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PROTECTIVE ORDER--FAMILY ABUSE
Commonwealth of Virginia vn ( oOi R le 1;'74 1
C'asc No. % //.. ?P./J?....
Juvenile anomJtic Rd?ions District Court
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1•E.I I I usi R
RI.SIx1NDENT
It appearing that the subject matter of this order and the above-named persons
are within the jurisdiction of the Juvenile and Domestic Relations District
Court and alter an adversary hearing in which the respondent was afforded
reasonable notice and an opportunity to be heard, the court, finding the need
to protect the health and safety of the petitioner and family or household
members of the petitioner, it is ORDERED that the Respondent is required
to observe reasonable conditions of behavior as set forth below:
('(/A11'L 1, 11 DATA III: LOW IP KNOWN
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refrain from committing further abuse.
? ` J r, / ?? _ _
rant the Petitioner possession of-
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o Iv residence located at. . .
'- I (and the Respondent shall immediately leave and stay away from the residence; however, no such grant of possession shall affect
title to any real or personal property.
? grant the Petitioner temporary exclusive possession or use of a motor vehiclejointly owned by the parties, described as follows:
""""' ............. .... _ .............. _ Such grant shall not effect title to the vehicle.
C? provide suitable alternative housing for the ....? Petitioner ...? Family or household members . _......
.....................
as follows: ............................................. ......
.....................................................
It is further ordered that the Respondent shall have no fort (contact of any type with the Petitioner or the named family or
household members of the Petitioner except as follows: __ 'to exceptions
............,................... ....... .............. ............ .............................
.....
It is further ordered that Respondent shall participate in the following treatment, counseling or other program:
............................................................................
PROGRAM NAME: ANO AIIORPSS
Until further order, as being necessary for the protection of the Petitioner and family or household members of the Petitioner,
I temporary custody I.. i tam Purnn' visitation i s {,?..I? i? 17 ? - ?
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............... ..... ....... _...... ....................................
It is further ordered that: . .......... ............. .. ......... ....................... ..........................
........................ ...... .................. ._ ........................................................... _.
This Order shall remain in full force and effect until ...... .1....... i .. :....... , at which time this order slat
terminate.
........... 71 ..-.... `t...
DATE R,oA 0.1 d E'. 'r, ?n 5 4 en, tUxF -r-LA) ,
The terms "family abuse" and "family or household member" are defined on the reverse side, of this order.
WARNING TO RESPONDENT: It' you violate the conditions of this Order, you may be sentenced to JAIL and/or ordered o pay a FME. Virginia
Code § 18.2•308.1:4 prohibits the purchase or transport of any firearm while this order is in effect. While this Protective Order is in effect,
Vu may be subject to a federal penalty under the 1994 amendment to the Gun Control Act, 18 U.S.C. 922(g)(8), for possessing, transporting
receiving a firearm. -
?TICE TO RESPONDENT: This order will be entered on the Virginia Criminal InformauomNetwork. Eithcr'pSny ma?-at anX,tlgle file a motion
h the Court requesting it hearing to dissolve or modify this Order.
FULL FAITH AND CREDIT: Thic order of protection is guided to enforcement by the court of another state or of the United States, or by a tribal
court.
(OVER)
FORM UCynsa,lFRONI).!?A„y.,.....,.
RETURNS: Each person was served according to law, as indicated below, unless not found.
Name ..C..9 ,7(/.....?3 K'/J. [?C'/? .............
X06:
Address... I AA.../}a.Q.r le ....
379"j ?vciw d?vd............
CI PERSONAL SERVICE Tel. No ....................
? Not Found
SERVING OFFICER
............. ....... .. f,r
DATE
Respondent's Description (for VCIN entry):
Sex ... ...... Race ...Ertl....... DOR
SSN .....//?. - . c?.?. .C,. (j. °a ? ............. .
J,?ri
HGT......?..../......r. WGT ....I. /??...........
Hair....-l!11W_ .. . yEycs..... w......
No .......................
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"Family abuse" means any act involving violence, force, or threat including any forceful detention, which results in physical
injury or places one in reasonable apprehension of serious bodily injury and which is committed by a person against such person's
family or household member.
"Family or household member" means W the person's spouse, whether or not he or she resides in the same home with the
person, (ii) the person's former spouse, whether or not he or she resides in the same home with the person, (iii) the person's parents,
stepparents, children, stepchildren, brothers and sisters, grandparents and grandchildren regardless of whether such persons reside in
the same home with the person, (iv) the person's mother-in-law, father-in-law, sons-in-law, daughters-in-law, brothers-in-law and
sisters-in-law who reside in the same home with the person, or (v) any individual who has a child in common with the defendant,
whether or not the person and that individual have been married or have resided together at any time, or (vi) any individual who
cohabits or who, within the previous twelve (12) months, cohabitated with the person, and any children of either of them residing in
the same home with the person.
Name ....&Ine7 t?/,
..... ........................
Address ?.
.
,
.. _
..
...
L7 PERSONAL SERVICE Tel. No .. .......... ..........
? Net Found
5ERVING OFFIC 1 R
for (') G-• _
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DATF. AND TIME
FORM DG677. DC-650 1REVERSE) 7;99 PC
PRELIMINARY PROTECTIVE ORDER-FAMILY ABUSE
Commonwealth of Virginia
-Ab 99 q yry ct?,l T-
VA. CODE 116.1:53.1 Court Case No.: . Ar-.7.21..24r.1...
Hearing Date and Time3/.31/.99. .
... Rewp.O rt . mws .............................................. Juvenile and Domestic Relations District Court
Donald„Betide;, , , ,, , , , v. ..... Ca.44
Y.. ?.Ade.rz.PONDEN..
PETITIONER RESPONDENT
It appearing that the above-named persons are within the jurisdiction COMPLETE DATA BELOW IF KNOWN
of the Juvenile and Domestic Relations District Court, the Petitioner having
alleged in the petition that he/she is or has been, within a reasonable period
of time, subjected to abuse and, after an ex parse proceeding when the petition
is supported by:
RACE SEX &)0.V NT NGT fl'E5 HAIR
va osr rs IT IN
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? an affidavit
sworn testimony before the judge or intake officer
and it further appearing that the Petitioner is a family or household member of the Respondent and that good cause has been shown
that:
? There is evidence sufficient to establish probable cause that family abuse, including forceful detention, resulting in
physical injury to the Petitioner or placing the Petitioner in reasonable apprehension of serious bodily injury has recently
occurred; or
The health and safety of the Petitioner or a household member of the Petitioner is in danger because of a finding that
there is immediate and present danger of family abuse;
it is therefore ORDERED that
??l the Respondent shall refrain from committing acts of family abuse.
the Respondent shall grant the Petitioner possession of the premises occupied by the parties located at
C._T.•,,,:_4•S?_ • J +v .r._J .../.. J.A ........ and the Respondent shall immediately leave and stay away from
the residence; however, no such grant of possession shall affect title to any real or personal property.
? the Respondent shall grant the Petitioner temporary exclusive possession or use of a motor vehicle jointly owned by the
parties, described as follows: Such grant shall not affect title to the vehicle.
? the Respondent shall provide suitable alternative housing for the
? petitioner ? family or household members .................................................
as follows:
.............................................................................................
the Respondent shall have no further contact of any type with the Petitioner except as follows:
171
no exceptions
.............................................................................................
.............................................................................................
.............................................................................................
the Respondent shall refrain from having contact with (7> F-rr, ?...
to protect their safety except as follows:
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The Respondent, pursuant to § 18.2-308.1:4 of the Code of Virginia shall not purchase or transport any firearm while this
order is in effect.
It is further ORDERED that a protective order hearing on the petition be held at this Court on az
and that notice of this hearing be given to the Respondent who is the alleged abuser.
1•u,ust 31 ace l ' ^-
DATE Ronal, E. .:ensten )oocE ?
The terms "family abuse" and "family or household mem'ber" are defined on the reverse side of this order.
WARNING TO RESPONDENT: If you violate the conditions of this order. you may be sentenced to JAIL and/or ordered to pay a FINE.
NOTICE TO RESPONDENT: This order will be entered on the Virginia Criminal Information Network. You may at any time file a motion with
the Court requesting a hearing to dissolve or modify this Order.
FORM DC A37 (FRONT) IC I(V)7 (11:6410591)
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