Form 6 Protection Order - Department Of Justice
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1J551E
23
REPUBLIC OF SOUTH AFRICA
FORM 6
[Regulation 8(a)]
PROTECTION ORDER
SECTION 6 OF THE DOMESTIC VIOLENCE ACT, 1998 (ACT NO. 116 OF 1998)
(This form must be completed if an interim protection order was issued in terms of section 5(2))
IN THE MAGISTRATE’S COURT FOR THE DISTRICT OF ____________________
HELD AT ___________________
APPLICATION NO._______/_____
In the matter between:
APPLICANT: ______________________________________________________
(*Id.No./Date of Birth:_________________________________)
AND
RESPONDENT: ____________________________________________________
(*Id.No./Date of Birth:_________________________________)
Whereas the Applicant successfully applied for a protection order which was issued on
the ............... day of ....................................................................... , and
after considering the facts of the matter;
The Court orders that the attached interim protection order be :
1.*Confirmed;
2.*Amended as follows: _______________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
____________________________________________________________; or
3.*Set Aside.
A copy of this order and interim protection order, as well as the warrant of arrest for the
Respondent must be forwarded to the ......................................................................
Police Station.
Dated at __________________ this ____ day of ________________ year _______.
___________________
______________
MAGISTRATE
DATE
______________________________________________________________
*Delete whichever is not applicable
Department of Justice and Constitutional Development
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