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TO BE USED IN BOND HEARINGS FOR CRIMINAL DOMESTIC VIOLENCE CASES AND/OR CASES WHERE DEFENDANT IS SUBJECT TO AN ORDER OF PROTECTION OR RESTRAINING ORDER

Pursuant to Section 16-25-125, it is unlawful for a person who has been charged with or convicted of criminal domestic violence or criminal domestic violence of a high and aggravated nature, who is subject to an order of protection, or who is subject to a restraining order, to enter or remain upon the grounds or structure of a domestic violence shelter in which the person's household member resides or the domestic violence shelter's administrative offices. A person who violates this provision is guilty of a misdemeanor and, upon conviction, must be fined not more than three thousand dollars or imprisoned for not more than three years, or both. If the person is in possession of a dangerous weapon at the time of the violation, the person is guilty of a felony and, upon conviction, must be fined not more than five thousand dollars or imprisoned for not more than five years, or both. Charging Document(s) # Charge (s)

Defendant's Name

Defendant's Signature

Date

Defendant was given the opportunity to review and sign this document, but refused to do so.

Witnessed: ____________________________________ A copy of this document has been provided to the defendant.

SCCA/698 (8/2008)