STATE OF SOUTH CAROLINA COUNTY OF Petitioner vs. Respondent. I ask this court to issue an Order of Protection, because: 1.
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IN THE FAMILY COURT JUDICIAL CIRCUIT PETITION FOR ORDER OF PROTECTION
(For Use in Family Court)
Respondent's SSN: DOB Race
This is the county where this case should be handled, since (check one): a. The alleged act of abuse occurred in this county; or, b. The person who caused the abuse lives in this county; or c. The person who caused the abuse and I last lived together in this county. The person who caused the abuse lives at , which is in
(street address) in or near the town or city of
County, and the State of
The person who was abused was (check one or both, and supply information): a. , who is the person asking for an Order of Protection; or, b. , who is a child under 18 years old who lives with me. That the abuser and the victim (check one or more): were formerly husband and wife
are husband and wife have a child/children in common, who is/are:
were formerly living together
are living together
are household or family members pursuant to S.C. Code Section 20-4-20(a)(2)
5. The abuse happened at (address/location) 2 , at o'clock, when on
(Name of person causing abuse)
Have there been prior convictions of domestic violence or prior orders of protection? Yes No . I ask this court to grant the following temporary relief (check as many as apply and supply information) a. issue an order of protection which prohibits and forbids from abusing, threatening to abuse, or molesting, or engaging in any other conduct that would place Petitioner in reasonable fear of bodily injury. b. issue an order of protection which restrains and prohibits from using, attempting to use, or threatening to use physical force against Petitioner that would reasonably be expected to cause bodily injury. c. issue an order of protection which restrains, prohibits, and forbids from communicating or attempting to communicate with Petitioner in any way, and from entering or attempting to enter the home of the victim, place of employment, education, or other location as the Court may order. d. issue an order granting temporary custody of the following minor child(ren).
, did this: . . If yes, please state date
Date of Birth
grant reasonable visitation or
e. f. g. h. i.
issue an order granting Petitioner temporary child support (Financial Declaration [Form SCCA/430] MUST be completed and attached). issue an order granting Petitioner temporary financial support (Financial Declaration [Form SCCA/430] MUST be completed and attached). issue an order granting Petitioner temporary exclusive use and possession of the home and furnishings. issue an order which forbids from transferring, selling destroying, encumbering, or otherwise disposing of real or personal property belonging to Petitioner or jointly owned. issue an order which gives Petitioner assistance from law enforcement in that Petitioner will be accompanied: (1)in removing Personal property from (Street Address)
in (Street Address) in (City) (City) (County), South Carolina.
(County), South Carolina.
(2)in placing Petitioner in possession of the home and furnishings at
j. k. l. m.
issue an order reimbursing Petitioner for costs and attorney's fees. hold a hearing within 15 days of the date of filing these papers. hold an emergency hearing within 24 hours. issue an order granting Petitioner the following additional requests: .
Sworn to and Subscribed before me this day of Notary Public for South Carolina My Commission expires
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Signature of Petitioner or Person on Behalf of Petitioner under 18 years old
NOTICE TO RESPONDENT: YOU HAVE THE RIGHT TO EMPLOY COUNSEL TO REPRESENT YOU.