Certificate For Registration Of Out-Of-State Order {B-26}

1 2 3 4 5 6 7 8 9 10 11 Case No. _____________________ Dept. No._____________________ IN THE JUSTICE COURT OF _____________ TOWNSHIP COUNTY OF __________________, STATE OF NEVADA _____________________________________, ) Employer,) ) ) ) vs. ) _____________________________________, ) Adverse Party.) CERTIFICATE FOR REGISTRATION OF OUT-OF-STATE ORDER RE: WORKPLACE HARASSMENT (NRS 33.310) According to NRS 33.310, an employer or an authorized agent of an employer may 12 13 14 15 16 17 18 19 20 21 22 23 24 25 register a Temporary or Extended Order for Protection Against Harassment in the Workplace issued by the court of another state by presenting a certified copy of the Order to the Clerk of the Court in a judicial district in which the employer believes that enforcement may be necessary. A Temporary or Extended Order for Protection Against Harassment in the Workplace that is registered has the same effect and must be enforced in like manner as such an Order issued by a Court of this State. On _________________, 20____, this Court received a copy of an Order for Protection Against Harassment in the Workplace from the _____________ Court in the State of _______________, Case Number _______________. This paperwork was submitted by: NAME OF EMPLOYER OR AUTHORIZED AGENT: _________________________________________________ Form B-26 Certificate for Registration of Out-of-State Order Page 1 of 2 ©2007 Nevada Supreme Court June 30, 2007 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 The out-of-state order: Indicates an expiration date of ___________________. Does not indicate any expiration date. The out-of-state Order was registered with this Court on the following date: ___________________________________________________________________________ All pertinent documentation, including this Certificate and the out-of-state Order, was forwarded to the following law enforcement agencies, on the following dates: LAW ENFORCEMENT AGENCIES: ___________________________________ ___________________________________ ___________________________________ ___________________________________ DATE OF NOTIFICATION: _________________________________ _________________________________ _________________________________ _________________________________ The Clerk of this Court will maintain a record of each order registered pursuant to NRS 33.310. DATE OF THIS CERTIFICATE:_________________________________________ DEPUTY CLERK SIGNATURE: _________________________________________ Form B-26 Certificate for Registration of Out-of-State Order Page 2 of 2 ©2007 Nevada Supreme Court June 30, 2007