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Petitioner, and Respondent. (Florida)

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Florida Supreme Court Approved Family Law Form 12.980(k), Temporary Injunction for Protection Against Repeat
Violence (03/15)
IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR COUNTY, FLORIDA
Case No.:
Division:
,
Petitioner,
and
,
Respondent.
TEMPORARY INJUNCTION FOR PROTECTION AGAINST REPEAT VIOLENCE
The Petition for Injunction for Protection Against Repeat 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 Repeat 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 Repeat 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. All witnesses and evidence, if any, must be presented at
this time. Petitioner and Respondent will be bound by the terms of any injunction or order issued at
the final hearing.
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(k), Temporary Injunction for Protection Against Repeat
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 repeat violence and that an immediate and present
danger of repeat violence exists to Petitioner or to a member of Petitioner's immediate family.
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. 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 parties together. Only the Court may modify the
Florida Supreme Court Approved Family Law Form 12.980(k), Temporary Injunction for Protection Against Repeat
Violence (03/15)
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 repeat 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 the Petitioner.
2. No Contact. Respondent shall have no contact with 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}__________________________
[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.
c. ____Other provisions regarding contact:
______________________________________________________________________________
______________________________________________________________________________.
Florida Supreme Court Approved Family Law Form 12.980(k), Temporary Injunction for Protection Against Repeat
Violence (03/15)
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 or e-mail shall be complete upon
mailing.
5. Additional order(s) necessary to protect Petitioner from repeat 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 law enforcement 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
Florida Supreme Court Approved Family Law Form 12.980(k), Temporary Injunction for Protection Against Repeat
Violence (03/15)
injunction should be reported to the appropriate law enforcement agency. Law enforcement
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
COPIES TO:
Sheriff of _____________________ County
Petitioner:
_____ by U.S. Mail
_____by hand delivery in open court
_____by e-mail to designated e-mail address(es)
Respondent:
_____ forwarded to the sheriff for service
_____State’s Attorney’s Office
_____Other:_____________________
Florida Supreme Court Approved Family Law Form 12.980(k), Temporary Injunction for Protection Against Repeat
Violence (03/15)
I CERTIFY the foregoing is a true copy of the original Temporary Injunction for Protection Against
Repeat 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}
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Petitioner, and Respondent. (Florida)

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Completed 10 January 2021

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