LAW ENFORCEMENT INFORMATION SHEET (Confidential) [Note: The DV-125 Request For Service must also be filled out.] Notice To Petitioner. You must supply the respondent's name and birth date, if known. Fill in as much of the other information as you can to help the police locate the respondent. This information will NOT be given to the respondent. Notice To Law Enforcement. This information is confidential and is supplied to assist you in serving the protective order. The petitioner needs to be notified if you are unable to serve the order. After serving (or failing to serve the order), you MUST complete the return of service section of DV-125. Petitioner Information Name: Residence Address: Contact Address or Phone (Confidential): Respondent Information Name: SSN Sex Race Nickname or Street Name: Scars/Marks/Tattoos: Home Address: Work Address: Friends/Relatives/Hangouts: ID/Driver's License No. Height Weight Date of Birth: Hair Facial Hair: Home Phone: Work Phone: Eyes
Where do you think respondent is now? Vehicle Year: Make/Model: Vehicle License Number:: Additional Information (Pending Court Dates? On Probation?): Officer Safety Information Previous contact with police by respondent? No
Any threats by respondent toward petitioner, family, police? Describe: Weapons accessible to respondent (pistol, rifle, knife, other): Expected mental state or history of respondent (include alcohol or drug use): Is a divorce or other legal action pending that involves the respondent (child custody, eviction, bankruptcy, repossession of property)?
Distribution: Original to Police. If the court retains a copy, it must be kept confidential.
DV-127 (9/03)(cs) Civil Rule 65.1 LAW ENFORCEMENT INFORMATION SHEET (DOMESTIC VIOLENCE OR STALKING)