§ 8-8.1-6 - Form of complaint.
SECTION 8-8.1-6
§ 8-8.1-6 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 DISTRICT COURT
COUNTY OF ]]]]]]]]]]]]]] ]]]]]]]] DIVISION
]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]] :
Plaintiff :
:
VS : NO:
:
]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]] :
Defendant :
COMPLAINT FOR PROTECTION FROM ABUSE
Pursuant to chapter 8.1 of title 8 I request that the courtenter an order protecting me from abuse.
(1) My full name, present street address, city and telephonenumber are as follows:
(2) My former residence, at which I resided with thedefendant, is as follows (street address and city):
(3) My former residence is a house
I own
Defendant owns
We jointly own
My former residence is an apartment
There is no lease
My name is on lease and defendant's is not
Defendant's name is on lease and mine is not
Both our names are on lease
(4) The full name, present street address, city and telephonenumber of the person causing me abuse (the defendant) are as follows:
(5) On or about ]]]]]]]]]]]], without cause or provocation Isuffered abuse when the defendant:
]]]]]]]] Threatened or harmed with a weapon:
(type of weapon used: ]]]]]]]]]]]]]])
]]]]]]]] 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 be restrained andenjoined from contacting, assaulting, molesting or otherwise interfering withthe plaintiff at home, on the street or elsewhere.
]]]]]]]] The court order the defendant to immediately leavethe household which is located at
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 aftersuch order is entered on the question of continuing such temporary order.
(7) I have not sought protection from abuse from any otherjudge of the district court arising out of the same facts or circumstancesalleged in this complaint.
]]]]]]]]]]]]]]]]]]]]
(Signature) (Date)
Subscribed and sworn to before me in ]]]]]]]]]]]]]] in theCounty of ]]]]]]]]]]]]]] in the state of Rhode Island and ProvidencePlantations, this ]]]]]]]] day of ]]]]]]]]]]]] A.D. 19]]]].
]]]]]]]]]]]]]]]]]]]]]]]]]]]]
Notary Public
Note: If this complaint is filed by an attorney, theattorney's certificate should appear below:
ATTORNEY CERTIFICATE
Signed: ]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]
Attorney for Plaintiff
Address: ]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]
]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]
Date: ]]]]]]]]]]]]]]]]]]]]]]]]]]]]]], 19]]]]
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 DISTRICT COURT
COUNTY OF ]]]]]]]]]]]]] ]]]]]]]] DIVISION
]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]] :
Plaintiff :
:
VS : NO:
:
]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]] :
Defendant :
(TEMPORARY) ORDER PURSUANT TO CHAPTER ]]]]]]]] OF THEG.L. OF R.I.
Upon consideration of plaintiff 's complaint, (andhaving found that immediate and irreparable injury, loss or damage will resultto the plaintiff before a notice can be served and a hearing had thereon) it isORDERED:
]]]]]]]] That the defendant is restrained and enjoined fromcontacting, assaulting, molesting, or otherwise interfering with plaintiff athome, on the street or elsewhere.
]]]]]]]] That the defendant vacate forthwith the householdlocated at
A hearing on the continuation of this ORDER will be held atthe District Court, ]]]]]]]]]]]] County, ]]]]]]]]]]]] Division, at (A.M.)(P.M.) on ]]]]]]]]]]]]. If the defendant wishes to be heard, she/he will beheard at that time. If she/he does not appear at that time, this ORDER shallremain 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. 19]]]].
ENTER: ]]]]]]]]]]]]]]]]]] PER ORDER:
Judge ]]]]]]]]]]]]]]]]]] Clerk ]]]]]]]]]]]]]]]]]]
Presented by:
Attorney for Plaintiff
WHITE COPY ]]]] Court
YELLOW COPY]]]] Plaintiff
PINK COPY ]]]] Defendant
GOLDENROD COPY ]]]] Police Department