Alabama Form C 2 – Fill Out and Use This PDF

State of Alabama	Case Number
Unified Judicial System

	Form C-2 (Page 1 of 5)	PETITION FOR PROTECTION FROM ABUSE
	Rev. 12/10
	IN THE CIRCUIT	COURT OF_______________________________COUNTY, ALABAMA
		(Name of County)
	___________________________________________________V. ______________________________________________________________
	Plaintiff (person to be protected)		Defendant (person to be restrained)
	____________________________________________________		______________________________________________________
	Plaintiff's Date of Birth		Defendant's Address (Business or Home)
	Ala. Code 1975, Section 30-5-5(e)(1) provides “ [t] he		______________________________________________________
	following information shall not be contained on any court		City	State	Zip Code
	document made available to the public and the defendant by
	the circuit clerk’s office: The plaintiff’s home address and, if		______________________________________________________
	applicable, business address; a plaintiff’s home telephone			Defendant's Date of Birth
	number and, if applicable, business telephone number; the
	home or business address or telephone number of any member		_____________________________________________________
	of the plaintiff’s family or household; or an address that would
	reveal the confidential location of a shelter for victims of			Defendant's Social Security Number
	domestic violence as defined in Section 30-6-1.”

YOU MUST PROVIDE COMPLETE AND TRUTHFUL INFORMATION. IF YOU DO NOT, THE COURT MAY DISMISS THIS CASE, AND YOU MAY BE SUBJECT TO BEING CHARGED WITH PERJURY FOR KNOWINGLY PROVIDING FALSE INFORMATION.

I. ELIGIBLE PLAINTIFFS: CHECK ALL THAT APPLY

(Note: The word, “Plaintiff,” is used throughout to describe you and/or the person(s) for whom you are applying):

I am 18 years of age or older seeking protection from domestic

violence for

myself;

I am

a parent;

a legal guardian;

a legal custodian; or

the State Department of Human Resources seeking this petition for protection

from

domestic violence on behalf of

the Plaintiff who is:

a minor, or

any person prevented by physical or mental incapacity from

seeking a protection order.

.

I am under 18 years of age and am

married; or

emancipated, and seeking protection from domestic violence for myself.

CHECK AND FILL OUT ONLY ONE SECTION (1,2,3,4 OR 5):

1. The Defendant is the Plaintiff’s

spouse;

or

former spouse;

common-law marriage

Date of Marriage: ________________________________:

Date of Divorce (if applicable):_____________________________.

2. The Defendant is related to the Plaintiff by marriage.

3. The Defendant and the Plaintiff have a dating relationship* (A relationship means a recent frequent, intimate association, primarily characterized by the expectation of affectionate or sexual involvement within the last six months. A dating relationship does not

include a casual or business relationship).

4. The Defendant is a current or former household member* (A household member is a person maintaining or having maintained a living arrangement with the Defendant where he/she is in or was engaged in, a romantic or sexual relationship).

I state that the following is true and correct:

The Plaintiff is a resident of ______________________________in_______________________. The Plaintiff’s age is: __________ years old.

(Name of County)

(Name of State)

Is the Plaintiff involved in any other civil, domestic relations, child support, or juvenile case (for example, divorce, paternity or custody) with

If YES, please state the County and State in which the case was brought: _______________________________ County,

____________________________(State).

If YES, the charges were brought in __________________________________County, _________________________(State).

(Note: If there are more civil or other cases with the Defendant or more criminal charges against the Defendant, please attach additional 8” x11” sheets of paper, if necessary, stating the case number(s), County(ies), and States(s) in which these cases are being handled).

Original-Court Record

Copy-Law Enforcement

Copy-Plaintiff

Copy-Defendant

residence;

place of employment;

school; and/or the

(3) Order

the Defendant to stay away from: the Plaintiff’s

฀

฀

฀

school; and/or any other designated person’s to wit:___________________;

฀

฀

the

child(ren)’s:

residence;

place of employment;

฀

฀

residence;

฀

place of employment;

฀

school;

฀

any specified place, which the court determines the Defendant has no legitimate

the Plaintiff, and/or

child(ren); and/or

any designated person.

reason to frequent, as designated below, frequented by

฀

฀

฀

Name(s) and location(s) of the other specified places(s):

____________________________________________________________________________________________________________.

(4) Award temporary custody of the child(ren) to _______________________________________________________________________.

(Please specify the name of the person to whom custody should be given)

(5) Enjoin the Defendant from interfering with the Plaintiff’s efforts to remove any of the Plaintiff’s child(ren)

and direct the appropriate law enforcement officer to accompany the Plaintiff during the effort to remove any of the Plaintiff’s child(ren).

(6) Enjoin the Defendant from removing any child(ren) from _________________________________________

(the individual having legal custody of the child(ren), except as subsequently authorized by a custody or visitation order issued by a court of competent jurisdiction).

(7) Order possession and use of an ฀ automobile and/or ฀ other essential personal effects regardless of ownership, and direct the appropriate law enforcement officer to accompany the Plaintiff to the residence of the parties or to other specified locations as necessary to protect the Plaintiff or any children from abuse.

(8) Remove and exclude the Defendant from the residence of the Plaintiff, regardless of ownership of the residence.

VIII. Additional relief requested for final hearing:(permanent order)

In addition to the relief requested above in “VII. Ex Parte Relief Requested,” I request the following relief for myself and/or the person(s) for whom I am applying:

(11) Order the Defendant to comply with the following visitation arrangements of any child(ren):

฀Visitation; ฀ Deny visitation; ฀ Require supervision by a third party

(Please specify visitation arrangements of any children below giving primary consideration to the safety of the Plaintiff or any child(ren) or both).

(12) Order the Defendant to pay attorney’s fees and court costs.

(13) Grant possession of the residence or household to the Plaintiff to the exclusion of the Defendant by: ฀ evicting the defendant; ฀ restoring possessions to the Plaintiff; or ฀ both; or ฀ agreeing to allow the Defendant to provide suitable alternate housing.

(14) Order the Defendant to pay temporary reasonable child support for the Plaintiff and/or any child(ren) in the Plaintiff’s custody, or both, in accordance with the Child Support Guidelines. (If this relief is sought, you must Attach COMPLETED copies of Form CS-41, Child Support Obligation Income Statement/Affidavit, Form CS-42, Child Support Guidelines, and form CS-47, Child Support Information Sheet).

Original-Court Record

Copy-Law Enforcement

Copy-Plaintiff

Copy-Defendant

(15) Order the Defendant to provide temporary possession of the vehicle (description):

_____________________________________________________________________________________________________to the Plaintiff

because the Plaintiff has no other means of transportation of his or her own and the Defendant										has control of more than one vehicle:
or				has alternate means of transportation.
			(16) Incorporate another			custody order (Case Number, County, State: ________________________________); or visitation
order (Case Number, County, State:___________________________________;								support order (Case Number, County,
State: ____________________________________) into this Order.

(17) Order the Defendant to surrender all firearms.

(18) Direct the appropriate law enforcement office to accompany the Plaintiff to: the residence of the parties; and/or another location, ________________________________________________ (description of location), as necessary to enforce

any of the terms of this Order.

(19) Order other relief not requested above

(describe):_______________________________________________________________________________________________________

________________________________________________________________________________________________________________

Before me, the undersigned authority, personally appeared the Plaintiff, who is known to me or presented an identification card to me, and who being duly sworn, deposes and says that he/she has read the foregoing Petition for Protection from Abuse and that the facts herein are true and correct.

Sworn to and subscribed before this, the ___________________day of ________________________________, ____________.

_________________________________________________

Plaintiff (Please print)

_________________________________________________

Plaintiff (Signature)

_________________________________________________

Judge/Clerk of County/Notary Public

(Notary: my commission expires _______________).

________________________________________________

_______________________________________________

_______________________________________________

Business Address and Telephone Number of Judge/Clerk Of Court/Notary Public

NOTICE TO DEFENDANT

The Defendant is advised that (1) he or she has the right to counsel at his or her own expense at the final hearing on this Petition but not counsel appointed by the court; and (2) he or she has a right to request a final hearing prior to 10 days of perfection of Service of this Petition.

Original-Court Record

Copy- Law Enforcement

Copy-Plaintiff

Copy-Defendant