Application For Order For Protection Of Children - Nevada Justice Court - 2007 Page 5
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Explain why protection is needed for the individuals listed above:
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______________________________________________________________________________
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______________________________________________________________________________
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______________________________________________________________________________
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(NOTE: YOUR APPLICATION WILL NOT BE DENIED BASED UPON A
PARTICULAR RELATIONSHIP. HOWEVER, DEPENDING UPON YOUR
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RELATIONSHIP, YOU MAY ALSO BE ELIGIBLE TO APPLY FOR AN ORDER OF
PROTECTION AGAINST DOMESTIC VIOLENCE PURSUANT TO NRS CHAPTER
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33.)
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2.
Have the minor and the Adverse Party ever lived together?
Yes
No
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If so, for how long? _______________________________________________________
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3.
Is anyone listed on Page 4 living with the Adverse Party now?
Yes
No
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If so, who? ___________________________________
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4.
Are there other children involved?
Yes
No. If so, how are they involved?
________________________________________________________________________
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________________________________________________________________________
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5.
Residence(s) where protection is needed:
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CONFIDENTIAL (If confidential, check and move to the next question) or,
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If not confidential, list address, city, state and zip code:
________________________________________________________________________
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________________________________________________________________________
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6.
Place(s) of employment where protection is needed:
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CONFIDENTIAL (If confidential, check and move to the next question) or,
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If not confidential, list name, address, city, state and zip code:
________________________________________________________________________
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________________________________________________________________________
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5 of 7
Application for Order for Protection of Children (NRS 33.400)
January 2007
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