Abuse Prevention Orders
209A Protection from Abuse Order/Restraining Order
Complaint for Protection from Abuse (page 1), This
form is two pages. The first page has blanks for you to fill in with
names and basic information. There are spaces to put your address and
phone number. Do not fill in these spaces. There is a separate Confidential Information form for your
address and phone number so you can keep them secret from the abusive
person. See How do I file for a 209A Protective Order? for more information.
Complaint for Protection from Abuse (page 2) You only need to fill out the second page of the Complaint if you have a child and you want the court to include things about your child in the order.
209A Instructions Instructions are included in the Complaint for Protection from Abuse. They should help you fill out the form.
Affidavit of Abuse: This form is on the back page of the Complaint for Abuse Prevention
form. You need to write on this form why you need the 209A protection
order. You do not need to write a lot, but you need to be clear and you
need to write down exactly what happened. Do not just say, "He
threatens me." Instead, write down the things he said or did: "He told
me he would get his gun and shoot me." Write down the things that
happened most recently. Also write down what he did before.
209A Abuse Prevention Order - sample This is a sample 209A abuse prevention order form. After your hearing, if the order is granted, the court will type up your order on this form. It is signed by a judge.
209A Affidavit - sample This form is actually on the back side of the complaint you will get from the clerk. This is what the judge will read when he first hears your case. So be sure to fill this out carefully. You may want to start by telling the judge about the most recent incident, why you came to court to get a protective order. Then you might want to tell the judge about any history of abuse, why you are afraid, etc.
209A Confidential Information form On this form you write your name, residential address, residential telephone number, workplace name, address, and telephone number. This information is confidential. It may be obtained by certain authorized persons who request it on a Request for Access to Confidential Information form.
Affidavit Disclosing Care and Custody Proceedings:
The clerk should only give you this form if a child is involved. The
form asks if there have been any other court cases about your child's
custody or child support.
Affidavit Disclosing Care or Custody Proceedings - sample If you are asking for protection, custody, or support for the children, you will have to fill this form out. The court must be informed if there were ever any other court actions about the care or custody of the children.
209A Defendant Information form - sample The court will need this so that the police can find your abuser to serve him his copy of the order. Be sure to include any and all information that will help the police in finding him.
209A Affidavit Seeking Child Support
209A complaint form seeking protection at school - sample
209A order providing protection at school - sample
District Court 209A child support order sample