Order Of Protection Form - Criminal Form 1 - New York printable pdf download

Criminal Form 1

12/2013

_______________

At a term of the _________________

________________________ ,

ORI No:

Court, County of

__________________________________, St

Order No: ________________

at the Courthouse at

ate of New York

ORDER OF PROTECTION

NYSID No: _______________

CJTN No._______________

Family Offenses - C.P.L. 530.12

“ “ “ “

PRESENT: Hon._________________________________,

Youthful Offender (check if applicable)

PEOPLE OF THE STATE OF NEW YORK

Part:____________ Index/Docket No: ___________________

Indictment No., if any:

___

_____________________________________

Charges:

against

[Check box]: “ “ “ “ Ex Parte “ “ “ “ Defendant Present In Court

______________________________________, Defendant Date of Birth:

NOTICE: YOUR FAILURE TO OBEY THIS ORDER MAY SUBJECT YOU TO MANDATORY ARREST AND CRIMINAL

PROSECUTION WHICH MAY RESULT IN YOUR INCARCERATION FOR UP TO SEVEN YEARS FOR CONTEMPT OF

COURT. IF THIS IS A TEMPORARY ORDER OF PROTECTION AND YOU FAIL TO APPEAR IN COURT WHEN YOU

ARE REQUIRED TO DO SO, THIS ORDER MAY BE EXTENDED IN YOUR ABSENCE AND THEN CONTINUES IN

EFFECT UNTIL A NEW DATE SET BY THE COURT.

THIS ORDER OF PROTECTION WILL REMAIN IN EFFECT EVEN IF THE PROTECTED PARTY HAS, OR CONSENTS

TO HAVE, CONTACT OR COMMUNICATION WITH THE PARTY AGAINST WHOM THE ORDER IS ISSUED. THIS

ORDER OF PROTECTION CAN ONLY BE MODIFIED OR TERMINATED BY THE COURT. THE PROTECTED PARTY

CANNOT BE HELD TO VIOLATE THIS ORDER NOR BE ARRESTED FOR VIOLATING THIS ORDER.

“ “ “ “ TEMPORARY ORDER OF PROTECTION - Whereas good cause has been shown for the issuance of a temporary order of

protection [as a condition of “ recognizance “ release on bail “ adjournment in contemplation of dismissal]

“ “ “ “ ORDER OF PROTECTION - Whereas defendant has been convicted of [specify crime or violation]: ________________________;

And the Court having made a determination in accordance with section 530.12 of the Criminal Procedure Law,

IT IS HEREBY ORDERED that the above-named defendant observe the following conditions of behavior:

[Check applicable paragraphs and subparagraphs]:

[01] ‘ Stay away from [A] ‘ [name(s) of protected person(s) or witness(es)]:_______________________________and/or from the

[B] ‘ home of _____________________________, [C] ‘ school of __________________________________________,

[D] ‘ business of ___________________________, [E] ‘ place of employment of ___________________________,

[F] ‘ other _________________________________________________________________________________;

– ” except for contact, communication or access permitted by a subsequent order issued by a family or supreme court in a

custody, visitation or child abuse or neglect proceeding.

[14] ‘ Refrain from communication or any other contact by mail, telephone, e-mail, voice-mail or other electronic or any other means

with [specify protected person(s)]:

;

– ” except for contact, communication or access permitted by a subsequent order issued by a family or supreme court in a

custody, visitation or child abuse or neglect proceeding.

02] ‘ Refrain from assault, stalking, harassment, aggravated harassment, menacing, reckless endangerment, strangulation, criminal

[

obstruction of breathing or circulation, disorderly conduct, criminal mischief, sexual abuse, sexual misconduct, forcible touching,

intimidation, threats, identity theft, grand larceny, coercion or any criminal offense against [specify protected person(s), members

of such person’s family or household, or person(s) with custody of child(ren)]:

;

[15] ‘ Refrain from intentionally injuring or killing without justification the following companion animal(s) (pet(s)) [specify type(s)

and, if available, name(s)]: _________________________________________________________________________

;

[11] ‘ Permit [specify individual]: ____________________ to enter the residence at [specify ]:_____________________________

during [specify date/time]: ____________

with [specify law enforcement agency, if any]: __________________ to remove

personal belongings not in issue in litigation [specify items]:

;

[04] ‘ Refrain from [indicate acts]: _________________________________________________________________________that

create an unreasonable risk to the health, safety, or welfare of [specify child(ren), family or household member]:

__________________________________________________________________________________________ ;

Order Of Protection Form - Criminal Form 1 - New York

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