PETITION FOR INJUNCTION FOR PROTECTION AGAINST DATING VIOLENCE

INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW FORM 12.980(n),
PETITION FOR INJUNCTION FOR PROTECTION AGAINST DATING VIOLENCE
When should this form be used? If you or a member of your immediate family are a victim of dating violence, you can use this form to ask the court for a protective order prohibiting dating violence. Dating violence means violence between individuals who have or have had a continuing and significant relationship of a romantic or intimate nature. The dating relationship must have existed within the past six months, the nature of the relationship must have been characterized by the expectation of affection or sexual involvement between the parties, and the frequency and type of interaction must have included that the persons have been involved over time and on a continuous basis during the course of the relationship. Dating violence does not include violence in a casual acquaintanceship or violence between individuals who only have engaged in ordinary fraternization in a business or social context. Dating violence includes assault, aggravated assault, battery, aggravated battery, sexual assault, sexual battery, stalking, aggravated stalking, kidnapping, or false imprisonment, or any criminal offense resulting in physical injury or death. Because you are making a request to the court, you are called the petitioner. The person whom you are asking the court to protect you from is called the respondent. If you are under the age of eighteen and have never been married or had the disabilities of nonage removed by a court, one of your parents or your legal guardian must sign this petition on your behalf.

The parent or legal guardian of any minor child who is living at home may seek an injunction for protection against dating violence on behalf of the minor child. With respect to a minor child who is living at home, the parent or legal guardian must have been an eye-witness to, or have direct physical evidence or affidavits from eye-witnesses of, the specific facts and circumstances that form the basis of the petition.

If the respondent is your spouse, former spouse, related to you by blood or marriage, living with you now or has lived with you in the past (if you are or were living as a family), or the other parent of your child(ren), whether or not you have ever been married or ever lived together, you should use Petition for Injunction for Protection Against Domestic Violence, Florida Supreme Court Approved Family Law Form 12.980(a), rather than this form.

This form should be typed or printed in black ink. You should complete this form (giving as much detail as possible) and sign it in front of a notary public or the clerk of the circuit court in the county where you live. The clerk will take your completed petition to a judge. You should keep a copy for your records. If you have any questions or need assistance completing this form, the clerk or family law intake staff will help you.

What should I do if the judge grants my petition?

If the facts contained in your petition convince the judge that you or a member of your immediate family are a victim of dating violence and that an immediate and present danger of dating violence to you or that family exists, the judge will sign a Temporary Injunction for Protection Against Dating Violence, Florida Supreme Court Approved Family Law Form 12.980(o). A temporary injunction is issued without notice to the respondent. The clerk will give your petition, the temporary injunction, and any other papers filed with your petition to the sheriff or other law enforcement officer for personal service on the respondent. The temporary injunction will take effect immediately after the respondent is served with a copy of it. It lasts until a full hearing can be held or for a period of 15 days, whichever comes first. The court may extend the temporary injunction beyond 15 days for a good reason, which may include failure to obtain service on the respondent.

The temporary injunction is issued ex parte. This means that the judge has considered only the information presented by one side -- YOU. The temporary injunction gives a date that you must appear in court for a hearing. At that hearing, you will be expected to testify about the facts in your petition. The respondent will be given the opportunity to testify at this hearing, also. At the hearing, the judge will decide whether to issue a Final Judgement of Injunction for Protection Against Dating Violence (After Notice), Florida Supreme Court Approved Family Law Form 12.980(p), which will remain in effect for a specific time period or until modified or dissolved by the court. If you and/or the respondent do not appear, the temporary injunction may be continued in force, extended, or dismissed, and/or additional orders may be granted, including entry of a permanent injunction and the imposition of court costs. You and respondent will be bound by the terms of any injunction or order issued at the final hearing.

IF EITHER YOU OR RESPONDENT DOES NOT APPEAR AT THE FINAL HEARING, YOU WILL BOTH BE BOUND BY THE TERMS OF ANY INJUNCTION OR ORDER ISSUED IN THIS MATTER.

If the judge signs a temporary or final injunction, the clerk will provide you with the necessary copies. Make sure that you keep one certified copy of the injunction with you at all times!

What can I do if the judge denies my petition? If your petition is denied solely on the grounds that it appears to the court that no imminent danger of domestic violence exists, the court will set a full hearing, at the earliest possible time, on your petition, unless you request that no hearing be set. The respondent will be notified by personal service of your petition and the hearing. If your petition is denied, you may: amend your petition by filing a Supplemental Affidavit in Support of Petition for Injunction for Protection Against Domestic Violence, Repeat or Dating Violence, Florida Family Law Form 12.980 (g); attend the hearing and present facts that support your petition; and/or dismiss your petition. Where can I look for more information? Before proceeding, you should read "General Information for Self-Represented Litigants" found at the beginning of these forms. The words that are in bold underline in these instructions are defined in that section. The clerk of the circuit court or family law intake staff will help you complete any necessary forms. For further information, see Section 784.046, Florida Statutes, and Rule 12.610, Florida Family Law Rules of Procedure.
Your full legal name:
Respondent's legal name:
(The respondent is the person you want to be protected from)

I, , being sworn, certify that the following statements are true:
This section is about you, the petitioner. It must be filled out.

I currently live at:

Address:
City, State, Zip
Your Date of Birth: Area Code and Phone: Area Code and Fax:
Petitioner seeks an injunction for protection on behalf of a minor child. Petitioner is the parent or legal guardian of {full legal name}
Your attorney's name: (If you don't have an attorney, type "none")

Your attorney's Phone: (Leave blank if you don't have an attorney)

Your attorney's Address: (Leave blank if you don't have an attorney)

Your attorney's City, State and Zip: (Leave blank if you don't have an attorney)


IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR  COUNTY, FLORIDA
,
,


,
Petitioner,

and

,
Respondent.




SECTION II. Respondent (This section is about the person you want to be protected from. It must be completed.)

Respondent's current address (if known)

Respondent's City, State and Zip (if known)

Respondent's Driver's License Number (if known)

You've known Respondent since {date}:
Respondent’s last known place of employment:
Employment address:
Working hours:

Physical description of Respondent:
Race:     Sex:     Birthdate:
Height:    Weight:    Eye Color:    Hair Color:
Distinguishing marks or scars: Vehicle Make/Model:    Color:    Tag Number:
Other names Respondent goes by (aliases or nicknames):
Respondent's attorney {If applicable}:

Attorney's Address {If applicable}:
Attorney's Phone {If applicable}:
If Respondent is a minor, the address of Respondent's parent or legal guardian is:




SECTION III. CASE HISTORY AND REASON FOR SEEKING PETITION
  1. Describe the nature of the relationship between the Petitioner and Respondent (include the length of time of the relationship, the romantic or intimate nature of the relationship, the frequency or type of interaction, and any other facts that characterize the relationship)

    Check here if you are attaching additional pages to continue these facts.
  2. Have the Petitioner and Respondent been involved in a dating relationship within the past six months?

  3. If yes, what happened in that case? (include case number, if known)

  4. If yes, what happened in that case? (include case number, if known)
  5. Describe any other court case that is either going on now or that happened in the past between Petitioner and Respondent {include case number, if known}:
  6. Respondent has directed an incident of violence, meaning assault, aggravated assault, battery, aggravated battery, sexual assault, sexual battery, stalking, aggravated stalking, kidnapping, or false imprisonment, or any criminal offense resulting in physical injury or death against Petitioner or a member of Petitioner’s immediate family. The incident (including date and location) is described below.
    On {date} , at {location}
    Check here if you are attaching additional pages to continue these facts.
  7. Other prior incidents (including dates and location) are described below:
    On {date} , at {location}
    Check here if you are attaching additional pages to continue these facts.
  8. Petitioner genuinely fears repeat violence by Respondent. Explain:
  9. Respondent owns, has, and/or is known to have guns or other weapons.
    Describe weapon(s):
  10. This or other acts of dating violence have been previously reported to {person or agency}:


SECTION IV.  INJUNCTION (This section must be completed.)
  1. I ask the Court to enter an injunction prohibiting Respondent from committing any acts of violence against me and:
    1. prohibiting Respondent from going to or within 500 feet of any place I live;
    2. prohibiting Respondent from going to or within 500 feet of my place(s) of employment or the school that I attend; the address of my place(s) of employment and/or school is(are):
    3. prohibiting Respondent from contacting me by mail, by telephone, through another person, or in any other manner;
    4. ordering Respondent not to use or possess any guns or firearms;
    5. prohibiting Respondent from going to or within 500 feet of the following place(s) Petitioner or Petitioner’s immediate family must go to often:
    6. prohibiting Respondent from knowingly and intentionally going to or within 100 feet of my motor vehicle;
      and any other terms the Court deems necessary for the safety of Petitioner and Petitioner’s immediate family.


I UNDERSTAND THAT BY FILING THIS PETITION, I AM ASKING THE COURT TO HOLD A HEARING ON THIS PETITION, THAT BOTH THE RESPONDENT AND I WILL BE NOTIFIED OF THE HEARING, AND THAT I MUST APPEAR AT THE HEARING. I UNDERSTAND THAT IF EITHER RESPONDENT OR I FAIL TO APPEAR AT THE FINAL HEARING, WE WILL BE BOUND BY THE TERMS OF ANY INJUNCTION OR ORDER ISSUED AT THAT HEARING.

I UNDERSTAND THAT I AM SWEARING OR AFFIRMING UNDER OATH TO THE TRUTHFULNESS OF THE CLAIMS MADE IN THIS PETITION AND THAT THE PUNISHMENT FOR KNOWINGLY MAKING A FALSE STATEMENT INCLUDES FINES AND/OR IMPRISONMENT.


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