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Form Cv-405 - Petition For Temporary Restraining Order And/or Petition And Motion For Injunction Hearing

STATE OF WISCONSIN, CIRCUIT COURT,

COUNTY

Amended

Name of person to

be protected

Petition for

(Petitioner):

Temporary Restraining

Name of person

completing Petition

Order and/or Petition and

(if different from

Motion for Injunction

Petitioner):

Date of Birth of

Hearing

Petitioner:

-vs-

(Harassment – 30711)

Respondent/

Defendant:

Case No.

Address:

If there is a CHIPS proceeding involving the child or the respondent is a minor, Use JC-1693. Do not use this form.

Respondent’s

Sex

Race

Date of Birth

Height

Weight

Hair color

Eye color

Name

Respondent’s Distinguishing Features:

Please specify Petitioner’s relationship(s) to Respondent:

(such as scars, marks or tattoos)

spouse

cousin

adoptive parent

former spouse

sibling

grandparent

person in dating relationship

parent

child (biological/adoptive/step)

current or former live-in

step parent

None known.

relationship

Other:

[Be specific]

CAUTION:

Respondent has access to weapon(s). Type of weapon(s):

(Check all that apply)

Location of weapon(s):

Weapon(s) were involved in an incident

involving the petitioner.

[past or present]

I am:

[Check one]

stepparent of the petitioner.

guardian ad litem for child

petitioner.

parent of the petitioner.

legal guardian of the petitioner.

Other:

I PETITION THE COURT for a temporary restraining order/or and injunction against the respondent under §813.125,

Wis. Stats., based on the following:

1. Stated below or attached as part of this petition is a statement of facts indicating that respondent has engaged in

conduct which is believed to be harassment.

(Harassment is defined as: (a) Striking, shoving, kicking or otherwise subjecting the person to physical contact; or (b)

Engaging in an act that would constitute child abuse under §48.02(1); or (c) Sexual assault under §940.225; or (d)

Stalking under §940.32; or attempts or threat to do same; or (e) Engaging in a course of conduct or repeatedly

committing acts which harass or intimidate the person and which serve no legitimate purpose.)

(State when, where, what happened, and who did what to whom)

See attached

2. Another no contact order between the petitioner and the respondent

does not exist or the petitioner does not know or is uncertain as to whether another no contact order exists.

does exist.

Name of other case:

County or State:

[If not Wisconsin]

Type of Case:

Case Number:

[If known]

Date of proceeding that resulted in no contact order:

[If known]

Details of no contact order:

CV-405, 05/16 Petition for Temporary Restraining Order and/or Petition and Motion for Injunction Hearing (Harassment) §§48.25(6) and 813.125, Wisconsin Statutes

This form shall not be modified. It may be supplemented with additional material.

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Form Cv-405 - Petition For Temporary Restraining Order And/or Petition And Motion For Injunction Hearing

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