Petition For Protective Order

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IN THE DISTRICT COURT OF ________________ COUNTY
STATE OF OKLAHOMA
)
Petitioner(s),
)
)
vs.
)
Case No. PO-
)
)
Defendant(s).
)
PETITION FOR PROTECTIVE ORDER
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 the petitioner is a victim of stalking,
but is not a family or household member or an individual who is or has been in a dating relationship with the
Defendant, the Petitioner must file a complaint against the Defendant with the proper law enforcement
agency before filing a petition for a protective order with the District Court. The petitioner should be
prepared to present a copy of the complaint to the court at the full hearing.)
2. The incident(s) which caused the filing of the petition occurred on or about
(Dates)
(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)
□ Married
□ Divorced
□ 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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