Free Personal Protection Order Against Stalking (Non Domestic Relationship) - Michigan

Personal Protection Order Against Stalking (Non Domestic Relationship)
Use this form if you filled out Form CC 377, Petition for Personal Protection Order Against Stalking

You must provide the court with this order. Fill out items A through D only. The court will complete the rest of the form.

You must serve the respondent with a copy of the petition and the signed order. Follow the instructions in the booklet.

An instruction booklet is available to help you get your personal protection order signed. See file P02.

Once the order is signed, the clerk of the court will send the order to the law enforcement agency stated in the order even if you take a copy to them yourself.

(Form CC 380)

INSTRUCTIONS FOR COMPLETING "PERSONAL PROTECTION ORDER AGAINST STALKING" Please print neatly. Items A through E must be completed before you give this form to the court clerk. Please read the instruction for each item. Then fill in the correct information for that item on the form. A B C If you checked box F on form CC 377, check the box for "Ex Parte." Fill in the "Case No." from form CC 377. Fill in the "petitioner" and "respondent" the same way you did on form CC 377. 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. Write in the respondent's name and as much of the other information as you know. This information will help the police identify the respondent if he or she disobeys the restraining order. Be sure to identify the respondent accurately.

D

The court will complete the rest of this form.

You must read the booklet "Instructions for Personal Protection Orders" for directions on the legal process. · · If you asked for an ex parte order (order without a hearing), read pages 3 and 4 of the booklet. If you did not ask for an ex parte order or the judge refuses to sign an ex parte order, read pages 5 and 6 of the booklet.

Important: If the respondent violates this personal protection order and is arrested, the court will set a date, time, and place for a hearing on the charges against the respondent to be held within 72 hours after arrest. The court or prosecutor is responsible for giving you notice of this hearing. If you are not notified within 24 hours of the arrest, contact the judge who signed this order. If a hearing is not held within 72 hours, the respondent may be released from jail after posting bond pending the hearing. If the respondent violates this personal protection order and there is no arrest, use form CC 382, Motion and Order to Show Cause for Violating Personal Protection Order. This form is available from the circuit court clerk.

Complete items A through D using the instructions. Fill out the form by tabbing to each item or moving the mouse Original - Court to each item. Select check box items with the mouse. 1st copy - Law enforcement agency (file) (green)
Approved, SCAO 2nd copy - Respondent (blue)

3rd copy - Petitioner (pink) 4th copy - Return (yellow) 5th copy - Return (goldenrod)

STATE OF MICHIGAN JUDICIAL CIRCUIT COUNTY
Court address ORI MIPetitioner's name

A

PERSONAL PROTECTION ORDER AGAINST STALKING (NONDOMESTIC) EX PARTE

B

CASE NO.

Court telephone no.

C

Respondent's name, address, and telephone no.

Address and telephone no. where court can reach petitioner

v Address and telephone no. where court can reach respondent

D

Full name of respondent (type or print) * Height Weight Race * Sex * Date of birth or Age* Hair color Eye color

Driver's license number (if known) Other identifying information

*These items must be filled in for the police/sheriff to enter on LEIN; the other items are not required but are helpful.

Date: 1. This order is entered

Judge:
Bar no.

without a hearing.

after hearing.

THE COURT FINDS: 2. A petition requesting an order to restrain conduct prohibited under MCL 750.411h and 750.411i has been filed under the authority of MCL 600.2950a. 3. Petitioner requested an ex parte order, which should be entered without notice because irreparable injury, loss, or damage will result from delay required to give notice or notice itself will precipitate adverse action before an order can be issued. 4. Respondent committed the following acts of willful, unconsented contact: (State the reasons for issuance.)

IT IS ORDERED: 5.
Full name of respondent

is prohibited from stalking as defined under

MCL 750.411h and MCL 750.411i, which includes but is not limited to following or appearing within sight of the petitioner. appearing at the workplace or the residence of the petitioner. approaching or confronting the petitioner in a public place or on private property. entering onto or remaining on property owned, leased, or occupied by the petitioner. sending mail or other communications to the petitioner. contacting the petitioner by telephone. placing an object on or delivering an object to property owned, leased, or occupied by the petitioner. threatening to kill or physically injure the petitioner. purchasing or possessing a firearm. other: 6. Violation of this order subjects the respondent to immediate arrest and to the civil and criminal contempt powers of the court. If found guilty, respondent shall be imprisoned for not more than 93 days and may be fined not more than $500.00. 7. This order is effective when signed, enforceable immediately, and remains in effect until . This order is enforceable anywhere in this state by any law enforcement agency when signed by a judge, and upon service, may also be enforced by another state, an Indian tribe, or a territory of the United States. If respondent violates this order in a jurisdiction other than this state, respondent is subject to enforcement and penalties of the state, Indian tribe, or United States territory under whose jurisdiction the violation occurred. 8. The court clerk shall file this order with who will enter it into the LEIN. 9. Respondent may file a motion to modify or terminate this order. For ex parte orders, the motion must be filed within 14 days after being served with or receiving actual notice of the order. Forms and instructions are available from the clerk of court. 10. A motion to extend the order must be filed 3 days before the expiration date in item 7, or else a new petition must be filed.
Date and time issued CC 380 (3/08) Judge MCL 600.2950a, MCR 3.705, MCR 3.706

PERSONAL PROTECTION ORDER AGAINST STALKING (Nondomestic)

PROOF OF SERVICE

Personal Protection Order Against Stalking Case No.

TO PROCESS SERVER: You must serve the personal protection order against stalking and file proof of service with the court clerk. If you are unable to complete service, you must return this original and all copies to the court clerk. CERTIFICATE / AFFIDAVIT OF SERVICE / NONSERVICE OR OFFICER CERTIFICATE I certify that I am a sheriff, deputy sheriff, bailiff, appointed court officer, or attorney for a party (MCR 2.104[A][2]), and (notarization not required) that: AFFIDAVIT OF PROCESS SERVER Being first duly sworn, I state that I am a legally competent adult who is not a party or an officer of a corporate party, and that: (notarization required)

I served a copy of the personal protection order against stalking by personal service on: registered mail, delivery restricted to the respondent (return receipt attached) on:
Name of respondent Complete address of service Day, date, time

Law enforcement agency

Complete address of service

Day, date, time

I have personally attempted to serve a copy of the personal protection order against stalking on the following respondent and have been unable to complete service.
Respondent's name Complete address of service

I declare that the statements above are true to the best of my information, knowledge, and belief.
Signature Service fee Miles traveled Mileage fee Total fee

$

$

$

Name (type or print) Title

Subscribed and sworn to before me on
Date

, Signature:
Deputy court clerk/Notary public

County, Michigan.

My commission expires:
Date

Notary public, State of Michigan, County of

ACKNOWLEDGMENT OF SERVICE I acknowledge that I have received a copy of the personal protection order against stalking on
Day, date, time Signature of respondent

.

MCR 2.105(A)