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IN THE CIRCUIT COURT OF THE IN AND FOR

JUDICIAL CIRCUIT, COUNTY, FLORIDA Case No.: Division: ,

Petitioner and , Respondent. ORDER EXTENDING INJUNCTION FOR PROTECTION AGAINST ( ) DOMESTIC VIOLENCE ( ) REPEAT VIOLENCE ( ) DATING VIOLENCE ( ) SEXUAL VIOLENCE THIS CAUSE came before the Court on {date} , upon Petitioner's motion for an extension of injunction for protection and it appearing to the Court as follows: Ex parte. The claims in the motion for extension of injunction for protection make it appear to the Court that there is an immediate and present danger of domestic, repeat, dating, or sexual violence, as required under section 741.30 or section 784.046, Florida Statutes. The previously entered injunction is extended until {date} . A full hearing on the petition is scheduled for {date} at a.m./p.m. in .

NOTICE: Because this is a civil case, there is no requirement that these proceedings be transcribed at public expense. YOU ARE ADVISED THAT IN THIS COURT: a. a court reporter is provided by the court. b. electronic audio tape recording only is provided by the court. A party may arrange in advance for the services of and provide for a court reporter to prepare a written transcript of the proceedings at that party's expense. c. If this is a repeat violence, dating violence, or sexual violence action, no electronic audio tape recording or court reporting services are provided by the court. A party may arrange in advance for the services of and provide for a court reporter to prepare a written transcript of the proceedings at that party's expense. A RECORD, WHICH INCLUDES A TRANSCRIPT, MAY BE REQUIRED TO SUPPORT AN APPEAL. THE PARTY SEEKING THE APPEAL IS RESPONSIBLE FOR HAVING THE
Florida Supreme Court Approved Family Law Form 12.980(m), Order Extending Injunction for Protection Against Domestic Violence, Repeat Violence, Dating Violence, or Sexual Violence (03/04)

TRANSCRIPT PREPARED BY A COURT REPORTER. THE TRANSCRIPT MUST BE FILED WITH THE REVIEWING COURT OR THE APPEAL MAY BE DENIED. If you are a person with a disability who needs any accommodation in order to participate in this proceeding, you are entitled, at no cost to you, to the provision of certain assistance. Please contact {name} , {address} , {telephone} , within 2 working days of your receipt of this order. If you are hearing or voice impaired, call TDD 1-800-955-8771. After notice and hearing. Respondent was served with a copy of the temporary injunction, if applicable, and a notice of this hearing within the time required by Florida law and was afforded an opportunity to be heard. The notice and opportunity to be heard were sufficient to protect Respondent's right to due process. The following persons attended the hearing: ( ) Petitioner ( ) Respondent. After hearing the testimony of each party present and of any witnesses, or upon consent of Respondent, the Court finds that Petitioner is a victim of domestic, repeat violence, dating violence, or sexual violence or reasonably fears that he/she will become a victim of domestic or dating violence from Respondent. The previously entered injunction is extended until or until further order of the Court. {date}_____ ORDERED on .

CIRCUIT JUDGE COPIES TO: County Sheriff of Petitioner (or his or her attorney):

Respondent (or his or her attorney):

by U.S. Mail by hand delivery in open court (Petitioner must acknowledge receipt in writing on the face of the original order -- see below) forwarded to sheriff for service by hand delivery in open court (Respondent must acknowledge receipt in writing on the face of the original order -- see below) by certified mail (may only be used when Respondent is present at the hearing and Respondent fails or refuses to acknowledge the receipt of certified copy of this injunction)

State Attorney's Office
Florida Supreme Court Approved Family Law Form 12.980(m), Order Extending Injunction for Protection Against Domestic Violence, Repeat Violence, Dating Violence, or Sexual Violence (03/04)

Other: I CERTIFY the foregoing is a true copy of the original as it appears on file in the office County, Florida, and that I have furnished of the Clerk of the Circuit Court of copies of this order as indicated above. CLERK OF THE CIRCUIT COURT (SEAL) By: Deputy Clerk ACKNOWLEDGMENT I, {Name of Petitioner} receipt of a certified copy of this Injunction for Protection. , acknowledge

Petitioner ACKNOWLEDGMENT I, {Name of Respondent} of a certified copy of this Injunction for Protection. , acknowledge receipt

Respondent

Florida Supreme Court Approved Family Law Form 12.980(m), Order Extending Injunction for Protection Against Domestic Violence, Repeat Violence, Dating Violence, or Sexual Violence (03/04)