TO THE RESPONDENT VIOLATION OF THIS RESTRAINING ORDER MAY

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TO THE RESPONDENT VIOLATION OF THIS RESTRAINING ORDER MAY Powered By Docstoc
					                        IN THE CIRCUIT COURT OF THE STATE OF OREGON

                                      FOR THE COUNTY OF LINN


                                                     )   CASE NO :__________________________
                                                     )
 _____________________________________
                                                     )   RESTRAINING ORDER TO PREVENT
 ” Petitioner (your nam e) ” Gua rdian Petitioner,
                                                     )   AUBSE
                                                     )
 vs.
                                                     )   [Elderly Persons and Person s with
                                                     )   Disabilities Abus e Prevention A ct]
 _____________________________________
                                                     )
 Respondent (person to be restrained)
                                                     )


TO THE RESPONDENT: VIOLATION OF THIS RESTRAINING ORDER MAY RESULT
IN YOUR ARREST AND IN CIVIL AND/OR CRIMINAL PENALTIES. REVIEW THIS
ORDER CAREFULLY. EACH PROVISION MUST BE OBEYED. SEE YOUR RIGHTS
TO A HEARING.

The court, having reviewed the petition, makes the following findings:
JUDGE’S INITIALS

[____]Petitioner or _________________________ has been abused by respondent as
defined by ORS 124.005;

[____]The abuse of petitioner or ______________________ by respondent occurred
within the last 180 days as provided in ORS 124.010;

[____]There is an immediate and present danger of further abuse to petitioner or
_______________________________________________                                  .

IT IS HEREBY ORDERED that:

Petitioner’s/Guardian Petitioner’s Request                                      JUDGE’S INITIALS

G 1. Respondent is restrained from mailing the petitioner or ____________________
(name of protected person) any sweepstakes promotions, effective on a date not less
than 150 days from the date of this
Order......................................................................................... [______]

Petitioner’s/Guardian Petitioner’s Request                                      JUDGE’S INITIALS

G 2. Respondent shall remove the petitioner or ______________________________
from the respondent’s sweepstakes promotion mailing list or shall place the petitioner or

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_________________________, on the respondent’s list of persons to whom
sweepstakes
promotions may not be
mailed.................................................................................................................. [______]

G3.Respondent shall refund promptly any payment received in any form from the
petitioner or _____________________________ after the date this Order is entered
by the court.......................................................................................................... [______]

G 4. Other relief:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________...[______]
G 5.No further service is necessary because respondent appeared in person before the
court.
IT IS FURTHER ORDERED that:

SECURITY AMOUNT FOR VIOLATION OF ANY PROVISION OF THIS ORDER IS
$5,000 unless otherwise specified. ” Other Amount ($     )

THE ABOVE PROVISIONS OF THIS RESTRAINING ORDER ARE IN EFFECT FOR A
PERIOD OF ONE YEAR OR UNTIL THE ORDER IS AMENDED OR DISMISSED,
WHICHEVER OCCURS FIRST.

IT IS HEREBY ORDERED that:
G The Petition for Restraining Order to Prevent Abuse of Elderly Person or Person
With Disabilities is dismissed.


         DATED this __________ day of ____________________, 20____.

                                                                     ________________________________
                                                                     JUDGE (Signature)

                                                                     ________________________________
                                                                     Print, Type or Stamp Name of Judge




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