§ 15-15-6 Form of complaint. – (a) A form in substantially the following language shall suffice for thepurpose of filing a complaint under this chapter:
STATE OF RHODE ISLAND FAMILY COURT
COUNTY OF ]]]]]]]]]]]]]]]]]]]]]]]]
]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]] :
Plaintiff :
:
VS. : F.C. NO.
:
]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]] :
Defendant :
COMPLAINT FOR PROTECTION FROM ABUSE
Pursuant to Chapter 15 of this title, I request that thecourt enter an order protecting me from abuse.
(1) My full name, present street address, city, and telephonenumber are as follows:
(2) My former residence, which I have left to avoid abuse, isas follows (street address and city):
(3) The full name, present street address, city, andtelephone number of the person causing me abuse (the defendant) are as follows:
(4) My relationship to the defendant is as follows:
]]]]]] We (are) (were formerly) married to oneanother.
]]]]]] I am the defendant's (child) (parent).
]]]]]] I am the blood relative or relative bymarriage of the defendant; specifically, the defendant is my .
]]]]]] I and the defendant are together the legalparents of one or more children.
(5) On or about ]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]], I sufferedabuse when the defendant:
]]]]]] Threatened or harmed me with a weapon; (type of weaponused: ]]]]]]]]]]]]]]]])
]]]]]] Attempted to cause me physical harm;
]]]]]] Caused me physical harm;
]]]]]] Placed me in fear of imminent physical harm;
]]]]]] Caused me to engage involuntarily in sexualrelations by force, threat of force, or duress. Specifically, the defendant
(6) I ask that:
]]]]]] The court order that the defendant berestrained and enjoined from contacting, assaulting, molesting, or otherwiseinterfering with the plaintiff at home, on the street or elsewhere.
]]]]]] The court order the defendant toimmediately leave the household which is located at
]]]]]] The court award me temporary custody of thefollowing minor child(ren)(the defendant and I are husband and wife):
Names Date of Birth
That
I request that the above relief be ordered without noticebecause it clearly appears from specific facts shown by affidavit or by theverified complaint that I will suffer immediate and irreparable injury, loss,or damage before notice can be served and a hearing had thereon. I understandthat the court will schedule a hearing no later than twenty-one (21) days afterthe order is entered on the question of continuing the temporary order.
(7) I have not sought protection from abuse from any otherjudge of the family court arising out of the facts or circumstances alleged inthis complaint.
(8) That the court award me support for my minor children asrequired by law for a period not to exceed ninety (90) days.
(Signature) (Date)
Subscribed and sworn to before me in]]]]]]]]]]]]]]]]]]]]]]]]]]]] in the county of ]]]]]]]]]]]]]]]]]]]]]]]]]]]] inthe state of Rhode Island and Providence Plantations, this ]]]]]]]]]] day of]]]]]]]]]]]]]]]]]]]]]]]]]]]] A.D. 20]]]]]]]].
Notary Public
Note: If this complaint is filed by an attorney, theattorney's certificate should appear as below:
ATTORNEY CERTIFICATE
Signed:
Attorney for Plaintiff
Address:
Date: ]]]]]]]]]]]]]]]]]]]], 20]]]]]]
WHITE COPY – Court
YELLOW COPY – Plaintiff
PINK COPY – Defendant
GOLDENROD COPY – Police Department
(b) A form in substantially the following language shallsuffice for the purpose of requesting temporary orders under this chapter:
STATE OF RHODE ISLAND FAMILY COURT
COUNTY OF ]]]]]]]]]]]]]]]]]]]]]]]]
]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]] :
Plaintiff :
:
VS. : F.C. NO.
:
]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]] :
Defendant :
TEMPORARY ORDER PURSUANT TO CHAPTER 15 OF THIS TITLEGENERAL LAWS OF RHODE ISLAND
Upon consideration of plaintiff's complaint and having foundthat immediate and irreparable injury, loss, or damage will result to theplaintiff before a notice can be served and a hearing had thereon it is ORDERED:
]]]]]] That the defendant is restrained andenjoined from contacting, assaulting, molesting, or otherwise interfering withplaintiff at home, on the street, or elsewhere.
]]]]]] That the defendant vacate forthwith thehousehold located at
.
]]]]]] That the plaintiff, being the[husband] [wife] of the defendant, be and [s]hehereby is awarded temporary custody of the minor child[ren], to wit,
.
]]]]]] That the defendant pay to the plaintiff thesupport of the minor child(ren) the sum of $]]]]]] per ]]]]]].
]]]]]] That
A hearing on the continuation of this ORDER will be held atthe family court, ]]]]]]]]]]]]]]]]]]]] County, at ]]]]]]]]]] [A.M.][P.M.] on ]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]. If the defendantwishes to be heard, [s]he will be heard at that time. If[s]he does not appear at that time, this ORDER shall remain in effect.
This ORDER is effective forthwith, and will remain in effectuntil the time and date of the above-mentioned hearing.
A copy of this ORDER shall be transmitted to the appropriatelocal law enforcement agency forthwith, and shall be served in-hand on thedefendant herein.
ENTERED as an order of court this ]]]]]]]]]] day of]]]]]]]]]]]]]]]]]]]]]]]], A.D. 20].
§ 15-15-6 Form of complaint. – (a) A form in substantially the following language shall suffice for thepurpose of filing a complaint under this chapter:
STATE OF RHODE ISLAND FAMILY COURT
COUNTY OF ]]]]]]]]]]]]]]]]]]]]]]]]
]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]] :
Plaintiff :
:
VS. : F.C. NO.
:
]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]] :
Defendant :
COMPLAINT FOR PROTECTION FROM ABUSE
Pursuant to Chapter 15 of this title, I request that thecourt enter an order protecting me from abuse.
(1) My full name, present street address, city, and telephonenumber are as follows:
(2) My former residence, which I have left to avoid abuse, isas follows (street address and city):
(3) The full name, present street address, city, andtelephone number of the person causing me abuse (the defendant) are as follows:
(4) My relationship to the defendant is as follows:
]]]]]] We (are) (were formerly) married to oneanother.
]]]]]] I am the defendant's (child) (parent).
]]]]]] I am the blood relative or relative bymarriage of the defendant; specifically, the defendant is my .
]]]]]] I and the defendant are together the legalparents of one or more children.
(5) On or about ]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]], I sufferedabuse when the defendant:
]]]]]] Threatened or harmed me with a weapon; (type of weaponused: ]]]]]]]]]]]]]]]])
]]]]]] Attempted to cause me physical harm;
]]]]]] Caused me physical harm;
]]]]]] Placed me in fear of imminent physical harm;
]]]]]] Caused me to engage involuntarily in sexualrelations by force, threat of force, or duress. Specifically, the defendant
(6) I ask that:
]]]]]] The court order that the defendant berestrained and enjoined from contacting, assaulting, molesting, or otherwiseinterfering with the plaintiff at home, on the street or elsewhere.
]]]]]] The court order the defendant toimmediately leave the household which is located at
]]]]]] The court award me temporary custody of thefollowing minor child(ren)(the defendant and I are husband and wife):
Names Date of Birth
That
I request that the above relief be ordered without noticebecause it clearly appears from specific facts shown by affidavit or by theverified complaint that I will suffer immediate and irreparable injury, loss,or damage before notice can be served and a hearing had thereon. I understandthat the court will schedule a hearing no later than twenty-one (21) days afterthe order is entered on the question of continuing the temporary order.
(7) I have not sought protection from abuse from any otherjudge of the family court arising out of the facts or circumstances alleged inthis complaint.
(8) That the court award me support for my minor children asrequired by law for a period not to exceed ninety (90) days.
(Signature) (Date)
Subscribed and sworn to before me in]]]]]]]]]]]]]]]]]]]]]]]]]]]] in the county of ]]]]]]]]]]]]]]]]]]]]]]]]]]]] inthe state of Rhode Island and Providence Plantations, this ]]]]]]]]]] day of]]]]]]]]]]]]]]]]]]]]]]]]]]]] A.D. 20]]]]]]]].
Notary Public
Note: If this complaint is filed by an attorney, theattorney's certificate should appear as below:
ATTORNEY CERTIFICATE
Signed:
Attorney for Plaintiff
Address:
Date: ]]]]]]]]]]]]]]]]]]]], 20]]]]]]
WHITE COPY – Court
YELLOW COPY – Plaintiff
PINK COPY – Defendant
GOLDENROD COPY – Police Department
(b) A form in substantially the following language shallsuffice for the purpose of requesting temporary orders under this chapter:
STATE OF RHODE ISLAND FAMILY COURT
COUNTY OF ]]]]]]]]]]]]]]]]]]]]]]]]
]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]] :
Plaintiff :
:
VS. : F.C. NO.
:
]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]] :
Defendant :
TEMPORARY ORDER PURSUANT TO CHAPTER 15 OF THIS TITLEGENERAL LAWS OF RHODE ISLAND
Upon consideration of plaintiff's complaint and having foundthat immediate and irreparable injury, loss, or damage will result to theplaintiff before a notice can be served and a hearing had thereon it is ORDERED:
]]]]]] That the defendant is restrained andenjoined from contacting, assaulting, molesting, or otherwise interfering withplaintiff at home, on the street, or elsewhere.
]]]]]] That the defendant vacate forthwith thehousehold located at
.
]]]]]] That the plaintiff, being the[husband] [wife] of the defendant, be and [s]hehereby is awarded temporary custody of the minor child[ren], to wit,
.
]]]]]] That the defendant pay to the plaintiff thesupport of the minor child(ren) the sum of $]]]]]] per ]]]]]].
]]]]]] That
A hearing on the continuation of this ORDER will be held atthe family court, ]]]]]]]]]]]]]]]]]]]] County, at ]]]]]]]]]] [A.M.][P.M.] on ]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]. If the defendantwishes to be heard, [s]he will be heard at that time. If[s]he does not appear at that time, this ORDER shall remain in effect.
This ORDER is effective forthwith, and will remain in effectuntil the time and date of the above-mentioned hearing.
A copy of this ORDER shall be transmitted to the appropriatelocal law enforcement agency forthwith, and shall be served in-hand on thedefendant herein.
ENTERED as an order of court this ]]]]]]]]]] day of]]]]]]]]]]]]]]]]]]]]]]]], A.D. 20].
§ 15-15-6 Form of complaint. – (a) A form in substantially the following language shall suffice for thepurpose of filing a complaint under this chapter:
STATE OF RHODE ISLAND FAMILY COURT
COUNTY OF ]]]]]]]]]]]]]]]]]]]]]]]]
]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]] :
Plaintiff :
:
VS. : F.C. NO.
:
]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]] :
Defendant :
COMPLAINT FOR PROTECTION FROM ABUSE
Pursuant to Chapter 15 of this title, I request that thecourt enter an order protecting me from abuse.
(1) My full name, present street address, city, and telephonenumber are as follows:
(2) My former residence, which I have left to avoid abuse, isas follows (street address and city):
(3) The full name, present street address, city, andtelephone number of the person causing me abuse (the defendant) are as follows:
(4) My relationship to the defendant is as follows:
]]]]]] We (are) (were formerly) married to oneanother.
]]]]]] I am the defendant's (child) (parent).
]]]]]] I am the blood relative or relative bymarriage of the defendant; specifically, the defendant is my .
]]]]]] I and the defendant are together the legalparents of one or more children.
(5) On or about ]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]], I sufferedabuse when the defendant:
]]]]]] Threatened or harmed me with a weapon; (type of weaponused: ]]]]]]]]]]]]]]]])
]]]]]] Attempted to cause me physical harm;
]]]]]] Caused me physical harm;
]]]]]] Placed me in fear of imminent physical harm;
]]]]]] Caused me to engage involuntarily in sexualrelations by force, threat of force, or duress. Specifically, the defendant
(6) I ask that:
]]]]]] The court order that the defendant berestrained and enjoined from contacting, assaulting, molesting, or otherwiseinterfering with the plaintiff at home, on the street or elsewhere.
]]]]]] The court order the defendant toimmediately leave the household which is located at
]]]]]] The court award me temporary custody of thefollowing minor child(ren)(the defendant and I are husband and wife):
Names Date of Birth
That
I request that the above relief be ordered without noticebecause it clearly appears from specific facts shown by affidavit or by theverified complaint that I will suffer immediate and irreparable injury, loss,or damage before notice can be served and a hearing had thereon. I understandthat the court will schedule a hearing no later than twenty-one (21) days afterthe order is entered on the question of continuing the temporary order.
(7) I have not sought protection from abuse from any otherjudge of the family court arising out of the facts or circumstances alleged inthis complaint.
(8) That the court award me support for my minor children asrequired by law for a period not to exceed ninety (90) days.
(Signature) (Date)
Subscribed and sworn to before me in]]]]]]]]]]]]]]]]]]]]]]]]]]]] in the county of ]]]]]]]]]]]]]]]]]]]]]]]]]]]] inthe state of Rhode Island and Providence Plantations, this ]]]]]]]]]] day of]]]]]]]]]]]]]]]]]]]]]]]]]]]] A.D. 20]]]]]]]].
Notary Public
Note: If this complaint is filed by an attorney, theattorney's certificate should appear as below:
ATTORNEY CERTIFICATE
Signed:
Attorney for Plaintiff
Address:
Date: ]]]]]]]]]]]]]]]]]]]], 20]]]]]]
WHITE COPY – Court
YELLOW COPY – Plaintiff
PINK COPY – Defendant
GOLDENROD COPY – Police Department
(b) A form in substantially the following language shallsuffice for the purpose of requesting temporary orders under this chapter:
STATE OF RHODE ISLAND FAMILY COURT
COUNTY OF ]]]]]]]]]]]]]]]]]]]]]]]]
]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]] :
Plaintiff :
:
VS. : F.C. NO.
:
]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]] :
Defendant :
TEMPORARY ORDER PURSUANT TO CHAPTER 15 OF THIS TITLEGENERAL LAWS OF RHODE ISLAND
Upon consideration of plaintiff's complaint and having foundthat immediate and irreparable injury, loss, or damage will result to theplaintiff before a notice can be served and a hearing had thereon it is ORDERED:
]]]]]] That the defendant is restrained andenjoined from contacting, assaulting, molesting, or otherwise interfering withplaintiff at home, on the street, or elsewhere.
]]]]]] That the defendant vacate forthwith thehousehold located at
.
]]]]]] That the plaintiff, being the[husband] [wife] of the defendant, be and [s]hehereby is awarded temporary custody of the minor child[ren], to wit,
.
]]]]]] That the defendant pay to the plaintiff thesupport of the minor child(ren) the sum of $]]]]]] per ]]]]]].
]]]]]] That
A hearing on the continuation of this ORDER will be held atthe family court, ]]]]]]]]]]]]]]]]]]]] County, at ]]]]]]]]]] [A.M.][P.M.] on ]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]. If the defendantwishes to be heard, [s]he will be heard at that time. If[s]he does not appear at that time, this ORDER shall remain in effect.
This ORDER is effective forthwith, and will remain in effectuntil the time and date of the above-mentioned hearing.
A copy of this ORDER shall be transmitted to the appropriatelocal law enforcement agency forthwith, and shall be served in-hand on thedefendant herein.
ENTERED as an order of court this ]]]]]]]]]] day of]]]]]]]]]]]]]]]]]]]]]]]], A.D. 20].
