You are on page 1of 6
eit GOURT NaR Iss {x “YOU ANE ORDERED Ta TAY Away me 88 {he GousT OADERS Sprngfetd Dstt Court fe 22 Wendall Street 50 State Street Hye Apt. 348 ‘Springfield, MA 01103. =, Hempstead, N.) VIOLATION GF THIS ONDER IG A CREAREL G le Sal rece contact ~ 1 esa 9: Se char {eg ofimrriness sence peice har, ARE SAUER Seu ane ono: blow, fates a Piet may rsd. Tee Seccons & ant ever Sigs you may Reve reeson to know p sanege ay strate eft sp opiate opal provesdos, the Court slzo CADERS yeu fe ae 16 dueling ica ho Peres essence is ces ORKFLACE toomed « 20-YOU ARG ORE Sa. THE COURT ORD 5c, THE COURT ORDERS ther [Sanita 1 year old Ts RL (‘mam 3 years old |¢ fa 7. YOU ARE GRDEREE GT TO CORTAGT THE GHEORER| rey GSE ther in perso, by elephone, in wang, electronical 2 otis eilnr zesty or trough sum ‘hem unless you roslve writin permission rem fee Cout todo otros "You are ato otdared lo stay aovay ior the flowing schoo), day cate(e), oer: mena] a E me 2| | ‘ WSITATION WITH THE GHILOREN LISTED IN SECTION 6S PERLINTED 6 2 i : : 4 ‘Fits only alowed f supaniaed anc the presence of anspotlaon cf ehcren to and om ts veion ep bo Gone by > You may only codec he Pail arange tis valon, Conact may be ade {YOU ARE CRORREH TO PAY SUPPORT it THE FOLLCAING RAARNER: cl eupoat pee [waetdrnants by noone witielsng trough the Deparment evens, P.O Bor Bi, Bost MA COATS GIaS uch enedoyer deasions Dach. id ouppoe per frets deco Plt pot lrthe PG pee meV eck er PRE OE: ote Eo aca Yow + Sune cern ecesowe pu TEUSE PREVENREN ORE ooKETTO eo (Gc. 2888) Page 2 of 2 | 1223R0 1034 TRIAL COURT OF MASSACHUSETTS & 11 18.Potice reports are on eat he Police Depertmont (0 16, OUTSTANDING WARRANTS FOR THE DEFENDANT'S ARREST: {DOCKET #3}, (PCF #) we = 5 47, A meinen teat of body inj onset tho Plan, Notion eouod Department(s) by J telephone 1) other. B. MOTICE TO LAW ENFORCEMENT 1. An eporoprit law enforcement ocr shal erve upon the Defendantin hand a copy ofthe Con ‘Order (and Summons), and make retum of service to this Court. If this hox Is checked 1), bbe made, but only ifthe officer is unable to deliver such copies in hand to the Dafendlan: (5 2. Defendant injormation Form accompanies this Order © 3. Defendant has bean served in hand by the Court's designee: Neme Date DATEGFORDER [TwEOFORmER LIAM | EXPRATONOATEOFORSER SIGNATURE OF JUDGE WA 6/4/12 12:15 __Kilem | June 18, 2012 epg |PRIIPYPENAMEOF vr ~ “The above and any sabeequent Orders expla on he exciton dates indicated. Hearings | NEXT HEARWO DATE: on whee: to continue andor mocfy Orders will held on Gas ava as cea. faint and a certified coay of this the following altsmative eorvice may instoed CG MODGATIONERTENSION eee Tis order was issued ator ean at which the Pe] eppeared (1c not eppeer andthe Defendant 3 appeared les not appear. “The Courthas ORDERED tha he por oder issued 20___be MODIFIED aefotiows: {53 The expiration date ofthis order has been EXTENDED (See Bsiow) {_] OTHER MODIFICATIONS) ‘Gy irearm surrender order continued. The lene surendered under paragraph 1 wil NOT be reluraed sine doing so would present a Ikalhad of use t the Pint ‘DATE OF THis NODIGATION ‘BPIRATION ORTEOF GmDER ‘SIGNATURE OF JUDGE at4em,_|PRINTTYPE NAME OF JUDG TIE OF TAM. o occas Bem | NEXTHEARINGDATE: at AM, CIRM, Courtroom Ty D. MODIFICATION/EXTENSION G. This order was issued alter « hearing al which the Piainttt CI appeared 1) did not appear and the Defendant appeared CI did not appear ‘The Cow has ORDERED that he prior oderissued_, 20_be MODIFIED a¢ follows C1 The expiration date ofthis order has been EXTENDED (See Below) ] OTHER HODIFICATION(S) O) Firearra surrender ordor continued. The Roms currendered under pategraph 12 nil NOT be retuned since doing so would presente ikelinood of abuse % the Plait. DATE OF TiS HODTIOATION EHPRATION BATE OF GRBER 'SGNATURE OF JUDGE PRINT/IYPE NAVE OF JUDGE Tae OF MODIFICATION: Cl E. PRIOR COURT ORDER TERMINATED ‘This Cour’ prior Order i terminated. Law enlorooment agensoa chal destoy all records of such Ore: 0) TERMINATED AT PLAINTIFF'S REQUEST. SIGNATURE oF JuoG= [DATE OF ORDER PRINT/TYPE NAME OF JUDGE op. Courtroom )WiTNESS" FIRST On CHEF JUSTICE WILLIAM J. BOYLE Ainae copy, atone G se SRiieg oT ISOM oT }1223R0 1034 TRIAL COURT OF ARSSAC! CD erosare & easy couRT Gi supesion courr [ Speingfietd — ovsion Namie of Paint (person seeking protection) TER OGSGEN PS GESTED] | Goots Monee pe : el Bharkine Hrieh aur Bryan 7: OW Te Kiar BA a 18 ot le C tam under the age of 18, and HE ee has filed this complaint for me. ‘WL The Defendant is 18 or older. (relationship to Plaintf) The Defendant and Plaintifi: 1 are currently married to each other G were formerly martiod io each other C1 are not matriad but we are rekéted to each other by ‘blood or marriage: spectically, the Defendant is my ‘To my knowledge, the Defendant possesses the following ‘guns, ammunition, firearms identification card, andl: ioense weary: “eS. FID Dare not refated but live in the same household 1 were formerly members of the seme householc |S. are or wore in a dating or engagement relationship. are the parents of one or more chikiren ‘Are there any prior or pending court actions in any state or ountty involving the Plaintiff and the Defendant for divorce, annulment, separate support, legal separation or abuoa prevention? BANo 3 Yes Hf Yes, give Cour, iype of case, date, and (if available) docket no. Does the Plaintiff have any children under the age of 187, [OND Yes Ii Yes, the Plaintiff shall complete the appropriate parts of Page 2. . in fear of imminent serious physical hat 1 5. to order the Defendant to pay me & direct result of the abuse: ‘On oF about (dates) Fis {suffered abuse when the Defendant: 1] O attempted to cause me physical harm placed me in fear of imminent serious physica! harin i caused me physical harm D1 caused me to engage in sexual refetions by force, threat or duress | ‘THEREFORE, [ASK THE COURT: 1% 1. to order the Defendant to stop abusing me by harming, zhreatehing or attempting to harin me physically, or placing rhe ‘or by using foice, threat or duress to make me engage in sexual relations. 2. to ofder the Defendant not fo contac’ me, unless authorized to do so by the Court. IM 32, 10 order the Defendant to leave and remain away from my residence: See Piaintff Confidential Information Font. If this is an apartment building or other mitipie family dueling, check here C) 8b. to order the Defendant to leave and remain sway from my workplace: See Plainliff Confidential Information For. ‘80. to order the Defendant to leave and rernzin away from my school: See Plaintiff Confidential information Form. (2 4a.to order that my residential address fot appear on the order, 4b. to order that my workplace address not appear on the order. (2 4c. to order that my schoo! address not apear on the order. in compensation for the following losses suffered as & os support from the Probate and Family Cou.) to order the ralief requested on Page 2 ofthis Cor to order the fotiowing: to order the Defendant, who has a legel obligation to do 69, to pay temporary support to me. (Vou may not obiein a femporary Order from ¢ Boston Municipal, otrict or Super curt if there is « prior er pending Crder fer mplaint pertaining to my minor child or children, gon een to order the relief I have requested, except ior temporary suppor for me and/or my child(ren) and for compensation {or losses suffered, without advance notice to.the Defendant because there is a substantial fikefhood of immediate danger of abuse. | understand that if the Court issues such 2 temporary Orders, the Court will schedule a Rearing within 10 court business days to cetertnine whether such a temporary Order should be continued, and | must appear in Court on that day if| wish the Order to be continued. ANTES SSN pti XE Oe Pease complete affidavit on reverse of his pags) This is a request fora civil order fo protect he Plaintif Tom fulare abuse. The actions of the Dutendant may aso consti a cme siiject io criminal panatiee For lnlormation about ing a criminal complain, you can tlk with the District Attonay's Office forthe looation where the alleged abuse oscured.

You might also like