Free Relevant Date Sheet - Oregon

RELEVANT DATA - ELDERLY/DISABLED RESTRAINING OR DER RESPONDENT _______________________________________ Sex _____ Telephone #___________ Residence Address ______________________________________________________________________________ City/State/Zip ________________________________________________ County:_________________ Birth Date _____________________________ Age ______________ Race ____________________ He ight _______________ W eight _______________ Hair Color _______________ Eye Color ______ PETITIONER or the Person on Whose Behalf the "Guardian Petitioner" Below is Petitioning Nam e ______________________________________ Sex _____ *Telephone # __________________ *Residence Address: ___________________________________________________________________________________ City/State/Zip _______________________________________________ County__________________ Birth Date _____________________________ Age ______________ Race ____________________ He ight _______________ W eight _______________ Hair Color _______________ Eye Color ______ *If you wish to have your residential address or telephone number, or the address/telephone number of the person on whose behalf the "guardian petitioner" is petitioning, withheld from respondent, use a conta ct a ddress and contac t tele phone num ber so the court and the sheriff can rea ch you/the m if necessary. GUARDIAN PETITIONER (Nam e) _______________________________ Telephone #_____________ Addres s: _____________________________________________________________________________ PLEASE FILL OUT THIS INFORMATION TO AID IN SERVICE OF THE RESTR AINING ORDER W here is re spondent m ost like ly to be located ? G Residence Hours: _______________ Address: _________________________________________ G Em ployment Hours:_______________Address:___________________________________________ _____________________________________________ G Other Ho urs: ______________Address:____________________________________________ Description of ve hicle ____________________________________________________________________________________ Does respondent have any weapons or access to weapons? EXPLAIN: ____________________________________________________________________________________ ____________________________________________________________________________________ Has respondent ever been arrested for or convicted of a violent crime? EXPLAIN: ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Is there anything about respondent's character, past behavior, or the present situation that indicates that respondent may be a danger to self or others? EXPLAIN: ____________________________________________________________________________________ ____________________________________________________________________________________

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