Free Ex-Parte Petition For An HRS 586 Temporary Restraining Order - Hawaii

If Attorney filing type name, address and phone no. below

1. 2. 3. 4.

CLEAR FORM
IN THE FAMILY COURT OF THE SECOND CIRCUIT STATE OF HAWAII

on behalf of

Petitioner,

vs.

Respondent.

) ) ) ) ) ) ) ) ) ) ) ) )

FC-DA NO. EX PARTE PETITION FOR AN HRS 586 TEMPORARY RESTRAINING ORDER ORDER [ ] Granting [ ] Denying Ex Parte Petition for an Temporary Restraining Order

HRS

586

EX PARTE PETITION FOR AN HRS 586 TEMPORARY RESTRAINING ORDER
This Petition is made pursuant to Hawaii Revised Statutes Chapter 586. Petitioner in support of this Petition states that: 1. This Petition is being filed on behalf of (hereinafter "Petitioner"). This petition is being filed on behalf of the Petitioner because he/she is:

2.

Petitioner resides on the island of

9 Maui 9 Molokai 9 Lanai.

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2JC-jy 03/04/09

3.

The following individual(s) live with Petitioner in his/her residence: Name Relationship to Petitioner Birthdate Age

4.

Petitioner has the following relationship with the Respondent above named: A. B. C.

9 9 9

they are married. they were married. they have the following child/children in common: Child(ren)'s Name(s) Birthdate

D. E. F. G. H.

9 9 9 9 9

they are parent and child. they are related by blood as follows: they lived together in the same dwelling unit from they are now living together. they are or were in a dating relationship 1. Length of our relationship (number 2. Nature of our relationship is/was years months days) to . .

9 9 9 9 9 9 9
5.

romantic a courtship an engagement intimate or sexual a casual relationship ordinary fraternization in business/social contact Frequency of interaction times per 9 day

9 week

9

month.

Petitioner's date of birth is: Petitioner's Social Security Number is: XXX-XXRespondent's date of birth is: Respondent's Social Security Number is: XXX-XX-

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6.

The most recent acts of domestic abuse or threats of domestic abuse against Petitioner are:

9

In the past the Respondent has committed the following acts of domestic abuse or threats of domestic abuse against Petitioner and other people:

9

The Respondent has used weapons against Petitioner or threatened to use weapons in the following incidents:

9

I believe the Respondent possesses, owns, or intends to own firearms or ammunition. The reason I believe this is (include description of firearm(s) and present location):

9

I believe that the Respondent may use a firearm to threaten, injure or abuse someone because:

9

Petitioner and Respondent live together at

It is necessary that Petitioner have exclusive occupancy of the joint residence until the court hearing because:

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9

Until there is a court hearing I am concerned about Respondent having contact with the parties' minor children who live with Petitioner because:

9

Until there is a court hearing I am concerned about Respondent having contact with the following people who live with Petitioner because:

9

Until there is a court hearing I am concerned about Respondent having contact with the following family members w ho do not live with Petitioner, because:

Name

Relationship to Petitioner

Birthdate

9

I would like the Court to be aware of the following additional matters in considering this application for a protective order.

9

Petitioner is or has been involved in other legal proceedings involving the Respondent as follows: Case Name: Case number: Location of Court: Date filed: Date concluded: Type of case:

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Petitioner asks the Court to immediately issue an Ex-Parte Temporary Restraining Order of Protection that orders the respondent and any other person acting on behalf of the Respondent:
1. Not to threaten or physically abuse Petitioner, or any other person residing with Petitioner. Not to contact, write, telephone or otherwise electronically contact Petitioner (by recorded message, pager, etc.). Not to be within one hundred (100) yards of Petitioner's residence at

2.

9

9

Not to be within one hundred (100) yards of anyplace where Petitioner goes to school, , or is cared for at .

9

Not to enter Petitioner's place of employment at: Employer: Address: To vacate the residence at

9

9

Not to have contact with the following minor child(ren) of the parties, who reside with Petitioner until a court hearing occurs:

9

Have only supervised contact with the minor child(ren) of the parties until a court hearing occurs, as follows:

9

Arrange for supervised visits with the child(ren) of the parties through a third party by telephoning at until a court hearing occurs.

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9

Not to have any contact with the following people who live(s) with Petitioner: Name Birthdate Age

9

Not to have any contact with the following family member(s) of the petitioner who do not live with the petitioner: Name Birthdate Age

I understand that if the court grants the relief that I have requested the court order w ill be in effect until a court hearing can be scheduled. I also understand that the terms of this order must be followed until the court hearing and that I can request changes in the order at the court hearing.

The Movant declares under penalty of perjury, that the statements made herein are true and correct to the best of the Movant's knowledge, information and belief.

Date Assisted by: (Agency)

Movant's Signature

CLEAR FORM

ORDER [ ] Granting [ ] Denying Ex Parte Petition for an HRS 586 Temporary Restraining Order.

Date

Judge

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