Personal Protection Order Against Stalking (Non-Domestic) (Ex Parte) {CC 380}

Approved, SCAO Original - Court 1st copy - Law enforcement agency (file) (green) 2nd copy - Respondent (blue) 3rd copy - Petitioner (pink) 4th copy - Return (yellow) 5th copy - Return (goldenrod) STATE OF MICHIGAN JUDICIAL CIRCUIT COUNTY Court address ORI MIPetitioner's name CASE NO. PERSONAL PROTECTION ORDER (NONDOMESTIC) EX PARTE Court telephone no. A Respondent's name, address, and telephone no. Address and telephone no. where court can reach petitioner v Address and telephone no. where court can reach respondent B Full name of respondent (type or print) * Height Weight Race * Sex * Date of birth or age* Hair color Eye color Driver's license number (if known) Other identifying information *These items must be filled in for the police/sheriff to enter on LEIN; the other items are not required but are helpful. Date: 1. This order is entered Judge: without a hearing. after hearing. Bar no. THE COURT FINDS: 2. A petition requesting an order to restrain conduct prohibited under MCL 750.411h and MCL 750.411i and/or MCL 750.411s has been filed under the authority of MCL 600.2950a. 3. Petitioner requested an ex parte order, which should be entered without notice because irreparable injury, loss, or damage will result from delay required to give notice or notice itself will precipitate adverse action before an order can be issued. 4. Respondent committed the following acts of willful, unconsented contact: (State the reasons for issuance.) IT IS ORDERED: 5. Full name of respondent is prohibited from a. stalking as defined under MCL 750.411h and MCL 750.411i, which includes but is not limited to following or appearing within sight of the petitioner. appearing at the workplace or the residence of the petitioner. approaching or confronting the petitioner in a public place or on private property. entering onto or remaining on property owned, leased, or occupied by the petitioner. sending mail or other communications to the petitioner. contacting the petitioner by telephone. placing an object on or delivering an object to property owned, leased, or occupied by the petitioner. threatening to kill or physically injure the petitioner. purchasing or possessing a firearm. other: b. posting a message through the use of any medium of communication, including the Internet or a computer or any electronic medium, pursuant to MCL 750.411s. 6. Violation of this order subjects the respondent to immediate arrest and to the civil and criminal contempt powers of the court. If found guilty, respondent shall be imprisoned for not more than 93 days and may be fined not more than $500.00. 7. This order is effective when signed, enforceable immediately, and remains in effect until . This order is enforceable anywhere in this state by any law enforcement agency when signed by a judge, and upon service, may also be enforced by another state, an Indian tribe, or a territory of the United States. If respondent violates this order in a jurisdiction other than this state, respondent is subject to enforcement and penalties of the state, Indian tribe, or United States territory under whose jurisdiction the violation occurred. 8. The court clerk shall file this order with who will enter it into the LEIN. 9. Respondent may file a motion to modify or terminate this order. For ex parte orders, the motion must be filed within 14 days after being served with or receiving actual notice of the order. Forms and instructions are available from the clerk of court. 10. A motion to extend the order must be filed 3 days before the expiration date in item 7, or a new petition must be filed. Date and time issued CC 380 (3/12) PERSONAL Judge PROTECTION ORDER (NONDOMESTIC) MCL 600.2950a, MCR 3.705, MCR 3.706 American LegalNet, Inc. www.FormsWorkFlow.com PROOF OF SERVICE Personal Protection Order (Nondomestic) Case No. TO PROCESS SERVER: You must serve the personal protection order and file proof of service with the court clerk. If you are unable to complete service, you must return this original and all copies to the court clerk. CERTIFICATE / AFFIDAVIT OF SERVICE / NONSERVICE OR OFFICER CERTIFICATE I certify that I am a sheriff, deputy sheriff, bailiff, appointed court officer, or attorney for a party (MCR 2.104[A][2]), and that: (notarization not required) AFFIDAVIT OF PROCESS SERVER Being first duly sworn, I state that I am a legally competent adult who is not a party or an officer of a corporate party, and that: (notarization required) I served a copy of the personal protection order by personal service on: registered mail, delivery restricted to the respondent (return receipt attached) on: Name of respondent Complete address of service Day, date, time Law enforcement agency Complete address of service Day, date, time I have personally attempted to serve a copy of the personal protection order on the following respondent and have been unable to complete service. Respondent's name Complete address of service I declare that the statements above are true to the best of my information, knowledge, and belief. Service fee Miles traveled Fee Signature TOTAL FEE Name (type or print) Title $ Incorrect address fee $ Miles traveled Fee $ $ $ Subscribed and sworn to before me on My commission expires: Date Date , Signature: Deputy court clerk/Notary public County, Michigan. Notary public, State of Michigan, County of ACKNOWLEDGMENT OF SERVICE I acknowledge that I have received a copy of the personal protection order on Day, date, time . Signature of respondent MCR 2.105(A) American LegalNet, Inc. www.FormsWorkFlow.com Form CC 380 PERSONAL PROTECTION ORDER (NONDOMESTIC) Use this form if you filled out form CC 377, Petition for Personal Protection Order (Nondomestic). American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTIONS FOR COMPLETING "PERSONAL PROTECTION ORDER (NONDOMESTIC)" Please print neatly. Items A and B must be completed before you give this form to the court clerk. Please read the instruction for each item. Then fill in the correct information for that item on the form. A Fill in the "petitioner" and "respondent" the same way you did on form CC 377. If you want your address and telephone number to be kept from the respondent, do not write your address here. Put in the address of a relative or friend or a post office box where the court can contact you. Write in the respondent's name and as much of the other information as you know. This information will help the police identify the respondent if he or she disobeys the restrainin