Form Ujs-091f - Order For Protection - 2016 (Page 4 of 4) in pdf

Form Ujs-091f - Order For Protection - 2016 Page 4

DATED

Service of this order is authorized on any day

including Sunday.

Judge

Attest:

, Clerk of Courts

By:

, Deputy

NOTICE OF ENTRY OF ORDER AND

ACKNOWLEDGMENT OF PERSONAL SERVICE

I acknowledge receipt of a copy of this Order of Protection.

_______________________

___________

____________________________

__________

Petitioner

Date

Respondent

Date

UNDER A PERMANENT PROTECTION ORDER: You may be subject to the following federal laws: (1) Effective

immediately, you may not possess, carry, ship or transport any firearm or ammunition that has been transported in interstate

or foreign commerce while this Protection Order is in effect. Title 18 United States Code Section 922(g)(8). (2) If you violate

this Protection Order and are convicted of an offense of domestic violence, you may be forbidden for life from possessing,

carrying, shipping or transporting, any firearm or ammunition that has been transported in interstate or foreign commerce.

Title 18 United States Code Section 922(g)(9). Violation of these federal laws carries a maximum penalty of ten years in

prison, a $250,000 fine, or both.

Form UJS-091F (Domestic Permanent Order of Protection) Rev. 07/01/16

Form Ujs-091f - Order For Protection - 2016 Page 4