Fillable IN THE JUSTICE COURT OF THE TOWNSHIP COUNTY (Civil Law Self-Help Center)

Fill Online, Printable, Fillable, Blank IN THE JUSTICE COURT OF THE TOWNSHIP COUNTY (Civil Law Self-Help Center) Form

Use Fill to complete blank online CIVIL LAW SELF-HELP CENTER pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

IN THE JUSTICE COURT OF THE TOWNSHIP COUNTY (Civil Law Self-Help Center)

On average this form takes 31 minutes to complete

The IN THE JUSTICE COURT OF THE TOWNSHIP COUNTY (Civil Law Self-Help Center) form is 8 pages long and contains:

  • 2 signatures
  • 29 check-boxes
  • 101 other fields

Country of origin: US
File type: PDF

Use our library of forms to quickly fill and sign your Civil Law Self-Help Center forms online.

BROWSE CIVIL LAW SELF-HELP CENTER 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
 
©2020 Nevada Supreme Court Application for Protection Order
(Revised October 2020)
Page 1 of 8
IN THE JUSTICE COURT OF THE
COUNTY OF
TOWNSHIP
, STATE OF NEVADA
_____________________________________
Applicant
(print your name above),
vs.
_____________________________________
Adverse Party
(print the name of the person you want
protection from above).
CASE NO.: ____________________
DEPT: ____________________
APPLICATION FOR PROTECTION
1. Your information (you are the “Applicant”).
Your name:
(first) (middle) (last)
2. Who do you want to be protected from (this person is the “Adverse Party”)?
Name:
(first) (middle) (last)
3. Who needs protection (check all that apply)?
☐ Me.
☐ Minor child (see definition on bottom of page 2).
☐ The following household members, including minor children not included in definition
on page 2.
Name Date of Birth
Relationship to
Applicant
Relationship
to Adverse
Party
©2020 Nevada Supreme Court Application for Protection Order
(Revised October 2020)
Page 2 of 8
4. Why do you need to be protected from the person named above (you must check one)?
☐ The Adverse Party committed acts of stalking or aggravated stalking against me.
Definition of stalking, aggravated stalking and harassment:
Stalking: A person commits the crime of stalking when, without lawful authority, that
person willfully or maliciously engages in a course of conduct directed towards a victim that would
cause a reasonable person under similar circumstances to feel terrorized, frightened, intimidated,
harassed or fearful for his or her immediate safety or the immediate safety of a family or household
member, and that actually causes the victim to feel terrorized, frightened, intimidated, harassed
or fearful for his or her immediate safety or the immediate safety of a family or household
member. NRS 200.575(1)
Aggravated Stalking: A person who commits the crime of stalking and in conjunction therewith
threatens the person with the intent to cause the person to be placed in reasonable fear of death or
substantial bodily. NRS 200.575(2)
Harassment: A person commits harassment when: (a) Without lawful authority, the person
knowingly threatens: (1) To cause bodily injury in the future to the person threatened or to any
other person; (2) To cause physical damage to the property of another person; (3) To subject the
person threatened or any other person to physical confinement or restraint; or (4) To do any act
which is intended to substantially harm the person threatened or any other person with respect to
his or her physical or mental health or safety; and (b) The person by words or conduct places the
person receiving the threat in reasonable fear that the threat will be carried out. NRS 200.571
☐ The Adverse Party committed a sexual assault on me.
Definition of sexual assault: A person commits sexual assault if they subject another person to
sexual penetration, or forces another person to make a sexual penetration on himself or herself or
another, or on a beast, against the will of the victim or under conditions in which the perpetrator
knows or should know that the victim is mentally or physically incapable of resisting or
understanding the nature of his or her conduct. NRS 200.366
☐ Protection of Children: The parent or guardian of a child may petition any court of competent
jurisdiction on behalf of the child for a temporary or extended order against a person who is 18
years of age or older and who the parent or guardian reasonably believes has committed or is
committing a crime involving: (a) Physical or mental injury to the child of a nonaccidental nature;
or (b) Sexual abuse or sexual exploitation of the child. NRS 33.400
Are you applying on behalf of a minor child? ☐ No ☐ Yes
Child’s name:
(first) (middle) (last)
As you complete the application, please keep in mind that you are filling in the questions as they
pertain to the actions/incident committed upon the child.
©2020 Nevada Supreme Court Application for Protection Order
(Revised October 2020)
Page 3 of 8
5. How do you know the person you need protection from (check all that apply)?
☐ We are related by blood or marriage. Explain
☐ We are or used to be friends/acquaintances.
☐ We are neighbors or reside in the same neighborhood.
☐ We are or were co-workers.
☐ Other: (specify relationship):
6. Are there any other current or prior court cases that involve you and the Adverse Party
in any court?
☐ No.
☐ Yes. If you know, please list the case type, county, state, and case number:
7. Firearms / Guns.
Does the Adverse Party own a gun or have a gun in his/her possession or control?
☐ No ☐ Yes ☐ I don’t know.
8. Most Recent Event. Think about the most recent event. These questions ask about the
most recent event only.
Approximate date it happened:
City / State / Location where it happened:
Did the other person use or threaten to use a weapon? ☐ No ☐ Yes.
What Happened? Explain the most recent event and describe any injuries. Give specific
and detailed information about the event. You can list past events on the next page. If you
are filing on behalf of a child, include details about what happened to the child.
©2020 Nevada Supreme Court Application for Protection Order
(Revised October 2020)
Page 4 of 8
Attach more pages if you need more room (pages 4a, 4b, 4c).
©2020 Nevada Supreme Court Application for Protection Order
(Revised October 2020)
Page 5 of 8
9. Past Event(s).
Think about any other times the person you want protection from threatened or abused you
and/or the child/children. The following questions ask about any past events that may have
happened.
Approximate Date:
What Happened:
Approximate Date:
What Happened:
10. Law enforcement involvement.
Was law enforcement informed? ☐ No ☐ Yes
a. If so, please provide a copy of the police/incident report.
Was anyone arrested? ☐ No ☐ Yes (Who):
Is the Adverse Party in jail? ☐ No ☐ Yes
©2020 Nevada Supreme Court Application for Protection Order
(Revised October 2020)
Page 6 of 8
11. Temporary Protections Requested (check all that apply).
Do not list any confidential addresses.
The other person will get a copy of this application and will see any
addresses you write down.
☐ Prohibited Activities. The Adverse Party should not threaten, physically injure, or
harass me and/or the minor child, either directly or through someone acting on his/her
behalf.
☐ No Contact or Restricted Contact. The Adverse Party should not contact me and/or
the minor child at all, either in person, by phone / text, by email or through social
media.
☐ Current Residence. The Adverse Party should stay away from my current residence.
Do you and the Adverse Party live together? ☐ No ☐ Yes
If yes, whose name is listed on the lease/title?
Does the Adverse Party know where you live? ☐ No ☐ Yes
If no, is your address confidential? ☐ No ☐ Yes (don’t list your address)
Address
City, State, Zip Code County
Do you and the Adverse Party live in the same complex/property/trailer park?
☐ No. Should the Adverse Party stay away from the entire complex/property/trailer
park? ☐ No ☐ Yes
☐ Yes. If so, explain the distance and need for protection in that complex/property/trailer
park:
☐ Personal Belongings.
☐ I need to get my belongings. I want law enforcement to come with me to
the Adverse Party’s residence so I can pick up my belongings. The address
I need to go to is (list street address, apartment number, city, state, zip):
☐ The other party needs to get his/her belongings. Law enforcement should
come with the Adverse Party to my residence to pick up his/her belongings.
©2020 Nevada Supreme Court Application for Protection Order
(Revised October 2020)
Page 7 of 8
☐ Work. The Adverse Party should stay away from my workplace.
Do you and the Adverse Party work at the same place? ☐ No ☐ Yes
Is your work address confidential? ☐ No ☐ Yes (do not write details below)
Employer Employer
Address Address
City, State, Zip Code County City, State, Zip Code County
☐ School/Daycare. The Adverse Party should stay away from my school and/or the
child’s school/daycare.
Is the school/daycare address confidential? ☐ No ☐ Yes (do not write details below)
School/Daycare School/Daycare
Address Address
City, State, Zip Code County City, State, Zip Code County
☐ Other Places. The Adverse Party should stay away from the following places that I
and/or the minor children go to regularly.
Location Location
Why? Why?
Address Address
City, State, Zip Code County City, State, Zip Code County
©2020 Nevada Supreme Court Application for Protection Order
(Revised October 2020)
Page 8 of 8
About Extended Protection Orders:
This application automatically asks the judge to issue up to a 45-day temporary protection order
without notifying the other person first.
You can
also ask for an extended order that could last for up to 2 years.
If you do, the judge will set a hearing. You and the other person will have to appear in court and
explain your side before the judge can extend the protection order.
12. Length of Protection Order.
☐ I want an order up to 45 days only.
☐ I want an order up to 45 days PLUS an extended order that could last up to 2
years.
13. Other Exhibits. You may attach documents, pictures, or anything else that you would like
the judge to look at and consider when reviewing your application. The Adverse Party will
receive a copy of all documents/evidence you provide.
Describe what you are attaching:
14. This document does not contain the personal information of any person as defined by
NRS 603A.040.
I declare under penalty of perjury under the law of the State of Nevada that the foregoing is
true and correct.
Dated , 20 . Submitted by:
(your signature)
________________________________
(print your name)
VERIFICATION
I declare that I am the applicant in the above-entitled action; that I have read the foregoing
application and know the contents thereof; that the pleading is true of my own knowledge, except
for those matters therein contained stated upon information and belief, and that as to those matters,
I believe them to be true. I declare under penalty of perjury under the law of the State of Nevada
that the foregoing is true and correct.
Dated , 20 . Submitted by:
(your signature)
________________________________
(print your name)
click to sign
signature
click to edit
click to sign
signature
click to edit
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 JUSTICE COURT OF THE TOWNSHIP COUNTY (Civil Law Self-Help Center)

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 3 October 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document