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Form Jc-1693 - Petition In Juvenile Court For Temporary Restraining Order And/or Petition And Motion For Injunction Hearing

STATE OF WISCONSIN, CIRCUIT COURT,

COUNTY

For Official Use

Name of Person to be

Petition in

Protected:

Juvenile Court for

Temporary Restraining Order

Date of Birth of

Protected Person:

and/or Petition and Motion for

Injunction Hearing

Name of Petitioner

(if different from

(Harassment – 30711)

Protected Person):

-vs.-

Respondent/

Defendant:

Address:

Case No.

If there is a CHIPS proceeding involving the child or the respondent is a minor, use this form.

Respondent’s

Sex

Race

Date of Birth

Height

Weight

Hair color

Eye color

Respondent’s Distinguishing Features:

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

spouse

cousin

adoptive parent

(such as scars, marks or tattoos)

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 (child).

[past or present]

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

§813.125, Wisconsin Statutes, based on the following:

, is the alleged victim of harassment.

[Name of Person to be Protected]

2. 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

3. 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.

CONFIDENTIAL COURT RECORD

JC-1693, 05/16 Petition in Juvenile Court 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 Jc-1693 - Petition In Juvenile Court For Temporary Restraining Order And/or Petition And Motion For Injunction Hearing

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