Permanent Order Of Protection {UJS-120F}

STATE OF SOUTH DAKOTA COUNTY OF ______________ ) ) ) IN ____________ COURT _________ JUDICIAL CIRCUIT VULNERABLE ADULT ABUSE EX PARTE TEMPORARY PERMANENT MODIFICATION ORDER FOR PROTECTION TPO NO. _____________________ PETITIONER IDENTIFIERS: PETITIONER First Middle Last Date of Birth of Petitioner Substitute Petitioner's Relationship to Petitioner: By Substitute Petitioner (name and DOB): _____________________________________________ On behalf of the Vulnerable Adult Petitioner. V. RESPONDENT First Middle Last __________________________________________ __________________________________________ RESPONDENT IDENTIFIERS: RACE H HEIGHT WEIGHT HAIR DATE OF BIRTH STATE EXPDATE SEX EYES Relationship to Petitioner: _____________________________________________ _____________________________________________ Respondent's Address: _____________________________________________ _____________________________________________ _____________________________________________ CAUTION: Weapon Involved DRIVERS LICENSE # Distinguishing Features: _____________________________________________ _____________________________________________ THE COURT FINDS: That it has jurisdiction over the parties and subject matter, and the Respondent has been provided with reasonable notice and opportunity to be heard, and that in the case of an ex parte order, the Respondent will be provided with reasonable notice and opportunity to be heard sufficient to protect the Respondent's due process rights. That the Respondent is restrained from acts of physical abuse, emotional and psychological abuse, neglect, and financial exploitation of a vulnerable adult. That the Respondent is restrained from contact with the Petitioner by any direct or indirect means except as authorized in this Order. Additional findings and orders are on the following pages. This Order shall be effective Month/Day Year , through Month/Day Year THE COURT ORDERS: Only this Court can change this Order. WARNING TO RESPONDENT: This Order shall be enforced, even without registration, by courts of any state, the District of Columbia, any U.S. Territory, and may be enforced by Tribal Lands (18 U.S.C.§2265). Crossing state, territorial, or tribal boundaries to violate this Order may result in federal imprisonment (18 U.S.C. §2262). Page 1 of 3 UJS-120F (Vulnerable Adult) Permanent Protection Order Rev. 6/16 American LegalNet, Inc. www.FormsWorkFlow.com ADDITIONAL FINDINGS: This matter came before this Court on this day and the following parties appeared personally: Petitioner Petitioner's Attorney ______________________ Other ____________________ Substitute Petitioner S. Petitioner's Attorney ___________ Other_____________________ Respondent Respondent's Attorney ___________________ Other ____________________ 1) This Court FINDS that, without admitting to the allegations in the Petition, the Respondent waives further hearing, findings of fact, and conclusions of law, and stipulates to the entry of an Order of Protection on the terms specified below. 2) Having considered the evidence presented and any affidavits and pleadings on file, this Court FINDS: A. That jurisdiction and venue are properly before this Court; B. That the above-named Petitioner is eligible for a protection order pursuant to SDCL ch. 21-65; C. By a preponderance of the evidence that "vulnerable adult abuse" as defined by SDCL 21-651(4), has occurred; and D. That the Respondent had actual notice of the hearing and an opportunity to participate. ADDITIONAL ORDERS: 1) The Respondent is excluded from the Petitioner's residence listed in 2B. 2) The Respondent shall not come within a distance of ___________ from the following persons and places: A. The Petitioner personally B. The Petitioner's residence (street/apt)_______________________________________________ (city)_______________________________, (state) _______ (zip) _________-_______ C. The Petitioner's place of employment (street)________________________________________ (city)_______________________________, (state) _______ (zip) __________- _______ D. Other places (street/apt) (city) , (state)_______ (zip) (street/apt) (city) , (state)_______ (zip) (street/apt) (city) , (state)_______ (zip) This distance restriction applies unless otherwise specified in this Order. 3) The Respondent is restrained from exercising any powers on behalf of the Petitioner through a courtappointed guardian, conservator, or guardian ad litem, an attorney in fact, or another third party. 4) This Court FINDS that Respondent has financially exploited the Petitioner pursuant to SDCL 21-65-1(7) and 21-65-12 and ORDERS: A. The Respondent is restrained from exercising control over the funds, benefits, property, resources, belongings, or assets of the Petitioner, except as otherwise provided for in this Order. B. The Respondent shall return custody or control of the funds, benefits, property, resources, belongings, or assets: To the Petitioner. To the Petitioner's guardian / conservator / attorney in fact, namely ____________________. (circle) C. The Respondent shall follow the instructions of the guardian, conservator, or attorney in fact of the Petitioner, namely _____________________________. D. The Respondent is prohibited from transferring any funds, benefits, property, resources, belongings, or assets of the Petitioner to any person other than the Petitioner, except as otherwise provided in this Order. Page 2 of 3 UJS-120F (Vulnerable Adult) Permanent Protection Order Rev. 6/16 American LegalNet, Inc. www.FormsWorkFlow.com 5) Phone calls, emails, third party contact, including correspondence direct or indirect, are not permitted, to Petitioner, except as follows: ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ 6) Other relief as follows:_________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ WARNING TO RESPONDENT: You may be held in contempt for violating this Protection Order even if any person protected by the Orde