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Your Full Legal Name:

I am the:  petitionerother

Petitioner’s full legal name (only if you aren’t the petitioner):

Respondent’s full legal name:

Other Party or his/her attorney Information:
Name of the person served: (The other party or attorney)

Address:
City, State, Zip:
Phone:

Fax:

IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR Select your countyAlachuaBakerBayBradfordBrevardBrowardCalhounCharlotteCitrusClayCollierColumbiaDeSotoDixieDuvalEscambiaFlaglerFranklinGadsdenGilchristGladesGulfHamiltonHardeeHendryHernandoHighlandsHillsboroughHolmesIndian RiverJacksonJeffersonLafayetteLakeLeeLeonLevyLibertyMadisonManateeMarionMartinMiami-DadeMonroeNassauOkaloosaOkeechobeeOrangeOsceolaPalm BeachPascoPinellasPolkPutnamSanta RosaSarasotaSeminoleSt. JohnsSt. LucieSumterSuwanneeTaylorUnionVolusiaWakullaWaltonWashington  COUNTY, FLORIDA

Case No:
(From the original injunction)
Division:
(From the original injunction)

Petitioner,
and
Respondent.

PETITION BY AFFIDAVIT FOR ORDER TO SHOW CAUSE FOR A VIOLATION OF
FINAL JUDGMENT OF INJUNCTION FOR PROTECTION AGAINST {Choose one only}

I, , being sworn, certify that I have actual knowledge of the following facts as set forth and the following statements are true:

1.The Court previously issued a
in this case on {date}

2. The Final Judgment of Injunction for Protection was served on Respondent on

Statements about the Violation

3. On {date}
, at {place and address}

,
the following event(s) took place:

{For cyberstalking, please include a description of all evidence of contacts and/or threats made by Respondent in voice messages, texts, emails, or other electronic communication}

Check here if you are attaching additional pages to continue these facts.

4. Respondent has willfully violated the Injunction by (explain what Respondent did that violated the Order of Protection.)


Check here if you are attaching additional pages to continue these facts.

5. Check here if you are attaching copies of medical records for treatment you may have received for injuries referred to in your affidavit, or copies of any police or sheriff reports concerning incidents of violence involving you and Respondent.

6. Respondent acted to impair, interfere with, delay, hinder, lessen the authority of, dignity of, and embarrass the cause of justice in a manner contemptuous of this court.

WHEREFORE, I respectfully request that the Court issue an Order to Show Cause, requiring Respondent to appear before the Court to show cause why Respondent should not be held in contempt of court for failure to abide by the terms and conditions of the Final Judgment of Injunction for Protection.

I understand that by filing this affidavit, I am asking the court to hold a hearing, that both Respondent and I will be notified of the hearing, and that I must appear at the hearing. In addition to my own testimony, I understand that I can bring other proof of the violation such as, for example, people who saw Respondent violate the order, pictures, medical records, police reports, or anything that might help show the judge how Respondent violated the Final Judgment of Injunction for Protection.

I have read every statement made in this affidavit and each statement is true and correct. I understand that the statements made in this affidavit are being made under penalty of perjury, punishable as provided in Section 837.02, Florida Statutes and that the punishment for knowingly making a false statement includes fines and/or imprisonment.

Dated:
01-01-16

I certify that a copy of this document was [check one only]

on{date}