Protection from Abuse forms

GENERAL INFORMATION

FOR THOSE SEEKING A PROTECTION FROM ABUSE ORDER

1. Before you can get a Protection from Abuse Order you and the person you want restrained must

be intimate partners or household members. This means you and the person you want restrained

must meet one of the following requirements:

a. You are in a dating relationship (a social relationship of a romantic nature);

b. You have been in a dating relationship in the past;

c. You are living together;

d. You have lived together in the past; or

e. You have had a child in common.

OR if you are seeking protection of a minor child, the child and the person you want restrained must

be intimate partners or household members. This means the child and the person you want restrained must

meet one of the above requirements.

2. Abuse must have occurred. This means that one of the following has occurred:

a. The person physically hurt you or a minor child on purpose.

The person tried to physically hurt you or a minor child.

b. The person recently threatened to physically hurt you or a minor child.

c. The person engaged in sexual conduct (touching or sexual intercourse) with a minor

child under 16 years of age.

3. You may file only two petitions for a Protection from Abuse Order in one calendar year, unless you

are filing the petition on behalf of a minor child who has been abused.

4. You should be available to testify at future hearings as set by the judge. If you fail to appear, the

case may be dismissed.

5. Legal help may be available through your private attorney or legal services.

6. A Final Protection from Abuse Order will expire after one year or on the date stated in the order,

unless you request an extension or modification from the court.

7. If you are the defendant, and you want an order restraining the plaintiff from abuse, you must file

a counter petition.

_______________________________________

JUDGE OF THE DISTRICT COURT

I have read the above information:

__________________________________

Signature

IN THE DISTRICT COURT OF ______________ COUNTY, KANSAS

____________________, Plaintiff

vs. Case No. _______________

____________________, Defendant

PROTECTION FROM ABUSE CONFIDENTIAL FORM

NOTE: IF THE COURT FINDS THAT THE PLAINTIFF’S ADDRESS AND TELEPHONE

NUMBER NEED TO REMAIN CONFIDENTIAL FOR THE PROTECTION OF

THE PLAINTIFF OR THE MINOR CHILDREN, THIS FORM WILL BE SHOWN

ONLY TO AUTHORIZED COURT OR LAW ENFORCEMENT PERSONNEL

AND WILL NOT BE DISCLOSED TO THE PUBLIC OR TO THE DEFENDANT.

IT IS THE PLAINTIFF’S RESPONSIBILITY TO NOTIFY THE COURT OF ANY

CHANGE IN ADDRESS OR TELEPHONE NUMBER.

Name of Plaintiff _______________________________________________________________

Confidential Address:

Street _______________________________________________________________________

City _________________________ State ________________ Zip Code ___________________

Phone Number ______________________

IN THE DISTRICT COURT OF ______________ COUNTY, KANSAS

____________________, Plaintiff

vs. Case No. _______________

____________________, Defendant

NOTICE: THIS INFORMATION IS FOR THE USE OF LAW ENFORCEMENT.

COMPLETION OF THIS INFORMATION WILL HELP LAW ENFORCEMENT IDENTIFY

THE DEFENDANT. THIS INFORMATION IS VOLUNTARY ON THE PART OF THE

PLAINTIFF.

1. Defendant’s name or names if he/she has been known at any other time by a different name:

2. General description of defendant (please attach recent photograph, if available):

Race Sex

Height Social Security Number

Weight Age or Date of Birth

Hair Color Usual length of hair

Eye Color Glasses?

3. Please describe any special identifying characteristics of the defendant which would help law

enforcement in identification (such at tattoos, scars, locations frequented by the defendant):

ATTACH TO PROTECTIVE ORDERS

IN THE DISTRICT COURT OF ______________ COUNTY, KANSAS

____________________, Plaintiff

vs. Case No. _______________

____________________, Defendant

PETITION FOR PROTECTIVE ORDER

(Pursuant to K.S.A. 60-3101, et seq.)

1. I live in the City of _________________, in the County of __________________, Kansas.

2. I have filed __________ (give number) petitions for protection from abuse in the past twelve

months. The dates of these petitions are _________________________________. These petitions were

filed in the counties of ________________________________________. (State which petitions, if any,

involved abuse of a minor child) _______________________________.

3. I am seeking protection for: (check all that apply)

_____ myself

_____ my minor children (under age 18)

_____ minor children who live with me

4. The defendant and I: (answer all that apply if you are asking for protection for yourself)

_____ are currently in a dating relationship

_____ were formerly in a dating relationship

_____ currently live together in the same residence

_____ formerly lived together in the same residence

_____ have never lived together in the same residence

_____ have had a child in common

(If you are alleging that you and the defendant are or were in a dating relationship, briefly

describe that relationship): _______________________________________________

_____________________________________________________________________

The residence is: (answer if you want the judge to order the defendant to move)

_____ a) jointly owned, or rented and jointly occupied by defendant and me

_____ b) owned, or rented by me

_____ c) owned, or rented by someone else (explain) ______________________

____________________________________________________________

_____ d) owned, or rented by me and someone else

_____ e) a home in which I have no property interest, but the defendant is my spouse

_____ f) not applicable because the defendant and I do not live together.

5. The minor child(ren): (check all that apply if you are asking for protection for minor child(ren))

_____ is currently in a dating relationship with the defendant

_____ was formerly in a dating relationship with the defendant

_____ currently lives with the defendant

_____ currently lives with me

_____ formerly lived with the defendant

_____ has never lived with the defendant

_____ has had a child in common with the defendant

(If you are alleging that the minor child and the defendant are or were in a dating relationship,

briefly describe that relationship): ______________________________

_____________________________________________________________________

6. The following legal actions have been filed between me and the defendant or involving the minor

children: (check case type, give county filed in, and give case number and date filed, if known)

_____ divorce/custody ____________________________________________________

_____ paternity ___________________________________________________________

_____ child in need of care _________________________________________________

_____ action seeking protective order ________________________________________

_____ other ______________________________________________________________

7. These minor children are involved in this matter: (give full names and ages)

________________________________________________________________________________

_______________________________________________________________________________

8. I am seeking protection from abuse because the defendant, _______________________

__________________ (name of person you are seeking protection from) has: (check all that apply)

_____ caused me bodily injury or attempted to cause me bodily injury

_____ placed me in fear of imminent bodily injury by threatening me

_____ caused the minor children bodily injury or attempted to cause them bodily injury

_____ placed the minor children in fear of imminent bodily injury

_____ engaged in any of the following acts with a minor under 16 years of age who is not

the spouse of the defendant: sexual intercourse or lewd fondling or touching of the

person of either the minor or the defendant

9. The acts complained of occurred on these dates: ________________________________

______________________________________________________________________________

10. (Briefly describe the facts about why you are seeking a protection from abuse order):

11. The defendant can be found at: (give all available addresses)

HOME: street __________________________________________________________

city ________________________ state ______________ zip code __________

phone number ____________________________________________________

times when defendant is usually there _________________________________

WORK: street __________________________________________________________

city ________________________ state ______________ zip code __________

phone number ____________________________________________________

times when defendant is usually there _________________________________

OTHER: please explain ___________________________________________________

street __________________________________________________________

city ________________________ state ______________ zip code __________

phone number ____________________________________________________

times when defendant is usually there _________________________________

WHEREFORE, plaintiff requests that the Court issue an order of protection restraining defendant

from:

_____ a) abusing, molesting or interfering with the privacy or rights of the plaintiff and the

minor child(ren)

_____ b) entering or coming on or around the premises or the residence of the plaintiff

located at: ____________________________________________

(Give address or other description of residence from which defendant is to be

excluded.)

I am requesting that my ____ address and ____ telephone number remain

confidential for the following reason: (complete if appropriate)

__________________________________________________________

___________________________________________________________

FURTHER, plaintiff requests that the Court also issue the following order(s): (check if

appropriate)

_____ c) defendant immediately move from and not return to the residence located at:

________________________________________________________

(You must include your address if defendant is ordered to be removed from

the residence)

_____ d) law enforcement officers be directed to evict the defendant from the

residence located at:

____________________________________________

_____ e) law enforcement officers be directed to grant any assistance necessary to

protect plaintiff and child(ren) from abuse

Plaintiff further requests that copies of orders be given to the appropriate law enforcement

agencies; that the Court issue an ex parte order of temporary custody of the minor child(ren), if

appropriate; that a date, time and place for a hearing on this matter be set; and that summons be issued

to defendant, notifying the defendant of this action and the relief requested.

Plaintiff further requests that upon hearing of this cause, the Court issue a final order of

protection, enjoining defendant from any acts of abuse against the plaintiff and the plaintiff's child(ren),

and that the Court award to plaintiff the following additional relief:

_____ a) suitable alternative housing for plaintiff and minor child(ren)

_____ b) custody of the minor child(ren)

_____ c) child support

_____ d) support of spouse

_____ e) possession of personal property, and the assistance of a law enforcement

officer in securing that property, if necessary

_____ f) attorney's fees, if represented by counsel; and costs

_____ g) counseling for defendant

_____ h) other, please specify: ________________________________________

__________________________________________________________

and for such other and further relief, all as appropriate and as the Court deems necessary.

__________________________________________

Plaintiff's signature

(If attorney represents the plaintiff, the

attorney's address and phone number

must be provided.)

___________________________

VERIFICATION

STATE OF KANSAS )

) ss:

COUNTY OF __________ )

_____________________________, of lawful age, being first duly sworn states that (she)(he)

is the plaintiff in the above action; that (she)(he) has read the foregoing Petition and knows the contents of

it and that the declarations in it are true and correct to the best of plaintiff's knowledge and belief.

__________________________________________

Plaintiff's signature

SIGNED AND SWORN to (or affirmed) before me on this _____ day of _______________, ______.

__________________________________________

Clerk of the District Court/Notary Public

My Appointment Expires:

___________________

IN THE DISTRICT COURT OF ______________ COUNTY, KANSAS

____________________, Plaintiff

vs. Case No. _______________

____________________, Defendant

ANSWER

I ___ admit or ___ deny the allegations of the plaintiff’s petition. (If you deny the allegations of the

plaintiff’s petition, state your version of what happened): ___________________________

______________________________________________________________________________

____________________________________

Defendant

NOTE TO DEFENDANT: YOU ARE NOT REQUIRED TO FILE A WRITTEN ANSWER IN A

PROTECTION FROM ABUSE ACTION. IF YOU CHOOSE TO FILE A WRITTEN ANSWER,

YOU MUST STILL APPEAR AT THE SCHEDULED HEARING TO PRESENT YOUR SIDE OF

THE CASE.

CERTIFICATE OF MAILING

I hereby certify that I served a copy of the foregoing answer by mailing it on the ____ day of

_____________, _______, as certified mail return receipt requested to the following name and address:

______________________________________________

_______________________________________

Defendant

IN THE DISTRICT COURT OF ______________ COUNTY, KANSAS

____________________, Plaintiff

vs. Case No. _______________

____________________, Defendant

COUNTER PETITION FOR PROTECTIVE ORDER

(Pursuant to K.S.A. 60-3101, et seq.)

1. I live in the City of _________________, in the County of __________________, Kansas.

2. I have filed __________ (give number) petitions for protection from abuse in the past twelve

months. The dates of these petitions are _________________________________. These petitions were

filed in the counties of ________________________________________. (State which petitions, if any,

involved abuse of a minor child) _______________________________.

3. I am seeking protection for: (check all that apply)

_____ myself

_____ my minor children (under age 18)

_____ minor children who live with me

4. The plaintiff and I: (answer all that apply if you are asking for protection for yourself)

_____ are currently in a dating relationship

_____ were formerly in a dating relationship

_____ currently live together in the same residence

_____ formerly lived together in the same residence

_____ have never lived together in the same residence

_____ have had a child in common

(If you are alleging that you and the plaintiff are or were in a dating relationship, briefly describe

that relationship): _______________________________________________

_____________________________________________________________________

The residence is: (answer if you want the judge to order the plaintiff to move)

_____ a) jointly owned, or rented and jointly occupied by plaintiff and me

_____ b) owned, or rented by me

_____ c) owned, or rented by someone else (explain) ______________________

____________________________________________________________

_____ d) owned, or rented by me and someone else

_____ e) a home in which I have no property interest, but the plaintiff is my spouse

_____ f) not applicable because the plaintiff and I do not live together.

5. The minor child(ren): (check all that apply if you are asking for protection for minor child(ren))

_____ is currently in a dating relationship with the plaintiff

_____ was formerly in a dating relationship with the plaintiff

_____ currently lives with the plaintiff

_____ currently lives with me

_____ formerly lived with the plaintiff

_____ has never lived with the plaintiff

_____ has had a child in common with the plaintiff

(If you are alleging that the minor child and the plaintiff are or were in a dating relationship,

briefly describe that relationship): ______________________________

_____________________________________________________________________

6. The following legal actions have been filed between me and the plaintiff or involving the minor

children: (check case type, give county filed in, and give case number and date filed, if known)

_____ divorce/custody ____________________________________________________

_____ paternity ___________________________________________________________

_____ child in need of care _________________________________________________

_____ action seeking protective order __________________________________________

_____ other ______________________________________________________________

7. These minor children are involved in this matter: (give full names and ages)

________________________________________________________________________________

_______________________________________________________________________________

8. I am seeking protection from abuse because the plaintiff, _______________________

__________________ (name of person you are seeking protection from) has: (check all that apply)

_____ caused me bodily injury or attempted to cause me bodily injury

_____ placed me in fear of imminent bodily injury by threatening me

_____ caused the minor children bodily injury or attempted to cause them bodily injury

_____ placed the minor children in fear of imminent bodily injury

_____ engaged in any of the following acts with a minor under 16 years of age who is not

the spouse of the plaintiff: sexual intercourse or lewd fondling or touching of the

person of either the minor or the plaintiff

9. The acts complained of occurred on these dates: ________________________________

______________________________________________________________________________

10. (Briefly describe the facts about why you are seeking a protection from abuse order):

WHEREFORE, defendant requests that the Court issue an order of protection restraining plaintiff

from:

_____ a) abusing, molesting or interfering with the privacy or rights of the defendant and

the minor child(ren)

_____ b) entering or coming on or around the premises or the residence of the defendant

located at: __________________________________________

(Give address or other description of residence from which plaintiff is to be

excluded.)

I am requesting that my ____ address and ____ telephone number remain

confidential for the following reason: (complete if appropriate)

__________________________________________________________

___________________________________________________________

FURTHER, defendant requests that the Court also issue the following order(s): (check if

appropriate)

_____ c) plaintiff immediately move from and not return to the residence located at:

________________________________________________________

(You must include your address if plaintiff is ordered to be removed from the

residence)

_____ d) law enforcement officers be directed to evict the plaintiff from the residence

located at: ____________________________________________

_____ e) law enforcement officers be directed to grant any assistance necessary to

protect defendant and child(ren) from abuse

Defendant further requests that copies of orders be given to the appropriate law enforcement

agencies; that the Court issue an ex parte order of temporary custody of the minor child(ren), if

appropriate; that a date, time and place for a hearing on this matter be set; and that summons be issued

to plaintiff, notifying the plaintiff of this action and the relief requested.

Defendant further requests that upon hearing of this cause, the Court issue a final order of

protection, enjoining plaintiff from any acts of abuse against the defendant and the defendant's

child(ren), and that the Court award to defendant the following additional relief:

_____ a) suitable alternative housing for defendant and minor child(ren)

_____ b) custody of the minor child(ren)

_____ c) child support

_____ d) support of spouse

_____ e) possession of personal property, and the assistance of a law enforcement

officer in securing that property, if necessary

_____ f) attorney's fees, if represented by counsel; and costs

_____ g) counseling for plaintiff

_____ h) other, please specify: ________________________________________

__________________________________________________________

and for such other and further relief, all as appropriate and as the Court deems necessary.

__________________________________________

Defendant's signature

(If attorney represents the defendant, the

attorney's address and phone number

must be provided.)

___________________________

VERIFICATION

STATE OF KANSAS )

) ss:

COUNTY OF __________ )

_____________________________, of lawful age, being first duly sworn states that (she)(he)

is the defendant in the above action; that (she)(he) has read the foregoing Petition and knows the contents

of it and that the declarations in it are true and correct to the best of defendant's knowledge and belief.

__________________________________________

Defendant's signature

SIGNED AND SWORN to (or affirmed) before me on this _____ day of _______________, ______.

__________________________________________

Clerk of the District Court/Notary Public

My Appointment Expires:

___________________

IN THE DISTRICT COURT OF ______________ COUNTY, KANSAS

____________________, Plaintiff

vs. Case No. _______________

____________________, Defendant

EMERGENCY ORDERS OF PROTECTION

THIS EMERGENCY ORDER SHALL EXPIRE AT 5:00 P.M. ON _____________________.

On this date, ______________________, plaintiff's petition for emergency orders of protection

comes for consideration under the provisions of K.S.A. 60-3101, et seq.

After considering the verified petition filed with the court by the plaintiff, the court finds that:

(1) The plaintiff has established good cause for the court to issue an emergency order of

protection from abuse.

(2) Including this petition, the plaintiff has not filed more than two actions under the Protection

from Abuse Act in the past twelve months which did not involve abuse of minor children.

IT IS THEREFORE BY THE COURT ORDERED THAT:

1. The defendant shall not abuse, molest, or interfere with the privacy or rights of the plaintiff, the

plaintiff's minor child(ren) or the minor child(ren) residing with the plaintiff, wherever they may be.

VIOLATION OF THIS ORDER MAY CONSTITUTE ASSAULT AS

PROVIDED IN K.S.A. 21-3408, BATTERY AS PROVIDED IN K.S.A.

21-3412, DOMESTIC BATTERY AS PROVIDED IN K.S.A. 2001 Supp.

21-3412a, AND VIOLATION OF A PROTECTIVE ORDER AS

PROVIDED IN K.S.A. 2002 Supp. 21-3843.

2. The defendant shall not enter or come on or around the premises or the residence or workplace

where the plaintiff resides, stays or works.

VIOLATION OF THIS ORDER SHALL CONSTITUTE CRIMINAL

TRESPASS AS PROVIDED IN K.S.A. 2002 Supp. 21-3721 AND

VIOLATION OF A PROTECTIVE ORDER AS PROVIDED IN K.S.A.

2002 Supp. 21-3843.

3. _______ (CHECK IF APPLICABLE) The plaintiff is granted exclusive possession of the

residence located at:

_______________________________________________________________________

_______ (CHECK IF APPLICABLE)

The plaintiff’s ____ address and ____ telephone number must remain confidential for the

protection of the plaintiff, plaintiff’s child(ren) or the minor child(ren) residing with plaintiff.

If the plaintiff is granted exclusive possession of the residence then the defendant must immediately

move from such address and take only personal clothing and effects until further order of the court.

Defendant shall not cancel utilities to such residence. Law enforcement officials are hereby directed to evict

the defendant from such residence, and to ensure that defendant does not enter or re-enter the premises

or any other residence the plaintiff may occupy.

(COMPLETE IF APPLICABLE)

4. Care, custody and control of the following minor child(ren) are temporarily awarded to _________

plaintiff or __________ defendant:

__________________________________________________________________________

5. Other:_____________________________________________________________________

__________________________________________________________________________

THIS ORDER IS EFFECTIVE WHEN SIGNED BY THE

JUDGE. LAW ENFORCEMENT OFFICIALS SHALL

ENFORCE THE ORDER IMMEDIATELY UPON

RECEIPT. THE DEFENDANT IS HEREBY PUT ON

NOTICE THAT VIOLATIONS OF THIS ORDER MAY

RESULT IN PROSECUTION AND CONVICTION UNDER

KANSAS CRIMINAL STATUTES OR A FINDING OF

CONTEMPT OF COURT WITH A JAIL SENTENCE.

IT IS SO ORDERED.

_________________________________

JUDGE OF THE DISTRICT COURT

IN THE DISTRICT COURT OF ______________ COUNTY, KANSAS

____________________, Plaintiff

vs. Case No. _______________

____________________, Defendant

NOTICE OF HEARING AND

TEMPORARY ORDERS OF PROTECTION

To defendant (name):

________________________________________________________________________

You may appear in this Court as follows to give any evidence you may have why orders sought

in the petition should not be granted.

Date: ______________________________

Time: ______________________________

Place: ______________________________

______________________________

If you do not attend the hearing, final orders may be made against you. You have the right to

appear and oppose the petition with or without an attorney.

TEMPORARY ORDERS OF PROTECTION

INFORMATION ABOUT DEFENDANT: Race _________________ Sex _________________

Date of Birth __________________ Social Security Number ________________________

THIS TEMPORARY ORDER SHALL EXPIRE ON THE DATE SCHEDULED FOR HEARING

UNLESS EXTENDED BY THE COURT.

On this date, ______________________, plaintiff's petition for temporary orders of protection

comes for consideration under the provisions of K.S.A. 60-3101, et seq.

After considering the verified petition filed with the court by the plaintiff, the court finds that:

(1) The plaintiff has established good cause for the court to issue a temporary order of protection

from abuse.

(2) Including this petition, the plaintiff has not filed more than two actions under the Protection

from Abuse Act in the past twelve months which did not involve abuse of minor children.

IT IS THEREFORE BY THE COURT ORDERED THAT:

1. The defendant shall not abuse, molest, or interfere with the privacy or rights of the plaintiff, the

plaintiff's minor child(ren) or the minor child(ren) residing with the plaintiff, wherever they may be.

VIOLATION OF THIS ORDER MAY CONSTITUTE ASSAULT AS

PROVIDED IN K.S.A. 21-3408, BATTERY AS PROVIDED IN K.S.A. 21-3412,

DOMESTIC BATTERY AS PROVIDED IN K.S.A. 2001 Supp. 21-3412a, AND

VIOLATION OF A PROTECTIVE ORDER AS PROVIDED IN K.S.A. 2002

Supp. 21-3843.

2. The defendant shall not enter or come on or around the premises or the dwelling or workplace

where the plaintiff resides, stays or works.

VIOLATION OF THIS ORDER SHALL CONSTITUTE CRIMINAL

TRESPASS AS PROVIDED IN K.S.A. 2002 Supp. 21-3721 AND VIOLATION

OF A PROTECTIVE ORDER AS PROVIDED IN K.S.A. 2002 Supp. 21-3843.

PURSUANT TO 18 U.S.C. 2265, THIS ORDER SHALL BE ENFORCED BY

THE COURTS OF ANY OTHER STATE, THE DISTRICT OF COLUMBIA,

ANY U.S. TERRITORY AND INDIAN TRIBAL LANDS.

3. _______ (CHECK IF APPLICABLE) The plaintiff is granted exclusive possession of the

residence located at:

_______________________________________________________________________

_______ (CHECK IF APPLICABLE)

The plaintiff’s ____ address and ____ telephone number must remain confidential for the

protection of the plaintiff, plaintiff’s child(ren) or the minor child(ren) residing with plaintiff.

If the plaintiff is granted exclusive possession of the residence then the defendant must immediately

move from such address and take only personal clothing and effects until further order of the court.

Defendant shall not cancel utilities to such residence. Law enforcement officials are hereby directed to evict

the defendant from such residence, and to ensure that defendant does not enter or re-enter the premises

or any other residence the plaintiff may occupy.

(COMPLETE IF APPLICABLE)

4. Care, custody and control of the following minor child(ren) are temporarily awarded to _________

plaintiff or __________ defendant:

__________________________________________________________________________

5. Other:_____________________________________________________________________

__________________________________________________________________________

THIS ORDER IS EFFECTIVE WHEN SIGNED BY THE

JUDGE. LAW ENFORCEMENT OFFICIALS SHALL

ENFORCE THE ORDER IMMEDIATELY UPON

RECEIPT. THE DEFENDANT IS HEREBY PUT ON

NOTICE THAT VIOLATIONS OF THIS ORDER MAY

RESULT IN PROSECUTION AND CONVICTION UNDER

KANSAS CRIMINAL STATUTES OR A FINDING OF

CONTEMPT OF COURT WITH A JAIL SENTENCE.

IT IS SO ORDERED.

_________________________________

JUDGE OF THE DISTRICT COURT

IN THE DISTRICT COURT OF ______________ COUNTY, KANSAS

____________________, Plaintiff

vs. Case No. _______________

____________________, Defendant

ORDER OF CONTINUANCE AND EXTENSION OF

TEMPORARY ORDERS OF PROTECTION

On this date, ____________________, this case comes on for hearing as previously set.

The plaintiff appears: __ in person __ and pro se

__ by his/her attorney _________________________

The defendant appears: __ in person __ and pro se

__ by his/her attorney _________________________

The Court finds that, for good cause shown, the hearing on the petition for protective orders should

be continued to the following date and time: ______________________________.

_______ (CHECK IF APPLICABLE) The Temporary Orders of Protection previously entered

herein shall remain in full force and effect until further order of the Court.

IT IS SO ORDERED.

_________________________________

JUDGE OF THE DISTRICT COURT

IN THE DISTRICT COURT OF ______________ COUNTY, KANSAS

____________________, Plaintiff

vs. Case No. _______________

____________________, Defendant

FINAL PROTECTION FROM ABUSE ORDER

INFORMATION ABOUT DEFENDANT: Race _________________ Sex _________________

Date of Birth __________________ Social Security Number ________________________

THIS FINAL ORDER SHALL EXPIRE AT MIDNIGHT ON ____________________ UNLESS

EXTENDED OR MODIFIED BY THIS COURT.

On this date, ____________________, plaintiff’s petition for protective orders comes for

consideration under the provisions of K.S.A. 60-3101, et seq.

The plaintiff appears: __ in person __ and pro se

__ by his/her attorney _________________________

The defendant appears: __ not, but was duly served and is otherwise in default

__ in person __ and pro se

__ by his/her attorney _________________________

WHEREAS, the plaintiff filed a verified petition for issuance of protective orders, and the cause

has been heard after duly serving and notifying the defendant, and the plaintiff has proved the allegations

of the abuse by the preponderance of the evidence;

IT IS THEREFORE BY THE COURT ORDERED:

1. This final order of protection supersedes the ex parte order of protection or any other temporary

or emergency order previously entered by the Court and serves as notice of termination thereof.

2. The defendant shall not abuse, molest, or interfere with the privacy or rights of the plaintiff, the

plaintiff's child(ren) or the minor child(ren) residing with the plaintiff, wherever they may be.

VIOLATION OF THIS ORDER MAY CONSTITUTE ASSAULT AS

PROVIDED IN K.S.A. 21-3408, BATTERY AS PROVIDED IN K.S.A.

21-3412, DOMESTIC BATTERY AS PROVIDED IN K.S.A. 2001 Supp.

21-3412a, AND VIOLATION OF A PROTECTIVE ORDER AS

PROVIDED IN K.S.A. 2002 Supp. 21-3843.

3. The defendant shall not enter or come on or around the premises or the residence or workplace

where the plaintiff resides, stays or works.

VIOLATION OF THIS ORDER SHALL CONSTITUTE CRIMINAL

TRESPASS AS PROVIDED IN K.S.A. 2002 Supp. 21-3721 AND VIOLATION

OF A PROTECTIVE ORDER AS PROVIDED IN K.S.A. 2002 Supp. 21-3843.

4. _______ (CHECK IF APPLICABLE) The plaintiff is granted exclusive possession of the

residence located at:

_______________________________________________________________________

_______ (CHECK IF APPLICABLE)

The plaintiff’s ____ address and ____ telephone number must remain confidential for the

protection of the plaintiff, plaintiff’s child(ren) or the minor child(ren) residing with plaintiff.

If the plaintiff is granted exclusive possession of the residence then the defendant must immediately

move from such address and take only personal clothing and effects until further order of the court.

Defendant shall not cancel utilities to such residence for 60 days following the issuance of this order. Law

enforcement officials are hereby directed to evict the defendant from such residence, and to ensure that

defendant does not enter or re-enter the premises or any other residence the plaintiff may occupy.

5. Law enforcement officers are directed to grant any assistance necessary to protect the plaintiff and

the plaintiff's child(ren) from abuse by the defendant, and to provide any other assistance necessary

to enforce these orders, including the order excluding the defendant from the plaintiff's place of

residence, wherever it may be.

6. _______ (CHECK IF APPLICABLE) Defendant shall provide suitable alternative housing for the

plaintiff and/or the minor children as follows: ___________________________

__________________________________________________________________________

7. _______ (CHECK IF APPLICABLE) Physical and legal custody and residency of the minor

child(ren), named:

_________________________________________________________________________

is hereby granted to _______ plaintiff or to ________ defendant until this order expires. Rights

of visitation shall be as follows: ________________________________________

__________________________________________________________________________

NO PERSON SHALL TAKE OR CONCEAL THE

CHILD(REN) EXCEPT AS ALLOWED BY THIS ORDER.

8. ________ (CHECK IF APPLICABLE) Defendant shall pay child support as follows:

$___________ per __________, commencing on the _________ day of ______________,

_____, and payable on the __________ day of each month thereafter for a period of ____

months.

9. ________ (CHECK IF APPLICABLE) Defendant shall pay support for plaintiff as follows: $

____________ per ____________, commencing on the _________ day of ______________,

_____, and payable on the __________ day of each month thereafter for a period of ____

months.

10. ________ (CHECK IF APPLICABLE) All child support and/or support payments shall be made

payable to the Kansas Payment Center, and each party shall inform the Kansas Payment Center

in writing of any change of name, address, and employer with business address, within seven days

of such change; income withholding to enforce such support orders shall take effect under the laws

of Kansas if there is an arrearage in an amount equal to or greater than the amount of support

payable for one month.

11. ________ (CHECK IF APPLICABLE) The personal property of the parties is divided as

follows: _________________________________________________________________

_________________________________________________________________________

12. ________ (CHECK IF APPLICABLE) Law enforcement officers are directed to assist in

securing possession of the personal property as described above.

13. ________ (CHECK IF APPLICABLE) Defendant /plaintiff shall pay the following

plaintiff's/defendant's attorney fees and costs:

__________________________________________________________________________

14. _________ (CHECK IF APPLICABLE) Defendant shall seek counseling to aid in the cessation

of abuse.

15. CERTIFICATE OF COMPLIANCE WITH THE VIOLENCE AGAINST WOMEN ACT

(VAWA): This Order meets all the requirements of the Violence Against Women Act, 18 U.S.C.

2265. This Court has jurisdiction of the parties and the subject matter; the defendant has been

afforded notice and a timely opportunity to be heard as provided by the laws of Kansas. This

Order is enforceable in all 50 states, the District of Columbia, all Indian tribal courts and all United

States territories and shall be enforced as if it were an order of that jurisdiction pursuant to 18

U.S.C. 2265.

16. _________ OTHER ORDERS:

__________________________________________________________________________

THIS ORDER IS EFFECTIVE WHEN SIGNED BY THE JUDGE.

LAW ENFORCEMENT OFFICIALS SHALL ENFORCE THE ORDER

IMMEDIATELY UPON RECEIPT. THE DEFENDANT IS HEREBY

PUT ON NOTICE THAT VIOLATIONS OF THIS ORDER MAY

RESULT IN PROSECUTION AND CONVICTION UNDER KANSAS

CRIMINAL STATUTES OR A FINDING OF CONTEMPT OF

COURT WITH A JAIL SENTENCE.

IT IS SO ORDERED.

_______________________________

JUDGE OF THE DISTRICT COURT

IN THE DISTRICT COURT OF ______________ COUNTY, KANSAS

____________________, Plaintiff

vs. Case No. _______________

____________________, Defendant

FINAL PROTECTION FROM ABUSE ORDER

[MUTUAL ORDER]

INFORMATION ABOUT DEFENDANT: Race _________________ Sex _________________

Date of Birth __________________ Social Security Number ________________________

THIS FINAL ORDER SHALL EXPIRE AT MIDNIGHT ON ____________________ UNLESS

EXTENDED OR MODIFIED BY THIS COURT.

On this date, ____________________, plaintiff’s petition for protective orders and defendant’s

counter petition for protective orders come for consideration under the provisions of K.S.A. 60-3101, et

seq.

The plaintiff appears: __ in person __ and pro se

__ by his/her attorney _________________________

__ not, but was duly served and is otherwise in default

The defendant appears: __ in person __ and pro se

__ by his/her attorney _________________________

__ not, but was duly served and is otherwise in default

WHEREAS, both parties have filed verified petitions for issuance of protective orders, and the

cause has been heard after duly serving and notifying both parties.

The Court finds that both parties have proven the allegations of the abuse by the preponderance

of the evidence. The Court also finds that both parties acted primarily as aggressors and neither party acted

primarily in self-defense.

IT IS THEREFORE BY THE COURT ORDERED:

1. This final order of protection supersedes the ex parte order of protection or any other temporary

or emergency order previously entered by the Court and serves as notice of termination thereof.

2. Neither party shall abuse, molest, or interfere with the privacy or rights of each other or the minor

children, wherever they may be.

VIOLATION OF THIS ORDER MAY CONSTITUTE ASSAULT AS

PROVIDED IN K.S.A. 21-3408, BATTERY AS PROVIDED IN K.S.A.

21-3412, DOMESTIC BATTERY AS PROVIDED IN K.S.A. 2001 Supp.

21-3412a, AND VIOLATION OF A PROTECTIVE ORDER AS

PROVIDED IN K.S.A. 2002 Supp. 21-3843.

3. Neither party shall enter or come on or around the premises or the residence or workplace where

the other resides, stays or works.

VIOLATION OF THIS ORDER SHALL CONSTITUTE CRIMINAL

TRESPASS AS PROVIDED IN K.S.A. 2002 Supp. 21-3721 AND VIOLATION

OF A PROTECTIVE ORDER AS PROVIDED IN K.S.A. 2002 Supp. 21-3843.

4. _______ (CHECK IF APPLICABLE) The plaintiff/defendant is granted exclusive possession of

the residence located at:

_______________________________________________________________________

_______ (CHECK IF APPLICABLE)

The plaintiff’s/defendant’s ____ address and ____ telephone number must remain confidential for

the protection of the plaintiff/defendant and the minor child(ren).

If the plaintiff is granted exclusive possession of the residence then the defendant must immediately

move from such address and take only personal clothing and effects until further order of the court.

Defendant shall not cancel utilities to such residence for 60 days following the issuance of this order. Law

enforcement officials are hereby directed to evict the defendant from such residence, and to ensure that

defendant does not enter or re-enter the premises or any other residence the plaintiff may occupy.

If the defendant is granted exclusive possession of the residence then the plaintiff is granted the right

to remove from the residence personal effects and clothing for the plaintiff and any children in the plaintiff’s

custody. Law enforcement officials are hereby directed to enter the residence with the plaintiff and pre

vent the defendant from interfering with the plaintiff removing the above mentioned possessions.

5. Law enforcement officers are directed to grant any assistance necessary to protect the parties and

the minor child(ren) from abuse, and to provide any other assistance necessary to enforce these

orders, including the order excluding one party from the other’s place of residence, wherever it may

be.

6. _______ (CHECK IF APPLICABLE) _______ Defendant or ______ Plaintiff shall provide

suitable alternative housing for the other party and/or the minor children as follows:

________________________________________________________________

__________________________________________________________________________

7. _______ (CHECK IF APPLICABLE) Physical and legal custody and residency of the minor

child(ren), named:

_________________________________________________________________________

is hereby granted to _______ plaintiff or to ________ defendant until this order expires. Rights

of visitation shall be as follows: ________________________________________

__________________________________________________________________________

NO PERSON SHALL TAKE OR CONCEAL THE

CHILD(REN) EXCEPT AS ALLOWED BY THIS ORDER.

8. ________ (CHECK IF APPLICABLE) _____ Defendant or ______ Plaintiff shall pay child

support as follows: $___________ per __________, commencing on the _________ day of

______________, _____, and payable on the __________ day of each month thereafter for a

period of ____ months.

9. ________ (CHECK IF APPLICABLE) ______ Defendant or ______ Plaintiff shall pay spousal

support as follows: $ ____________ per ____________, commencing on the _________ day

of ______________, _____, and payable on the __________ day of each month thereafter for

a period of ____ months.

10. ________ (CHECK IF APPLICABLE) All child support and/or support payments shall be made

payable to the Kansas Payment Center, and each party shall inform the Kansas Payment Center

in writing of any change of name, address, and employer with business address, within seven days

of such change; income withholding to enforce such support orders shall take effect under the laws

of Kansas if there is an arrearage in an amount equal to or greater than the amount of support

payable for one month.

11. ________ (CHECK IF APPLICABLE) The personal property of the parties is divided as

follows: _________________________________________________________________

_________________________________________________________________________

12. ________ (CHECK IF APPLICABLE) Law enforcement officers are directed to assist in

securing possession of the personal property as described above.

13. ________ (CHECK IF APPLICABLE) ______ Defendant or ______ Plaintiff shall pay the

following attorney fees and costs:

__________________________________________________________________________

14. _________ (CHECK IF APPLICABLE) ______ Defendant and/or _____ Plaintiff shall seek

counseling to aid in the cessation of abuse.

15. CERTIFICATE OF COMPLIANCE WITH THE VIOLENCE AGAINST WOMEN ACT

(VAWA): This Order meets all the requirements of the Violence Against Women Act, 18 U.S.C.

2265. This Court has jurisdiction of the parties and the subject matter; the defendant has been

afforded notice and a timely opportunity to be heard as provided by the laws of Kansas. This

Order is enforceable in all 50 states, the District of Columbia, all Indian tribal courts and all United

States territories and shall be enforced as if it were an order of that jurisdiction pursuant to 18

U.S.C. 2265.

16. _________ OTHER ORDERS:

__________________________________________________________________________

THIS ORDER IS EFFECTIVE WHEN SIGNED BY THE JUDGE.

LAW ENFORCEMENT OFFICIALS SHALL ENFORCE THE

ORDER IMMEDIATELY UPON RECEIPT. THE PARTIES ARE

HEREBY PUT ON NOTICE THAT VIOLATIONS OF THIS

ORDER MAY RESULT IN PROSECUTION AND CONVICTION

UNDER KANSAS CRIMINAL STATUTES OR A FINDING OF

CONTEMPT OF COURT WITH A JAIL SENTENCE.

IT IS SO ORDERED.

_______________________________

JUDGE OF THE DISTRICT COURT

IN THE DISTRICT COURT OF ______________ COUNTY, KANSAS

____________________, Plaintiff

vs. Case No. _______________

____________________, Defendant

MOTION TO MODIFY

PROTECTION FROM ABUSE ORDER

The undersigned party in the above captioned matter moves the court to set a hearing to modify

the protection from abuse order entered on ___________________, ______.

In support of the motion, I request modification of the order by changing it in the following way:

______________________________________________________________________________

The name, current address and telephone number of the other party where the order for hearing

may be served is:

______________________________________________________________________________

WHEREFORE, I request that the court modify its original order and ask for any other relief the

court deems just and equitable. I also request that the court set this matter for hearing.

____________________________________

Movant

Date of hearing: ____________________ ____________________________________

Time: ____________________ ____________________________________

Place: ____________________ Movant’s address

____________________ ____________________________________

____________________ Movant’s phone number

NOTE: DO NOT DISCLOSE THE MOVANT’S ADDRESS IF SUCH LOCATION

MUST REMAIN CONFIDENTIAL FOR THE PROTECTION OF THE

PLAINTIFF, PLAINTIFF'S CHILD(REN) OR THE MINOR CHILD(REN)

RESIDING WITH THE PLAINTIFF!

CERTIFICATE OF MAILING

I hereby certify that I served a copy of the foregoing motion to modify a protection from abuse

order by mailing it on the _____ day of _____________, _____, as certified mail return receipt

requested to the following name and address:

______________________________________________

_______________________________________

Movant

IN THE DISTRICT COURT OF ______________ COUNTY, KANSAS

____________________, Plaintiff

vs. Case No. _______________

____________________, Defendant

MOTION TO EXTEND

FINAL PROTECTION FROM ABUSE ORDER

The undersigned party in the above captioned matter moves the court to set a hearing to extend

the protection from abuse order entered on ___________________, ______.

In support of the motion, I request extension of the order because:

______________________________________________________________________________

The name, current address and telephone number of the other party where the order for hearing

may be served is:

______________________________________________________________________________

WHEREFORE, I request that the court extend its final order and ask for any other relief the

court deems just and equitable. I also request that the court set this matter for hearing.

____________________________________

Movant

Date of hearing: ____________________ ____________________________________

Time: ____________________ ____________________________________

Place: ____________________ Movant’s address

____________________ ____________________________________

____________________ Movant’s phone number

NOTE: DO NOT DISCLOSE THE MOVANT’S ADDRESS IF SUCH LOCATION

MUST REMAIN CONFIDENTIAL FOR THE PROTECTION OF THE

PLAINTIFF, PLAINTIFF'S CHILD(REN) OR THE MINOR CHILD(REN)

RESIDING WITH THE PLAINTIFF!

CERTIFICATE OF MAILING

I hereby certify that I served a copy of the foregoing motion to extend a final protection from

abuse order by mailing it on the _____ day of _____________, _____, as certified mail return receipt

requested to the following name and address:

______________________________________________

_______________________________________

Movant

IN THE DISTRICT COURT OF ______________ COUNTY, KANSAS

____________________, Plaintiff

vs. Case No. _______________

____________________, Defendant

PROTECTION FROM ABUSE

EXTENSION OF FINAL ORDER

THIS ORDER SHALL EXPIRE AT MIDNIGHT ON ____________________ UNLESS

EXTENDED OR MODIFIED BY THIS COURT.

On this date, _____________________, the above captioned matter comes on for hearing on

a motion to extend final order.

The plaintiff appears: __ in person __ and pro se

__ by his/her attorney _________________________

The defendant appears: __ not and does otherwise default

__ in person __ and pro se

__ by his/her attorney _________________________

The court, having reviewed the file, having heard the statements of the parties and the evidence

adduced finds as follows:

______________________________________________________________________________

IT IS THEREFORE ORDERED BY THE COURT that the protection from abuse final order

entered on _______________, ____, be extended for a period of one year.

_______________________________

JUDGE OF THE DISTRICT COURT

IN THE DISTRICT COURT OF ______________ COUNTY, KANSAS

____________________, Plaintiff

vs. Case No. _______________

____________________, Defendant

MOTION TO DISMISS

Comes now _____________________________, plaintiff, and moves the court for an order

dismissing the above entitled action without prejudice.

___________________________________

Plaintiff

IN THE DISTRICT COURT OF ______________ COUNTY, KANSAS

____________________, Plaintiff

vs. Case No. _______________

____________________, Defendant

ORDER OF DISMISSAL

On this date, _____________________________, this matter comes on for hearing.

(CHECK AS APPLICABLE)

_____ The plaintiff filed a motion to dismiss, and the Court finds that the above entitled action

should be and is hereby dismissed on plaintiff’s motion without prejudice.

_____ The plaintiff fails to appear either in person or by counsel, and the Court finds that the

above entitled action should be and is hereby dismissed.

_____ The Court finds that the plaintiff has failed to prove the allegations of abuse by a

preponderance of the evidence, and that the above entitled action should be and is hereby dismissed.

Any temporary orders entered in this case are hereby vacated.

IT IS SO ORDERED.

__________________________________

JUDGE OF THE DISTRICT COURT