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IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR COUNTY, FLORIDA
Case No.:
Division:
,
Petitioner,
and
,
Respondent.
TEMPORARY INJUNCTION TO PREVENT REMOVAL OF MINOR
CHILD(REN) AND/OR DENIAL OF PASSPORT SERVICES
(AFTER NOTICE)
Upon verified motion of _____Petitioner _____ Respondent, the Court has jurisdiction of the parties and
the subject matter and the Court being fully advised, it is ORDERED and ADJUDGED that:
{Indicate all that apply}
1. The following minor child(ren) shall not be removed from the jurisdiction of this Court during the
pendency of this proceeding, or until further order of this Court:
Name Birth date
2. _____ Petitioner _____Respondent shall not apply for any passports or passport services on behalf
of the child(ren).
3. _____ Petitioner _____Respondent shall immediately deliver any existing passports for the
child(ren) to {name} _____________________________________________________________.
4. The Court may enforce compliance with the terms of this injunction through civil and/or indirect
criminal contempt proceedings, which may include arrest, incarceration, and/or the imposition of a
fine.
5. Violation of this injunction may constitute criminal contempt of court.
Florida Supreme Court Approved Family Law Form 12.941(c), Temporary Injunction to Prevent Removal of Minor
Child(ren) and/or Denial of Passport Services (After Notice) (03/15)
____________________________________________
_______________________________________
6. Bond.
a.
_____Bond is waived because this injunction is issued solely to prevent physical injury or abuse o
f
a natural person.
b.
_____This order is conditioned upon _____Petitioner _____Respondent posting bond in the su
m
o
f $ _______ with the clerk of this Cou
rt.
7.
Expiration
.
This temporary injunction shall remain in effect until the minor child(ren) reach(es) the age of 18, or
u
ntil {date} ____________________, not to exceed one year from the date of this order, whichev
er
o
ccurs first, unless modified by further order of this Cou
rt.
D
ONE AND ORDERED at ______________________, Florida, on {date}_____________________.
CIRCUIT JUDGE
I certify that a copy of the {name of document(s)} ___________________________________________
was ( ) mailed ( ) faxed and mailed ( ) e-mailed ( ) hand-delivered to the parties and any other
person(s) or entities listed below on {date}_____________________.
By: Clerk of Court, Designee, or Judicial Assistant
Petitioner (or his or her attorney)
Respondent (or his or her attorney)
U.S. Department of State
Office of Children’s Issues
2201 “C” Street NW
CA/OCS/CI
Washington, D.C. 20520
Fax (202) 736-9133
preventabduction@state.gov
Florida Supreme Court Approved Family Law Form 12.941(c), Temporary Injunction to Prevent Removal of Minor
Child(ren) and/or Denial of Passport Services (After Notice) (03/15)