Order To Modify Prior Protective Order

ORI ___________________ THE SUPERIOR COURT FOR THE COUNTY OF________________ STATE OF GEORGIA ________________, ] ] Petitioner, ] Civil Action File v. ] ] _________________, ] No._____________________ ] Respondent. ] ORDER TO MODIFY PRIOR PR OTECTIVE ORD ER IT IS HEREBY ORDERED, ADJUDGED and DECREED that the prior Family Violence Protective Order issued _______________________, 20____ is modified as follows: ______________________________________________________________________________ ______________________________________________________________________________ _________________________________________________________________________ the remaining parts of the Protective Order issued ____________________, 20_____ remains unmodified and in full effect. This _______ day of _______________, 20___. ___________________________ JUDGE, SUPERIOR COURT __________________ County ___________________________ Print or stamp Judges name TRANSMITTED TO GEORGIA PROTECTIVE ORDER REGISTRY DATE _______ CLERK _______ Revd 1/10/03<<<<<<<<<********>>>>>>>>>>>>> 2 * REMOVE THIS PAGE FROM ORDER *Pursuant to O.C.G.A. Section 19-13-3, Petitioner assisted by: Name: _________________________Address: _______________________ _______________________Telephone: _____________________