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STATE OF SOUTH CAROLINA COUNTY OF

Petitioner vs. Respondent

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IN THE FAMILY COURT ________ JUDICIAL CIRCUIT SUPPLEMENT TO THE PETITION FOR ORDER OF PROTECTION
(For Use in Family Court)

FILE NO.

You must complete this form if you live or are sheltered in this county, but the abuse occurred in another county; the person who caused the abuse lives in another county; or both of you last lived together in another county.
1. I live or am sheltered in _______________________County. 2. I am asking the court to transfer this case to ___________________________ County for the hearing, because: (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 caption in the Petition for Order of Protection must designate the county identified in Item 2 above. (S.C. Code Ann. Section 20-4-30, as amended.)

______________________________________________ Signature of Petitioner or Person on Behalf of Petitioner under 18 years old

This form is for Internal Use Only. Because of safety concerns, the petitioner should be contacted at the following address which shall be confidential and not subject to Public Disclosure.
Contact Person: ___________________________________________ Address: _________________________________________________ Phone: ______________________

SCCA/425C (12/2002)