clerk of the

Court of any change in either his or her mailing address or designated e-mail address(es)within

10 days of the change. All further papers (excluding pleadings requiring personal service) shall

be served either by mail to Respondent’s last known mailing address or by e-mail to

Respondent’s designated e-mail address(es). Service shall be complete upon mailing or e-

mailing.

Additional order(s) necessary to protect Petitioner from stalking:

_________________________________________________________________________.

Referral to Appropriate Services for Petitioner:

Petitioner may contact the following services as needed:

_____________________________________________________________________________.

Florida Supreme Court Approved Family Law Form 12.980(u), Temporary Injunction for Protection Against Stalking

(03/15)

_________________________________________________________________________________

__________________________________________________________________________________

SECTION IV. OTHER SPECIAL PROVISIONS

{This section to be used for inclusion of local provisions approved by the chief judge as provided in

Florida Family Law Rule 12.610.}

__________________________________________________________________________________.

SECTION V. DIRECTIONS TO LAW ENFORCEMENT OFFICER IN ENFORCING THIS INJUNCTION

{Unless ordered otherwise by the judge, all provisions in this injunction are considered mandatory

provisions and should be interpreted as part of this injunction.}

1. The Sheriff of ___________________County, or any other authorized law enforcement officer,

is ordered to serve this temporary injunction upon Respondent as soon as possible after its

issuance.

2. This injunction is valid and enforceable in all counties of the State of Florida. Violation of this

injunction should be reported to the appropriate law enforcement agency. Law enforcement

officers of the jurisdiction in which a violation of this injunction occurs shall enforce the

provisions of this injunction and are authorized to arrest without a warrant pursuant to Section

901.15, Florida Statutes, for any violation of its provisions, which constitutes a criminal act

under Section 784.0487, Florida Statutes.

3. THIS INJUNCTION IS ENFORCEABLE IN ALL COUNTIES OF FLORIDA AND LAW ENFORCEMENT

OFFICERS MAY EFFECT ARRESTS PURSUANT TO SECTION 901.15(6), FLORIDA STATUTES. The

arresting agent shall notify the State Attorney’s Office immediately after arrest.

4. Reporting alleged violations. If Respondent violates the terms of this injunction and has not

been arrested, Petitioner may contact the clerk of the circuit court of the county in which the

violation is alleged to have occurred. The clerk shall assist Petitioner in preparing an affidavit in

support of reporting the violation or direct Petitioner to the office operated by the court that

has been designated by the chief judge of that circuit as the central intake point for violations of

injunctions for protection where Petitioner can receive assistance in the preparation of the

affidavit in support of the violation. The affidavit shall be immediately forwarded by the office

assisting Petitioner to the state attorney of that circuit and to the judge designated by the chief

judge as the recipient of affidavits of violations of an injunction. Procedures relating to reporting

alleged violations are governed by section 784.0487, Florida Statutes.

DONE AND ORDERED in ____________________________, Florida, on _________________.

CIRCUIT JUDGE

Florida Supreme Court Approved Family Law Form 12.980(u), Temporary Injunction for Protection Against Stalking

(03/15)

COPIES TO:

Sheriff of ________ County

Petitioner (or his or her attorney):

__ by U. S. Mail

__ by hand delivery in open court

_____ by e-mail to a designated e-mail address

Respondent:

__ forwarded to sheriff for service

____ State Attorney’s Office

__ Other: ________________________

I CERTIFY the foregoing is a true copy of the original Temporary Injunction for Protection Against

Stalking as it appears on file in the office of the Clerk of the Circuit Court of __________

County, Florida, and that I have furnished copies of this order as indicated above.

CLERK OF THE CIRCUIT COURT

(SEAL)

By:_______________________________________

{Deputy Clerk or Judicial Assistant}

Florida Supreme Court Approved Family Law Form 12.980(u), Temporary Injunction for Protection Against Stalking

(03/15)

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