Free So that the Order of Protection is valid, - Indiana

So that the Order of Protection is valid, after you print, YOU MUST REPLACE THIS PAGE with the

Cover Sheet: Order of Protection
(available for download in PDF format)

CHPO-0100

Approved 7-1-07 Revised 7-1-08

STATE OF INDIANA ) COUNTY OF ___________ ) SS: Department of Child Services, Petitioner v. _________________________ Alleged Perpetrator/Respondent

IN THE ________________COURT ____ (_____________ DIVISION, ROOM ___)

Case Number: ____-JM-______

_________________________ Parent, or other adult with whom the child will continue to reside In the Matter of: ) ) ) ) ) ) )

___________________, Initials of the Child(ren) Alleged to be a Child in Need of Services

TEMPORARY CHILD PROTECTIVE ORDER - CHINS Comes now the Department of Child Services (DCS) and files a petition to remove the alleged perpetrator/respondent from the residence of

___________________________ (insert initials of child or children), under Indiana Code § 31-34-2.3 and the court now issues this Temporary Child Protective Order.

Findings a. The Court finds the Department of Child Services has filed a Verified Petition for a Child Protective Order. b. The Court finds: (1) there is an immediate danger to the physical health or safety of the child or the child has been a victim of sexual abuse; (2) there is not time for an adversary hearing given the immediate danger to the physical health or safety of the child;

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CHPO-0100

Approved 7-1-07 Revised 7-1-08

(3) the child is not in danger of child abuse or neglect from a parent or other adult with whom the child will continue to reside in the child's residence at _____________ ___________________________________________________________________; (4) the issuance of a temporary child protective order is in the best interest of the child. c. The Court finds the best interests of the child will be served if the Alleged

Perpetrator/Respondent is removed from the child's residence.

ORDER 1. THE ALLEGED PERPETRATOR/RESPONDENT, ______________________, shall be removed from the child's residence at ___________________________ ________________________________________________________________. 2. THE ALLEGED PERPETRATOR/RESPONDENT, _____________________, shall not enter the child's residence at__________________________________ ________________________________________________________________. 3. ___________________________, the parent or other adult with whom the child will continue to reside in the child's residence shall make reasonable efforts: (a) to monitor the residence; and (b) to report to the department and the appropriate law enforcement agency any attempt by the alleged perpetrator of child abuse or neglect to return to the child's residence. This Order remains in effect until _________________________ [not more than forty-eight (48) hours (excluding Saturdays, Sundays, and any day on which a legal holiday is observed for state employees as provided in Indiana Code § 1-1-9) after this order is issued.] The hearing on the temporary child protective order shall be held:___________ 04
IDACS Codes

04

DATE: _______________

___________________________________ Judge

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CHPO-0100

Approved 7-1-07 Revised 7-1-08

IMPORTANT NOTICE VIOLATION OF THIS ORDER IS PUNISHABLE BY CONFINEMENT IN JAIL, PRISON, AND/OR A FINE. IF SO ORDERED BY THE COURT, THE RESPONDENT IS FORBIDDEN TO ENTER OR STAY AT THE PETITIONER'S RESIDENCE OR RESIDENCE OF ANY CHILD WHO IS THE SUBJECT OF THE ORDER, EVEN IF INVITED TO DO SO BY THE PETITIONER OR ANY OTHER PERSON. IN NO EVENT IS THE ORDER FOR PROTECTION VOIDED. PURSUANT TO 18 U.S.C. 2265, THIS ORDER FOR PROTECTION SHALL BE GIVEN FULL FAITH AND CREDIT IN ANY OTHER STATE OR TRIBAL LAND AND SHALL BE ENFORCED AS IF IT WERE AN ORDER ISSUED IN THAT STATE OR TRIBAL LAND. PURSUANT TO 18 U.S.C. 922(g), ONCE A RESPONDENT HAS RECEIVED NOTICE OF THIS ORDER AND AN OPPORTUNITY TO BE HEARD, IT IS A FEDERAL VIOLATION TO PURCHASE, RECEIVE, OR POSSESS A FIREARM WHILE SUBJECT TO THIS ORDER IF THE PROTECTED PERSON IS: (A) THE RESPONDENT'S CURRENT OR FORMER SPOUSE; (B) A CURRENT OR FORMER PERSON WITH WHOM THE RESPONDENT RESIDED WHILE IN AN INTIMATE RELATIONSHIP; OR (C) A PERSON WITH WHOM THE RESPONDENT HAS A CHILD. INTERSTATE VIOLATION OF THIS ORDER MAY SUBJECT THE RESPONDENT TO FEDERAL CRIMINAL PENALTIES UNDER 18 U.S.C. 2261 AND 18 U.S.C. 2262. A PARENT OR OTHER ADULT WITH WHOM A CHILD CONTINUES TO RESIDE AFTER THE ISSUANCE OF A CHILD PROTECTIVE ORDER ISSUED UNDER SECTION 2 OR 5 OF THIS CHAPTER FOR REMOVAL OF AN ALLEGED PERPETRATOR OF CHILD ABUSE OR NEGLECT WHO KNOWINGLY OR INTENTIONALLY FAILS TO COMPLY WITH THE REQUIREMENTS UNDER INDIANA CODE § 31-34-2.3-6 COMMITS A CLASS A MISDEMEANOR.

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