INSTRUCTIONS FOR COMPLETING "PETITION FOR PERSONAL PROTECTION ORDER (NONDOMESTIC)"
Please print neatly.
By filling in this form, you are asking for a personal protection order that tells the respondent not to do certain things
you don't want him or her to do. If you are in immediate danger, you should ask the judge for an "ex parte" order,
which will be issued without waiting for a hearing.
Items A through H must be completed before your petition can be filed with the court. Please read the instruction for
each item. Then fill in the correct information for that item on the form.
A
B
C
D
E
F
G
H
Wr
ite your name, address, and telephone number in the "Petitioner" box. If you are under 18 years of age,
write in your age. Write the name, address, and telephone number of the person you want restrained in the
"Respondent" box; if he or she is under 18 years of age, write in his/her age. If you want your address and
telephone number to be kept from the respondent, do not write your address here. Put in the address
of a relative or friend or a post office box where the court can contact you.
Check the box if the respondent is required to carry a firearm while at work. If you aren't sure, check the box
"unknown."
Check whether there is a pending action between you and the respondent. If there is, fill in the case number,
the name of the court, the county, and the state or province where the action was filed, and the name of the judge.
Check whether there are any court orders or judgments between you and the respondent. If there are, fill in
the case number, the name of the court, the county, and the state or province where the order or judgment was
entered, and the name of the judge that signed the order.
Explain in as much detail as possible why you are asking for a personal protection order. Describe what has
happened or what has been threatened so the judge has enough facts to decide if a personal protection order
should be signed. If you want to prohibit stalking, you must detail two or more separate instances of harassment
(unconsented contact) that caused you to feel terrorized, frightened, intimidated, threatened, harassed, or
molested. Include dates and places. Write on a separate sheet of paper and attach it to this form. If you only
want to prohibit the posting of a message through the use of any medium of communication, including the
Internet or a computer or any electronic medium, you must detail what caused you to feel terrorized, frightened,
intimidated, threatened, harassed, or molested.
Check only those boxes you need because you must be able to convince the judge you need all the protection
you are requesting. Check box a only if you provided details in item 4 that support an order against stalking.
An "ex parte order" means you do not have to let the other party know in advance that you are asking the
court for an order and you do not have to wait for a court hearing to get the order. Check the box for an
"ex parte order" if you believe the other party might hurt you or threaten you if he or she found out you were
getting an ex parte personal protection order.
If you do not check the box for an ex parte order, you must have a court hearing.
If you are under 18 years old, you may need an adult (called a "next friend") to petition for you. Check this
box if you have a next friend helping you file this form, and have the next friend sign the petition.
Write in today's date and sign the form. Hand the form to the court clerk. The clerk will fill in the rest of the
information and will give you your copies.
You must read the booklet "Instructions for Personal Protection Orders" for directions on the legal process.
