Order Of Protection Form - Criminal Form 1 - New York (Page 2 of 2) in pdf

Criminal Form Crim-1

Page 2

[05]‘

Permit [specify individual(s)]: __________________________________________________________________,

entitled by a court order or separation or other written agreement, to visit with [specify child(ren)]:____________________

_______________________ during the following periods of time [specify]: _____________________________________

_________________________ , under the following terms and conditions [specify]: _______________________________

___________________________________________________________________________________________________;

‘

[12]

Surrender any and all handguns, pistols, revolvers, rifles, shotguns and other firearms owned or possessed, including, but not

limited to, the following

and do not obtain any further guns or other

firearms. Such surrender shall take place immediately, but in no event later than [specify date/time]:

at: __________________________________________________________________________________________________.

‘

[ ]

Promptly return or transfer the following identification documents [specify]:_________________________________________

___________________________________________to the party protected by this Order NOT LATER THAN [specify

date]:____________in the following manner [specify manner or mode of return or transfer]: _________________________________.

‘

[Check box(es) if applicable]:

Such documents shall be made available for use as evidence in this judicial proceeding.

‘

[Jointly owned documents or documents in both parties’ names only]: the following document(s)

may be used as necessary for legitimate use by the defendant [specify]:____________________

____________________________________________________________________________.

[99] ‘

Specify other conditions defendant must observe for the purposes of protection:

______________________________________________________________________________________________________

IT IS FURTHER ORDERED that the above-named Defendant's license to carry, possess, repair, sell or otherwise dispose of a

‘

firearm or firearms, if any, pursuant to Penal Law §400.00, is hereby [ 13A]

suspended or [13B]

revoked (note: final order only),

‘

and/or [13C]

the Defendant shall remain ineligible to receive a firearm license during the period of this order. (Check all applicable

boxes).

IT IS FURTHER ORDERED that this order of protection shall remain in force until and including [specify date]:

but if you fail to appear when you are required to do so, the order may be extended and continue in effect until a new date set by the Court.

DATED: _________________________

JUDGE / JUSTICE

‘ Defendant advised in Court of issuance and contents of Order.

Court (Court Seal)

‘ Order personally served on Defendant in Court

______________________________________________

(Defendant's signature)

‘ Order to be served by other means [specify]:

‘ Warrant issued for Defendant

‘ ADDITIONAL SERVICE INFORMATION: [specify]: _________________________________________

The Criminal Procedure Law provides that presentation of a copy of this order of protection to any police officer or peace officer acting

pursuant to his or her special duties shall authorize and in some situations may require, such officer to arrest a defendant who is alleged to

have violated its terms and to bring him or her before the Court to face penalties authorized by law.

Federal law requires that this order be honored and enforced by state and tribal courts, including courts of a state, the District of

Columbia, a commonwealth, territory or possession of the United States, if the person against whom the order is sought is an intimate

partner of the protected party and has been or will be afforded reasonable notice and opportunity to be heard in accordance with state law

sufficient to protect that person's rights (18 USC §§2265, 2266).

It is a federal crime to:

• cross state lines to violate this order or to stalk, harass or commit domestic violence against an intimate partner or family member;

• buy, possess or transfer a handgun, rifle, shotgun or other firearm or ammunition while this Order remains in effect

(Note: there is a limited exception for military or law enforcement officers but only while they are on duty); and

• buy, possess or transfer a handgun, rifle, shotgun or other firearm or ammunition after a conviction of a domestic violence-related

crime involving the use or attempted use of physical force or a deadly weapon against an intimate partner or family member, even

after this Order has expired. (18 U.S.C. ''922(g)(8), 922(g)(9), 2261, 2261A, 2262).

Order Of Protection Form - Criminal Form 1 - New York Page 2

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