Free Plaintiff Guide Sheet and General Petition - Arizona

All Courts in Arizona

Plaintiff's Guide Sheet for Protective Orders - Please Read Carefully
The following information is provided to further explain the protective order process. required, that the Plaintiff carries a copy of the protective order at all times. 1. You can request one of the following types of protective orders: ORDER OF PROTECTION: An Order of Protection is used for a "family" relationship between you and the Defendant. This can include one of the following: 1) married now or in the past, 2) live together now or lived together in the past, 3) parent of a child in common, 4) one of you is pregnant by the other, or 5) you are a relative (parent, in-law, brother, sister, or grandparent). Also, you must state how an act of domestic violence was threatened or committed against you within the last year. INJUNCTION AGAINST HARASSMENT: The Defendant has committed a series of acts (more than one) of harassment against you in the last year. Also, a "dating" relationship without living together could be the basis for this Injunction. INJUNCTION AGAINST WORKPLACE HARASSMENT: This Injunction may be filed by an employer or owner of a business or operation for the benefit of an employee or the business against a single act or series of acts of harassment. 2. OTHER PROTECTED PERSONS: It is possible that you will be referred to Superior Court if your children are listed as protected persons in this order. Only a Superior Court Judge can decide child custody or parenting time in a separate action. 3. ONE DEFENDANT: You must list only one defendant per petition. A separate petition must be filed for each defendant. A copy of your petition and the order will be given to the Defendant and may be used in future judicial proceedings. 4. SERVICE AND EFFECT: This protective order is valid for one year from the date it is served on the Defendant and is enforceable by law enforcement in any state or tribal nation in the United States. There is no fee for law enforcement service of an Order of Protection or Injunction Against Harassment involving a dating relationship. There is a fee to serve an Injunction Against Harassment not involving a dating relationship or an Injunction Against Workplace Harassment. The court will instruct you on how service can be made. The cost to serve injunctions varies depending on mileage and number of attempts. If you cannot afford to hire a process server, you can ask the judge to defer or waive the fee. 5. PROTECTIVE ORDER HEARING: If the Defendant disagrees with this protective order, he/she has the right to request a hearing which will be held within 5 to 10 business days after a written request has been filed in the court that issued this order. If you do not appear at the hearing, your Order may be quashed (dismissed); therefore, you must notify the court of any change in your contact information to assure you are notified of any hearing dates and times. 6. MODIFYING OR QUASHING (DISMISSING) THIS PROTECTIVE ORDER: Only a judge can modify or quash (dismiss) this protective order. If you file an action for maternity, paternity, annulment, legal separation, or dissolution against the Defendant, advise this court at once. Nothing you do can stop, change, or undo this protective order without the Court's written approval. 7. PLAINTIFF CONTACT: Even if you initiate contact, the Defendant could be arrested for violating this protective order. If the Defendant does not want you to contact him/her, the Defendant has the right to request a protective order against you. 8. LAW ENFORCEMENT STANDBY: If you or the Defendant needs to get personal belongings from the other, you may request standby from the judge. Standby allows you or the Defendant to return once with a law enforcement officer to obtain necessary personal belongings from the residence. Neither law enforcement nor this protective order can resolve conflicts over property, title, furniture, finances, real estate, or other ownership issues. 9. FIREARMS: You may request that the judge order the Defendant not to possess, receive, or purchase firearms or ammunition. 10. COUNSELING: If requested, counseling for the Defendant can only be ordered at a hearing at which you and the Defendant must appear. 11. PUBLIC ACCESS: Only the information contained in the served protective order, not the petition, will be entered into the state computer system and will be made public on the internet. See next page to keep your address(es) private. It is recommended, but not

Effective: January 2007

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Adopted by Administrative Directive No. 2006-01

All Courts in Arizona Case No. ________________________

Plaintiff's Guide Sheet for Protective Orders - Please Read Carefully
PRINT ALL INFORMATION ON THIS FORM AND ON THE PETITION. _______________________________________ Your Name (_____)_________________________________ Your Daytime Telephone Number _________________________________________________ Your Address _________________________________________________ City, State, ZIP

You may request that the Court keeps your address confidential if the Defendant does not know where you live or work. If checked, the following addresses will be restricted and will not appear on the petition served on the Defendant:

[ ] Restrict home address [ ] Restrict school address

[ ] Restrict work address

[ ] Restrict other address

Your relationship to the defendant is: [ ] married now or in the past [ ] live together now or lived together in the past [ ] parent of a child in common [ ] one party is pregnant by the other [ ] relative (parent, in-law, brother, sister, or grandparent) [ ] dating-never lived together [ ] Other ________________________________________ Defendant's Name (_____)_________________________________ Defendant's Daytime Telephone Number _________________________________________________ Defendant's Address _________________________________________________ City, State, ZIP

DEFENDANT IDENTIFIERS Please provide all information below to the best of your knowledge. If you do not know the Defendant's date of birth, an estimated date of birth is acceptable. Please indicate the date of birth is an estimate by checking the "Est." box below.

SEX

RACE

DOB

Est. [ ]

HT WT

EYES

HAIR

SOC SEC NUMBER

DRIVER'S LICENSE #

STATE

EXP DATE

Effective: January 2007

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Adopted by Administrative Directive No. 2006-01

All Courts in Arizona

Case No. Plaintiff / Plaintiff Employer (Work Injunction ONLY) Birth Date: Defendant PETITION for [ ] Order of Protection [ ] Injunction Against Harassment [ ] Workplace Injunction

Address City, State, Zip Code __________________________ Phone

Agent's Name (Work Injunction ONLY) DIRECTIONS: Please read the Plaintiff's Guide Sheet before filling out this form. 1. Defendant/Plaintiff Relationship: [ ] Married now or in the past [ ] Live together now or lived together in the past, [ ] Child in common [ ] One of us pregnant by the other [ ] Related (Parent, In-law, Brother, Sister or Grandparent) [ ] Dating-never lived together [ ] Other: 2. [ ] If checked, there is a pending action involving maternity, paternity, annulment, legal separation, dissolution, custody, parenting time or support in Superior Court, (COUNTY) . Case #: 3. Have you or the Defendant been charged or arrested for domestic violence OR requested a Protective Order? [ ] Yes [ ] No [ ] Not sure If yes or not sure, explain: 4. I need a Court Order because: (PRINT both the date(s) and briefly what happened): Date(s) Describe what happened (Attach additional paper if necessary ­ Do not write on back)

Effective: January 2007

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Adopted by Administrative Directive No. 2006-01

All Courts in Arizona Case No. 5. The following persons should also be on this Order. As stated in number 4, the Defendant is a danger to them: (___/___/_____) (___/___/_____) Birth Date Birth Date (___/___/_____) (___/___/_____) Birth Date Birth Date 6. Defendant should be ordered to stay away from these locations, at all times, even when I am not present: [ ] Home [ ] Work [ ] School/Others 7. [ ] If checked, because of the risk of harm, order the defendant NOT to possess firearms or ammunition. 8. [ ] If checked, request an order for the Defendant to participate in domestic violence counseling or other counseling. 9. Other: Under penalty of perjury, I swear or affirm the above statements are true to the best of my knowledge, and I request an Order / Injunction granting relief as allowed by law.

Plaintiff

Attest: Judicial Officer/ Clerk / Notary

___/___/_____ Date

Effective: January 2007

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Adopted by Administrative Directive No. 2006-01