Petition for Injunction for Protection Against Domestic Violence

"No one, not even someone in your family, has the right to hit you, slap you, punch you or hurt you in any way"

PETITION FOR INJUNCTION FOR PROTECTION AGAINST DOMESTIC VIOLENCE (Example Only)

Before me, the undersigned authority, personally appeared Petitioner:

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(Name)

who has been sworn and says, that the following statements are true:

(a) Petitioner resides at:

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(Address)

(b) Respondent resides at:

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(Last Known Address)

(c) Respondent is: (Please indicate applicable selection)

• the spouse of the Petitioner

• the former spouse of the Petitioner

• any other person related by blood or to the Petitioner

• any other person who is or was residing within a single dwelling unit with the Petitioner as if family

• a person with whom the Petitioner has a child in common

(d) The following describes any other cause of action including, but not limited to, a dissolution of marriage action, currently pending between the Petitioner and the Respondent.

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Specify attorneys of record in the action(s) listed

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For Petitioner                                          For Respondent

(e) The petitioner should also describe any previous or pending attempts by the petitioner to obtain an injunction for protection against domestic violence in this or any other circuit, and the results of that attempt:

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(Case numbers should be included if available)

(f) Petitioner has suffered or has reasonable cause to fear violence because the respondent has:

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(g) Petitioner alleges the following additional specific facts: (mark appropriate sections)

• Petitioner is the custodian of a minor child or children as more fully detailed in the Uniform Custody Jurisdiction Act

• Petitioner need the exclusive use and possession of the dwelling that the parties share

• Petitioner is unable to obtain safe alternative housing because:

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(h) Petitioner genuinely fears domestic violence by respondent.

(i) Petitioner seeks an injunction- (mark appropriate section or sections)

• Immediately restraining the respondent from committing any acts of domestic violence.

• Restraining the respondent from committing any acts of domestic violence.

• Awarding temporary custody of, or temporary visitation rights with regard to the minor child or children of the Petitioner.

• Directing the respondent to participate in a batterer's intervention program or other treatment pursuant to s.415.601

• Providing any terms the court deems necessary for the protection of a victim of domestic violence, including any injunctions or directives to law enforcement agencies.