Fillable LPOR 05 LPOR 05

Fill Online, Printable, Fillable, Blank LPOR 05 LPOR 05 Form

Use Fill to complete blank online OTHERS pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

LPOR 05 LPOR 05

On average this form takes 7 minutes to complete

The LPOR 05 LPOR 05 form is 1 page long and contains:

  • 0 signatures
  • 20 check-boxes
  • 19 other fields

Country of origin: OTHERS
File type: PDF

BROWSE OTHERS 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
 
Page 1 of 1 LPOR 5
v.12
LOUISIANA UNIFORM ABUSE PREVENTION ORDER
COURT NAME AND PARISH/CITY:
DOCKET No.: _____________________________ DIV.: ___________
FILED: ___________________ CLERK: ________________________
ORDER TO MODIFY DISSOLVE
A PRIOR LOUISIANA UNIFORM ABUSE PREVENTION ORDER, pursuant to:
La. R. S. 46:2131 et seq., La. R.S. 46:2151, La. Ch. C. Article 1564 et seq., La. R. S. 46:2171 et seq.,
La. R. S. 46:2181 et seq., La. R.S. 9:372, La. R.S. 9:361 et seq.
Court Approved Consent Agreement
PETITIONER’S NAME: ________________________________________________________________________________
First Maiden/Middle Last
Date of Birth _________________________ Sex: F M Race: ______________
month/year/date
Protected person is: Petitioner Other(s) List other(s) name & date of birth:
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
V.
DEFENDANT’S NAME: __________________________________________________________________________________
Parent/Guardian name if defendant is a minor: ________________________________________________________________
Alias: ________________________ Date of Birth:________________________ Sex: F M Race: __________
month/year/date
Address:______________________________________________________________________________________________
No. & Street Apt. No. City State Zip Code
Social Security #: __________________________ Dr. Lic. # ___________________ State ____ Exp. ______________(date)
IT IS ORDERED THAT THE DEFENDANT BE SERVED WITH A COPY OF THIS ORDER.
IT IS HEREBY ORDERED, ADJUDGED, and DECREED that the Louisiana Uniform Abuse Prevention Order issued on
________________________________ (month/day/year) in the above-captioned and numbered matter in the form of a
Protective Order pursuant to: La. R.S. 46:2131 et seq. La. R.S. 46:2151
La. Ch. C. Article 1564 et seq. La. R.S. 46:2171 et seq. La. R.S. 46:2181 et seq.
OR
A Temporary Restraining Order Preliminary Injunction Permanent Injunction
pursuant to: La. R.S. 9:372 La. R.S. 9:361 et seq.
is MODIFIED on this date as indicated on the attached Louisiana Uniform Abuse Prevention Order form.
OR
is DISSOLVED.
THE DEFENDANT IS ORDERED TO pay all court costs.
Date of Order
____________________________________________
SIGNATURE OF JUDGE
_________________________
month/day/year
___________________________________________
PRINT OR STAMP JUDGE’S NAME
___________________________________________ ____________________________________________
PETITIONER DEFENDANT
DEFENDANT WAS SERVED AT CLOSE OF HEARING.
Date _________________________ Clerk ______________________________________________
FAXED OR ELECTRONICALLY TRANSMITTED TO LOUISIANA PROTECTIVE ORDER REGISTRY
Date ________________________ Clerk ______________________________________________
Copies to: 1) Court file 2) Petitioner/protected person(s) 3) Defendant 4) Chief Law Enforcement Official of the parish where the
protected person resides 5) Louisiana Protective Order Registry.
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

LPOR 05 LPOR 05

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 31 August 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document