____ prohibiting defendant from interfering with the custody of the minor child(ren) or alleged incompetent.
____ allowing ______________________ to return to the residence at a date and time to be agreed upon by
petitioner and law enforcement agency, to recover his/her personal clothing and necessities, only if s/he is
accompanied by a law enforcement officer to ensure the protection and safety of the parties. NO
FORCED ENTRY ALLOWED.
____ ordering a representative of __________________________________ (Sheriff’s office) to accompany
_______________________________ to the family residence to recover her/his personal clothing and
Petitioner desires that a rule issue herein ordering defendant to show cause why the orders requested in Paragraph 9
should not be made into protective orders, and why defendant should not also be ordered:
___ to pay petitioner a reasonable amount of child support in accordance with Louisiana Law.
___ to pay petitioner a reasonable amount of spousal support (alimony).
___ to seek professional counseling.
___ to pay costs of court in this matter.
___ to pay attorney fees.
___ to pay evaluation fees.
___ to pay expert witness fees.
___ to pay cost of medical and/or psychological care for the petitioner, minor child(ren), and/or alleged incompetent,
necessitated by the domestic violence.
___ to vacate the residence or household, thereby granting petitioner possession thereof.
___ other: ________________________________________________________________.
WHEREFORE, petitioner prays that service and citation issue herein, and:
(check all that apply)
___ that ex parte orders requested in Paragraph 9 be granted.
___ a rule issue to show cause why protective orders as requested in Paragraph 10 should not be granted.
___ defendant be cast with costs.
___ defendant be advised of penalties for violating Abuse Prevention Orders.
___ all other equitable relief as the court deems proper and necessary.
Respectfully submitted by,
PETITIONER, IN PROPER PERSON
PLEASE SERVE DEFENDANT:
________________________________________personally at his/her home or place of employment at the following
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