Professional Documents
Culture Documents
______________________________,
Respondent.
x--------------------------------------------------------x
PETITION
WITH PRAYER FOR THE ISSUANCE OF A TEMPORARY
PROTECTION ORDER
1. PETITIONER,
7. Parties may be served with summonses and other court processes of the
Honorable Court at their indicated addresses.
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ANTECEDENT FACTS
WHICH LED TO THE FILINNG OF THE PETITION
8. The MOST RECENT EVENT that caused the offended party to fear
immediate and imminent danger of violence against women and their
children is:
10. The offended party a minor child has neither property nor
income with which to support
to pay attorney’s fees and their expenses incurred in bringing the above-
entitled action. Petitioner is, therefore, requesting the court to appoint
counsel to assist him / her in prosecuting the case on behalf of the
offended party.
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paying attorney’s fees and the expenses incurred in bringing the above-
entitled action.
12. The aforesaid acts of violence have caused the offended party great
physical and mental pain, suffering and anguish have seriously impaired
her / his physical and mental health and development.
PRAYER
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(Use additional page if necessary; indicate at the top of page “Prayer-
Protected Designated Family and Household Members, “Petition with
Prayer for TPO)
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(2) After hearing, judgment be rendered in the offended party’s
favor by making permanent the Temporary Protection Order prayed for.
Other reliefs just and equitable in the premises are prayed for.
______________________, ___________.
_________________________
(Petitioner)
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VERIFICATION
AND
CERTIFICATION OF NON-FORUM SHOPPING
I, ___________________________________________, Filipino, of
legal age, and residing at ____________________________________, after
having been duly sworn in accordance with law, depose and state that:
________________________
(date)
_________________________
Affiant
_________________________
Administering Officer
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REPUBLIC OF THE PHILIPPINES)
______________________________) S.S.
______________________________)
AFFIDAVIT OF INDIGENCY
2. I filled up the foregoing petition with the assistance of the Clerk of Court;
_________________________
Affiant
_________________________
Administering Office