Free Petitioner's Motion, Affidavit and Order to Renew - Oregon

IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF LINN

_____________________________________
Petitioner (your nam e) Gua rdian Petitioner,
vs. _____________________________________ Respondent (person to be restrained)

) ) ) ) ) ) ) ) )

CASE NO :__________________________ PE TITIONER 'S/G UAR DIAN PE TITIONER 'S MOT ION AND AFFIDAVIT TO RENEW RESTRAINING ORDER AND ORD ER RENEWING [Elderly Persons and Person s with Disabilities Abus e Prevention A ct]

MOTION On the basis of ORS 124.035 and the attached affidavit, the petitioner guardian petitioner , moves the court to issue an Order renewing the restraining order signed on: _______/_______/_______, in this matter for a period of one year, and continuing the security amount in the amount set forth in the original order or in such other amount as the court deems appropriate. Points and Authorities ORS 124.035 authorizes the Court to renew an Elderly Persons and Persons With Disabilities Abuse Prevention Act Restraining Order upon the request of the petitioner/guardian petitioner and for good cause shown. _________________________ Date __________________________________ Signature of Petitioner/Guardian Petitiioner __________________________________________ Print or Type Name of Petitioner /Guardian Petitioner

AFFIDAVIT STATE OF OREGON ) ) ss. County of _______________________ )

I, _______________________________________________, swear/affirm that I am the Petitioner Guardian Petitioner in this matter, and:
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based on the conditions of abuse described in the original Petition or
previous Motion to Renew, there is good cause to renew the Restraining Order;

based on the following events that have happened, or additional facts I have learned, since the court signed the original Restraining Order or previous Order Renewing the Restraining Order in this matter, there is good cause to renew the Restraining Order :
_____________________________________ Signature of Petitioner/Guardian Petitioner _____________________________________ Print or Type Name of Petitioner/Guardian SUBSCRIBED AND SWORN TO before me this ______ day of __________________ ________________________ 20 ___, by ________________________________________. (Print Name of Petitioner/Guardian Petitioner) _____________________________________ NOTARY PUBLIC FOR OREGON / COURT CLERK My Commission expires:__________________

Submitted by: __________________________________________________________________ Print Name Address or Contact Address Petitioner Guardian Petitioner _____________________________________________ Attorney for Petitioner/Guardian Petitioner OSB No: Telephone or Contact:___________________________________________ Telephone Number(s)_____________________________________________ _

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ORDER RENEWING ELDER/DISABLED RESTRAINING ORDER TO THE RESPONDENT: THIS ORDER CONTINUES THE ORIGINAL OR MODIFIED RESTRAINING ORDER AND BECOMES EFFECTIVE IMMEDIATELY. VIOLATION OF THE CONTINUED RESTRAINING ORDER MAY RESULT IN YOUR ARREST OR IN CIVIL AND/OR CRIMINAL PENALTIES. IF YOU WISH TO CONTEST THE CONTINUATION OF THIS ORDER, SEE YOUR RIGHTS TO A HEARING IN THE "NOTICE TO RESPONDENT/REQUEST FOR HEARING" ATTACHED TO THIS ORDER. TO THE ELDERLY/DISABLED PERSON ON WHOSE BEHALF THIS ORDER WAS OBTAINED: THIS ORDER CONTINUES THE ORIGINAL OR MODIFIED RESTRAINING ORDER OBTAINED BY "GUARDIAN PETITIONER" ON YOUR BEHALF. IF YOU WISH TO CONTEST THE CONTINUATION OF THIS ORDER, SEE YOUR RIGHTS TO OBJECT AND REQUEST A HEARING IN THE "NOTICE TO ELDERLY PERSON OR PERSON WITH DISABILITIES/ OBJECTIONS AND REQUEST FOR HEARING" FORM (FORM 2E) ATTACHED TO THIS ORDER. The court, having reviewed the Petitioner's /Guardian Petitioner's Motion and Affidavit to Renew, makes the following findings: JUDGE'S INITIALS There is good cause to renew the Restraining Order. ____ No further service is necessary because the respondent appeared in person before the court. This matter coming before the court on the motion of the petitioner/guardian petitioner, IT IS HEREBY ORDERED that: ____ The Restraining Order in this matter is renewed for a period of one year. ____Other:

The SECURITY AMOUNT FOR VIOLATION OF ANY PROVISION OF THIS ORDER OR THE ORIGINAL RESTRAINING ORDER IS $5,000 UNLESS OTHERWISE SPECIFIED; OTHER AMOUNT $__________
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Petitioner's/Guardian petitioner's motion is denied.
DATED this ____ day of _____________, 20 ___.

__________________________________________ Circuit Judge

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