Petition For Protective Order (Page 5 of 5) in pdf

Petition For Protective Order Page 5

Case No.

10. Petitioner information. [The court needs your mailing address to send court papers,

including notices of hearing, to you. If you believe it is not safe for the respondent to

know where you live, write a "message" address where you can be sure you will

receive court papers. If you do not have an address and telephone number that

can safely be revealed to the respondent, ask the court clerk how you can

provide this information so that it will be kept confidential and not revealed to

the respondent. Civil Rule 65.1]

My mailing/message address

Street or Box No.

City

State

Zip

My message phone:

My full legal name:

Any nicknames or other names:

Date

Petitioner's Signature

Print Name

Subscribed and sworn to or affirmed before me at

, Alaska on

(date)

(SEAL)

Clerk of Court, Notary Public or other person

authorized to administer oaths

My commission expires:

This is Not a Court Order

Page 5 of 5

CIV-752 (10/13)(cs)

AS 18.65.850-.870

PETITION FOR STALKING OR SEXUAL ASSAULT PROTECTIVE ORDER

Civil Rule 65.1

Petition For Protective Order Page 5