Complaint And Motion For Restraining Order Page 2

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On ___________________ ________, 20_______, at ______ O’clock, A.M./P.M. (circle
one),
at
______________________________________________,
which
is
in
_______________________, ________, the conduct complained of occurred when the
defendant:
(State details of harassment/stalking and other facts and circumstances upon which relief is
sought above. Attach additional sheets if necessary.)
6.
Plaintiff requests: (Check one or more)
a. That the defendant by enjoined from abusing, threatening to abuse, or molesting
the plaintiff or members of the plaintiff’s family.
b. That the defendant be enjoined from entering or attempting to enter the plaintiff’s
place of residence, employment, education, or other location.
c. That the defendant be enjoined from communicating or attempting
to communicate with the plaintiff in a way that would violate Article 17, Chapter
16 of the 1976 South Carolina Code of Laws, as amended.
SWORN to and Subscribed before me
)
)
This ___ day of ________________, 20_____.
)
)
)
Notary Public for South Carolina
)
Signature of Plaintiff or Person Filing
My Commission expires:
_______________ )
e on Behalf of Plaintiff
NOTICE: THE NON-PREVAILING PARTY IN THIS ACTION IS ASSESSED A FILING
FEE OF FIFTY-FIVE DOLLARS ($55.00). THE COURT MAY HOLD A PERSON IN
CONTEMPT OF COURT FOR FAILURE TO PAY THIS FILING FEE. §16-03-170(D).
NOTICE TO DEFENDANT: YOU HAVE THE RIGHT TO EMPLOY COUNSEL TO
REPRESENT YOU.
SCCA/749 (Amended 12/2015)

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