Fillable IN THE DISTRICT/SUPERIOR COURT FOR THE STATE OF (State of Alaska)

Fill Online, Printable, Fillable, Blank IN THE DISTRICT/SUPERIOR COURT FOR THE STATE OF (State of Alaska) Form

Use Fill to complete blank online STATE OF ALASKA (AK) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

IN THE DISTRICT/SUPERIOR COURT FOR THE STATE OF (State of Alaska)

On average this form takes 84 minutes to complete

The IN THE DISTRICT/SUPERIOR COURT FOR THE STATE OF (State of Alaska) form is 9 pages long and contains:

  • 0 signatures
  • 106 check-boxes
  • 285 other fields

Country of origin: US
File type: PDF

U.S.A. forms for State of Alaska

BROWSE STATE OF ALASKA (AK) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
This is Not a Court Order
Page 1 of 8
DV-100-M (9/19)(cs) AS 18.66.100-.990
PETITION FOR DOMESTIC VIOLENCE PROTECTIVE ORDER(S) (MULTIPLE PETITIONERS) Civil Rule 65.1
IN THE DISTRICT/SUPERIOR COURT FOR THE STATE OF ALASKA
AT
)
) Case No. CI
PETITIONER (protected person), Identifies as: M F )
Birthdate: )
Petitioner is a child. Who is signing for the child? )
Name: Birthdate: )
Relationship to child: )
)
) Case No. CI
PETITIONER (protected person), Identifies as: M F )
Birthdate: )
Petitioner is a child. Who is signing for the child? )
Name: Birthdate: )
Relationship to child: )
)
) Case No. CI
PETITIONER (protected person), Identifies as: M F )
Birthdate: )
Petitioner is a child. Who is signing for the child? )
Name: Birthdate: )
Relationship to child: )
)
) Case No. CI
PETITIONER (protected person), Identifies as: M F )
Birthdate: )
Petitioner is a child. Who is signing for the child? )
Name: Birthdate: )
Relationship to child: )
)
) Case No. CI
PETITIONER (protected person), Identifies as: M F )
Birthdate: )
Petitioner is a child. Who is signing for the child? )
Name: Birthdate: )
Relationship to child: )
)
v. )
)
)
RESPONDENT (restrained person), Identifies as: M F )
Birthdate ) PETITION FOR
Respondent is a child. Who is signing for the child? ) DOMESTIC VIOLENCE
Name: Birthdate: ) PROTECTIVE ORDER(S)
Relationship to child: ) (MULTIPLE PETITIONERS)
)
This is Not a Court Order
Page 2 of 8
DV-100-M (9/19)(cs) AS 18.66.100-.990
PETITION FOR DOMESTIC VIOLENCE PROTECTIVE ORDER(S) (MULTIPLE PETITIONERS) Civil Rule 65.1
1. TYPE OF ORDER. Select the type of order being requested. Select both the 20-day order
and the long-term order if petitioners want a protective order for more than 20 days
20-day protective order
A 20-day order can take effect immediately and without prior notice to the respondent.
Did you notify respondent before filing this petition? yes no
Describe your efforts, if any, to notify respondent before filing this petition:
Long-term protective order
A long-term order may be issued after notice to respondent and a court hearing, and
will usually last for one year. Long term orders may be extended. Each extension lasts
for one additional year, and you may request an extension each year for as many
years as needed.
2. HOW ARE PETITIONERS AND RESPONDENT RELATED? (Check all that apply.)
a. Married to each other now or in the past
b. Child together
c. Living together now or in the past (but not also dating or sexual relationship)
d. Dating or sexual relationship now or in the past (but not also living together)
e. Living together and dating or sexual relationship now or in the past
f. Related by marriage now or in the past (such as in-laws)
g. Other family relationship, respondent is petitioners’
child or step-child parent step-parent
grandchild grandparent first cousin
uncle or aunt niece or nephew brother or sister
other relative (describe)
h. Petitioner is a child of a person in a relationship described in (a) through (g) above
3. Are there children in petitioners’ household? yes no
4. DESCRIBE THE DOMESTIC VIOLENCE. Attach additional pages if necessary.
a. Describe what happened, when it happened, where it happened, and whether children
were involved. Please be specific.
This is Not a Court Order
Page 3 of 8
DV-100-M (9/19)(cs) AS 18.66.100-.990
PETITION FOR DOMESTIC VIOLENCE PROTECTIVE ORDER(S) (MULTIPLE PETITIONERS) Civil Rule 65.1
b. Was a weapon involved? yes no (If yes, describe.)
c. Was anyone injured? yes no (If yes, describe.)
d. Has respondent been involved in other instances of domestic violence with petitioners or
anyone else? yes no (If yes, describe.)
5. PROTECTIONS REQUESTED. (Check all that apply.)
a. Respondent not to threaten or commit acts of domestic violence, stalking, or
harassment.
b. Respondent not to telephone, contact, or communicate in any other way, directly or
indirectly, with petitioners. Exceptions where it would be safe for the respondent to
contact petitioners:
no exceptions by email to
through an attorney by telephone to
through a third person (such as a grandparent) named
other
c. Respondent to leave and stay away from petitioners’ residence(s).
Petitioner(s) do not want respondent to know the address of the petitioner(s)
residence(s). Attach form DV-127 with Petitioners’ address(es).
Petitioners’ residence is at:
Does respondent live in this residence too? yes no
Does respondent know this address? yes no
This is Not a Court Order
AS 18.66.100-.990
Page 4 of 8
DV-100-M (9/19)(cs)
PETITION FOR DOMESTIC VIOLENCE PROTECTIVE ORDER(S) (MULTIPLE PETITIONERS)
Civil Rule 65.1
d. Respondent to stay away from and not telephone or contact the following places that
petitioner(s) or members of petitioners’ household go to:
Place Street Address Distance to Stay Away
Petitioner’s school ft. mi.
Children’s school ft. mi.
Place of employment ft. mi.
ft. mi.
ft. mi.
Exceptions:
e. Respondent not to enter, follow, or interfere with the operation of any vehicle
occupied by one or more petitioner or in petitioners’ possession.
f. Respondent not to possess or use controlled substances.
g. Award temporary possession and use of
the following, regardless of ownership:
(1) Residence located at and everything in it.
(street address)
(2) Vehicle and all keys to it. License plate number
Vehicle Description
(3) Essential personal items (check all that apply):
house keys garage door opener children’s belongings
mailbox keys clothes medicine children’s medicine
toiletries Medicare/Medicaid coupons food stamps
pet(s) named
birth certificates belonging to
passports belonging to
immigration documents belonging to
ANCSA Corp. ID Tribal enrollment card Certificate of Indian blood
other
h. Respondent to pay spousal support to petitioner
How much monthly spousal support is requested and why is support necessary?
i. Respondent not to sell or dispose of any personal property of the petitioners, any
property jointly held, or any disputed property.
j. Other requests for short-term protection:
This is Not a Court Order
AS 18.66.100-.990
Page 5 of 8
DV-100-M (9/19)(cs)
PETITION FOR DOMESTIC VIOLENCE PROTECTIVE ORDER(S) (MULTIPLE PETITIONERS)
Civil Rule 65.1
6. LONG-TERM PROTECTIONS REQUESTED. In addition to the protections listed above,
petitioners request that the following be included in the long-term protective order. Note that
these requirements cannot be included in the 20-day order. (Check all
that apply.)
a. Respondent not to use or possess a deadly weapon, including a firearm.
b. Respondent to surrender any firearm owned or possessed by respondent.
c. Respondent to pay to the costs and
fees petitioner(s) paid in bringing this action, in the amount of $
d. Respondent to pay petitioners or the person(s) named below for expenses
associated with the domestic violence (such as medical expenses, counseling,
shelter, and repair or replacement of damaged property) described below:
Pay to Type of Expense Amount
$
$
$
e. Respondent to enroll in and complete, at respondent's expense (check all that apply):
Program for the rehabilitation of batterers
Treatment for substance abuse
f. Other requests for long-term protection:
7. CHILDREN. (If child custody or child support do
es not apply, skip to question 8.)
a. Award
temporary custody of the minor child(ren) named below:
(1) Child's Full Name Child’s
Petitioner’s Respondent's
Date of Birth Relationship Relationship
to Child to Child
(2) Have the child(ren) lived in Alaska for the past six months?
yes no
This is Not a Court Order
AS 18.66.100-.990
Page 6 of 8
DV-100-M (7/17)(cs)
PETITION FOR DOMESTIC VIOLENCE PROTECTIVE ORDER(S) (MULTIPLE PETITIONERS)
Civil Rule 65.1
(3) Who has the child(ren)?
Petitioner currently has the child(ren).
currently has the child(ren).
(4) Is there already a custody order about one or more of the children?
yes no do not know. If yes, describe each order below:
Child's Name State that Case Number Order Grants
Issued Order (if known) Custody to
b. Visitation. The court may only grant visitation to the respondent if
the safety of the
petitioner(s) and children can be protected. Describe any safety concerns about
visitation. What visitation schedule would work, if any, and where should exchanges
take place?
c. Child Support. requests that the court require the
respondent to pay child support:
yes no
(1) Financial information about respondent
Respondent's occupation
Name of respondent’s employer
Respondent's monthly take-home pay is $
(2) Child support checks should be sent to
(mailing address that can be revealed to respondent)
Important Note: To get a child support order, fill out a Child Support Guidelines
Affidavit (court form DR-305, available from the court clerk or online at
https://public.courts.alaska.gov/web/forms/docs/dr-305.pdf) and bring it to each court
hearing, together with proof of petitioner’s and respondent’s income if available. If
you cannot bring an affidavit, bring proof of income anyway. Proof of income includes
documents such as paystubs, tax returns, W2 forms, and 1099 forms.
This is Not a Court Order
AS 18.66.100-.990
Page 7 of 8
DV-100-M (9/19)(cs)
PETITION FOR DOMESTIC VIOLENCE PROTECTIVE ORDER(S) (MULTIPLE PETITIONERS)
Civil Rule 65.1
8. OTHER CASES.
a. List all open domestic violence criminal cases and open civil court cases (such as
divorce and custody), in Alaska or elsewhere, that involve any petitioner or respondent:
Type of Case
Court Location Petitioner or
Respondent
b. List all other cases, open and closed, that involve respondent:
Type of Case Court Location
9. ASSISTANCE FROM LAW ENF
ORCEMENT. In addition to the protections listed above,
petitioners ask the court to issue an order requiring law enforcement to do the following
(check all that apply):
a. Accompany and assist petitioners to take possession of the residence identified in
paragraph (5)(g)(1) above. Remove respondent from the residence if necessary.
b. Accompany and assist petitioners to take possession of the personal items listed in
paragraph (5)(g)(3) above.
c. Accompany and assist petitioners to take possession of the vehicle identified in
paragraph (5)(g)(2) above.
d. Assist to obtain custody of the minor child(ren)
named in paragraph (7)(a)(1) above.
e. Accompany respondent to the residence at (street address)
once
to recover undisputed personal items, clothing, and
Law enforcement to notify the petitioner of the time and date they will accompany
respondent to the residence. The petitioner may be present. Any item the petitioner
objects to respondent removing, law enforcement shall restrain the respondent from
removing from
the residence.
10. INFORMATION ABOUT RESPONDENT.
Respondent’s full legal name: Other information about respondent:
Sex Race
*Date of Birth*
HT WT
Hair Eyes State ID /Driver’s Lic. # ST
Other Identifiers
Any nicknames or other names used:
Respondent’s mailing/physical address:
Respondent’s Phone 1
Respondent’s Phone 2
Respondent’s Employer
11. INFORMATION ABOUT PETITIONERS. The court needs petitioners’ mailing address in
order to send court papers, including notices of hearing, to petitioners. If petitioners may be
endangered by giving petitioners’ mailing address, write a "message" address where
petitioners can be sure to receive court papers. If petitioners do not have any address
and telephone number that can safely be revealed to respondent, ask the court clerk
how petitioners can provide this information so that it will be kept confidential and
not revealed to respondent.
List the full legal name and any nicknames or other names used by each petitioner:
Petitioners’ (safe) mailing address: Petitioners’ telephone numbers:
Home
Work
Cell
I swear or affirm under penalty of perjury that all the information I provided in this petition is true
to the best of my knowledge and belief.
Date Signature
Print Name
Subscribed and sworn to or affirmed before me at
, Alaska
on
.
(date)
(SEAL) Clerk of Court, Notary Public or other person
authorized to administer oaths
My commission expires:
This is Not a Court Order
AS 18.66.100-.990
Page 8 of 8
DV-100-M (9/19)(cs)
PETITION FOR DOMESTIC VIOLENCE PROTECTIVE ORDER(S) (MULTIPLE PETITIONERS)
Civil Rule 65.1
CONFIDENTIAL LAW ENFORCEMENT INFORMATION SHEET
Notice to Petitioner
: You must supply the respondent's name and birth date, if known. Give as much information
as possible. This information will NOT
be given to the respondent.
Notice to Law Enforcement
: This information is confidential and supplied to assist you in serving the protective
order. After serving (or failing to serve) the order, notify petitioner and complete the return of service section on
the DV-125.
A. PETITIONER INFORMATION
Full name:
Date of birth: Petitioner is a child.
Petitioner’s residence address:
Is this the address respondent is to stay away from?
Yes No
Do you want to be notified when respondent is served?
Yes No
Contact phone(s): home
work cell msg
B. RESPONDENT INFORMATION
Full name:
Nicknames: Respondent is a child.
Residence Address:
Is this the address respondent is to stay away from?
Yes No Last four digits of SSN
Other Addresses:
Contact phone(s): home
work cell msg
Where is respondent now (what street address)? Other information about respondent:
Sex Race
*Date of Birth*
HT WT
Hair Eyes State ID / Driver’s Lic. # ST
Other Identifiers
(facial hair, piercings, scars, tattoos, marks, etc.)
Friends / relatives / phone numbers / hangouts:
Hazards at respondent’s home (dogs, traps, guns):
Describe respondent’s house:
log frame apartment single family duplex
1 story 2 story 3+ story main color trim color
Garage:
separate attached none 4x4 needed to access address? Y N
Respondent’s employer
Employer address
Work phone
Work hours
Respondent’s position
Supervisor
Respondent’s vehicle information
Make
Model
Plate No.
State
Year
van pickup canopy camper
toolbox car 2 door 4 door
SUV other
Other vehicles respondent is known to drive:
C. OFFICER SAFETY INFORMATION
Previous contact with police by respondent?
No Yes Explain:
Any threats by respondent toward petitioner, family, police? Describe:
Weapons accessible to respondent (pistol, rifle, knife, other):
Expected mental state or history of respondent (include alcohol or drug use):
Is a divorce or other legal action pending that involves the respondent (child custody, eviction, bankruptcy,
repossession of property)?
Draw a map on the back of this form if it will help law enforcement.
DV-127 (5/10)(cs) Civil Rule 65.1
CONFIDENTIAL LAW ENFORCEMENT INFORMATION SHEET (DOMESTIC VIOLENCE OR STALKING)
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

IN THE DISTRICTSUPERIOR COURT FOR THE STATE OF (State of Alaska)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 23 December 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document