TITLE 8
Courts and Civil ProcedureCourts
CHAPTER 8-8.1
Domestic Assault
SECTION 8-8.1-6
§ 8-8.1-6 Form of complaint.
(a) A form in substantially the following language shall suffice for the
purpose 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 court
enter an order protecting me from abuse.
(1) My full name, present street address, city and telephone
number are as follows:
(2) My former residence, at which I resided with the
defendant, 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 telephone
number of the person causing me abuse (the defendant) are as follows:
(5) On or about ]]]]]]]]]]]], without cause or provocation I
suffered 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 sexual
relations by
force, threat of force, or duress
specifically, the defendant:
(6) I ask that:
]]]]]]]] The court order that the defendant be restrained and
enjoined from contacting, assaulting, molesting or otherwise interfering with
the plaintiff at home, on the street or elsewhere.
]]]]]]]] The court order the defendant to immediately leave
the household which is located at
I request that the above relief be ordered without notice
because it clearly appears from specific facts shown by affidavit or by the
verified complaint that I will suffer immediate and irreparable injury, loss,
or damage before notice can be served and a hearing had thereon. I understand
that the court will schedule a hearing no later than twenty-one (21) days after
such order is entered on the question of continuing such temporary order.
(7) I have not sought protection from abuse from any other
judge of the district court arising out of the same facts or circumstances
alleged in this complaint.
]]]]]]]]]]]]]]]]]]]]
(Signature) (Date)
Subscribed and sworn to before me in ]]]]]]]]]]]]]] in the
County of ]]]]]]]]]]]]]] in the state of Rhode Island and Providence
Plantations, this ]]]]]]]] day of ]]]]]]]]]]]] A.D. 19]]]].
]]]]]]]]]]]]]]]]]]]]]]]]]]]]
Notary Public
Note: If this complaint is filed by an attorney, the
attorney'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 shall
suffice 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 THE
G.L. OF R.I.
Upon consideration of plaintiff 's complaint, (and
having found that immediate and irreparable injury, loss or damage will result
to the plaintiff before a notice can be served and a hearing had thereon) it is
ORDERED:
]]]]]]]] That the defendant is restrained and enjoined from
contacting, assaulting, molesting, or otherwise interfering with plaintiff at
home, on the street or elsewhere.
]]]]]]]] That the defendant vacate forthwith the household
located at
A hearing on the continuation of this ORDER will be held at
the District Court, ]]]]]]]]]]]] County, ]]]]]]]]]]]] Division, at (A.M.)
(P.M.) on ]]]]]]]]]]]]. If the defendant wishes to be heard, she/he will be
heard at that time. If she/he does not appear at that time, this ORDER shall
remain in effect.
This ORDER is effective forthwith, and will remain in effect
until the time and date of the above-mentioned hearing.
A copy of this ORDER shall be transmitted to the appropriate
local law enforcement agency forthwith, and shall be served in-hand on the
defendant 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
History of Section.
(P.L. 1985, ch. 492, § 2; P.L. 1988, ch. 539, § 4; P.L. 1989, ch. 78,
§ 2; P.L. 1995, ch. 145, § 1.)
