R.I. Gen. Laws § 8-8.1-6
STATE OF RHODE ISLAND | DISTRICT COURT | |
COUNTY OF ________ | ______ DIVISION | |
_________ | : | |
Plaintiff | : | |
: | ||
VS | : | NO: |
: | ||
_________ | : | |
Defendant | : |
COMPLAINT FOR PROTECTION FROM ABUSE
Pursuant to chapter 8.1 of title 8 I request that the court enter an order protecting me from abuse.
_________
I own _________
Defendant owns _________
We jointly own _________
My former residence is an apartment
There is no lease _________
My name is on lease and defendant's is not _________
Defendant's name is on lease and mine is not _________
Both our names are on lease _________
_________
_____ Threatened or harmed with a weapon:
(type of weapon used: ____________)
_____ Attempted to cause me physical harm;
_____ Caused me physical harm;
_____ Placed me in fear of imminent physical harm;
_____ Caused me to engage involuntarily in sexual relations by
force, threat of force, or duress
specifically, the defendant: _________
_____ The court order that the defendant be restrained and enjoined from contacting, assaulting, molesting or otherwise interfering with the plaintiff at home, on the street or elsewhere.
_____ The court order the defendant to immediately leave the household which is located at _________
_________
I request that the above relief be ordered without notice because it clearly appears from specific facts shown by affidavit or by the verified complaint that I will suffer immediate and irreparable injury, loss, or damage before notice can be served and a hearing had thereon. I understand that the court will schedule a hearing no later than twenty-one (21) days after such order is entered on the question of continuing such temporary order.
(Signature)(Date)
Subscribed and sworn to before me in ____________ in the County of ____________in the state of Rhode Island, this ________ day of ____________ A.D. 20_____.
Notary Public
Note: If this complaint is filed by an attorney, the attorney's certificate should appear below:
ATTORNEY CERTIFICATE
Signed: _______________
Attorney for Plaintiff
Address: ______________
______________
Date: ___________, 20__
WHITE COPY | ___ Court |
YELLOW COPY | ___ Plaintiff |
PINK COPY | ___ Defendant |
GOLDENROD COPY | ___ Police Department |
STATE OF RHODE ISLAND | DISTRICT COURT | |
COUNTY OF ________ | ______ DIVISION | |
_________ | : | |
Plaintiff | : | |
: | ||
VS | : | NO: |
: | ||
_________ | : | |
Defendant | : |
(TEMPORARY) ORDER PURSUANT TO CHAPTER
______ OF THE G.L. OF R.I.
Upon consideration of plaintiff's complaint, (and having found that immediate and irreparable injury, loss or damage will result to the plaintiff before a notice can be served and a hearing had thereon) it is ORDERED:
_____ That the defendant is restrained and enjoined from contacting, assaulting, molesting, or otherwise interfering with plaintiff at home, on the street or elsewhere.
_____ That the defendant vacate forthwith the household located at
_________
_________
A hearing on the continuation of this ORDER will be held at the District Court, __________ County, __________ Division, at (A.M.) (P.M.) on __________. If the defendant wishes to be heard, she/he will be heard at that time. If she/he does not appear at that time, this ORDER shall remain in effect.
This ORDER is effective forthwith, and will remain in effect until the time and date of the above-mentioned hearing.
A copy of this ORDER shall be transmitted to the appropriate local law enforcement agency forthwith, and shall be served in-hand on the defendant herein.
ENTERED as an Order of Court this ______ day of ________ A.D. 20____.
ENTER: __________ PER ORDER: __________
Judge __________Clerk __________
Presented by: Attorney for Plaintiff
WHITE COPY | ___ Court |
YELLOW COPY | ___ Plaintiff |
PINK COPY | ___ Defendant |
GOLDENROD COPY | ___ Police Department |
R.I. Gen. Laws § 8-8.1-6