Petition For Protective Order - Oklahoma District Court, Aoc Form 67 - Order Of Protection

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IN THE DISTRICT COURT OF ______________________ COUNTY
Case No. PO-
Petitioner, being sworn, states:
1. (Check one or more)
The Defendant has caused or attempted to cause serious physical harm to
The Defendant has threatened
The Defendant has harassed
The Defendant has stalked _______________________________.
(If parties are not related, or not in a previous or
current dating relationship, a complaint must be filed with law enforcement and a copy must be attached.)
2. The incident(s) which caused the filing of the petition occurred on or about
(Describe what happened)(Harassment requires a pattern of conduct. Stalking requires repeated following.)
(Attach additional sheet with more information, if necessary)
3. Was a weapon used in the incident? ______ If “yes” what kind of weapon?
Are there weapons on the premises?
If “yes” what kinds of weapons?
4. The Petitioner and additional parties are related to the Defendant as follows: (check all that apply)
Parent & Child
Persons Related by Blood
Persons Related by Marriage
Present Spouse of an Ex-Spouse
Persons Living Same Household
Formerly Living Same Household
Biological Parents Same Child
Persons in a Previous Dating Relationship
Persons in a Dating Relationship
Not Related
(Stalking requires filing police complaint, with copy
attached. No other relief is permitted by the Protection from
Domestic Abuse Act for non-related parties.)
5. (Check and Complete A or B)
A. Petitioner does not request an Emergency Ex Parte Order but requests the relief checked below after
notice and hearing.
B. Petitioner is in immediate and present danger of abuse from the Defendant and an Emergency Ex Parte
Order is necessary to protect the Petitioner from serious harm. The Petitioner requests the following relief in the
Ex Parte Order: (check one or more)


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