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 SEXUAL VIOLENCE

The Petition for Injunction for Protection Against Sexual Violence under Section 784.046, 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 Sexual Violence has been issued without

notice to Respondent, the 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 to issue a Final Judgment of Injunction for Protection

Against Sexual Violence, 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 {room name/number, location, address, city}

____________________________________________________________________________, 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. Petitioner and Respondent will be bound by the terms of

any injunction or order issued at the final hearing. All witnesses and evidence, if any, must be presented

at this time.

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(r), Temporary Injunction for Protection Against Sexual

Violence (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.

c.____ neither electronic recording nor court reporting services are 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 784.046, Florida Statutes,

applies to the parties, that Petitioner is a victim of sexual violence by Respondent and meets the

requirements for an injunction established by law.

SECTION III. TEMPORARY INJUNCTION AND TERMS

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

unless extended by court order or unless the Respondent is incarcerated, and if incarcerated, shall be

effective for 15 days following the date Respondent is released from incarceration. 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

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

Violence (03/15)

______________________________________________________________________________

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 refusing to vacate the dwelling which the

parties share, going to Petitioner's residence, place of employment, school, or other place prohibited

in this injunction, telephoning, contacting or communicating with Petitioner, if prohibited by this

injunction, or committing an act of sexual violence against Petitioner constitutes a misdemeanor of

the first degree punishable by up to one year in jail, 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. Violence Prohibited. Respondent shall not commit, or cause any other person to commit, any

acts of violence against Petitioner, including assault, aggravated assault, battery, aggravated

battery, sexual assault, sexual battery, stalking, aggravated stalking, kidnapping, or false

imprisonment, or any criminal offense resulting in physical injury or death. Respondent shall

not commit any other violation of the 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. 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: Petitioner’s current

residence {list address}_______________________________________________________

or any residence to which Petitioner may move; Petitioner’s current or any subsequent place of

employment {list address of current employment} _____________________________________

________________________________ or place where Petitioner attends school {list address of

school}___________________________________________________; or the following other

places (if requested by Petitioner) where Petitioner or Petitioner’s minor child(ren) go often:

{Initial if applies; write N/A if not applicable}

b. _____Respondent may not knowingly come within 100 feet of Petitioner’s automobile at any

time.

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

Violence (03/15)

________________________________________________________________________

____________________________________________________________________________

________________________________________________________________________

_____________________________________________________________________________

__________________________________________________________________________

___________________________________________________________________________

c._____ Other provisions regarding contact:_________________________________________

________________________________________________________________________.

3. Firearms.

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

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

b.____Respondent shall surrender any firearms and ammunition in Respondent's possession to

the ____________________County Sheriff's Department.

c. ____Other directives relating to firearms and ammunition:_______________________

____________________________________________________________________________.

4. 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 by mail shall be complete upon mailing or

e-mailing.

5. Additional order(s) necessary to protect Petitioner from sexual violence:___________

________________________________________________________________________.

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 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

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

Violence (03/15)

__________________________________________

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 784.047, Florida Statutes.

3. Should any Florida law enforcement officer having jurisdiction have probable cause to believe

that Respondent has knowingly violated this injunction, the officer may arrest Respondent,

confine him/her in the county jail without bail, and shall bring him/her before the Initial

Appearance Judge on the next regular court day so that Respondent can be dealt with according

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

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

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

4. Reporting alleged violations. If Respondent violates the terms of this injunction and there has

not been an arrest, Petitioner may contact the Clerk of the Circuit Court of the county in which

the violation occurred and complete an affidavit in support of the violation or Petitioner may

contact the State Attorney’s office for assistance in filing an action for indirect civil contempt or

indirect criminal contempt. Upon receiving such a report, the State Attorney is hereby

appointed to prosecute such violations by indirect criminal contempt proceedings, or the State

Attorney may decide to file a criminal charge, if warranted by the evidence.

DONE AND ORDERED in ________________________, Florida on ______________________.

CIRCUIT JUDGE

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

Violence (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 designated e-mail address(es)

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 Sexual

Violence 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(r), Temporary Injunction for Protection Against Sexual

Violence (03/15)

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