TITLE 15
Domestic Relations
CHAPTER 15-15
Domestic Abuse Prevention
SECTION 15-15-6
§ 15-15-6 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 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 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, which I have left to avoid abuse, is
as follows (street address and city):
(3) The full name, present street address, city, and
telephone 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 one
another.
]]]]]] I am the defendant's (child) (parent).
]]]]]] I am the blood relative or relative by
marriage of the defendant; specifically, the defendant is my .
]]]]]] I and the defendant are together the legal
parents of one or more children.
(5) On or about ]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]], I suffered
abuse when the defendant:
]]]]]] Threatened or harmed me 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
]]]]]] The court award me temporary custody of the
following 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 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
the order is entered on the question of continuing the temporary order.
(7) I have not sought protection from abuse from any other
judge of the family court arising out of the facts or circumstances alleged in
this complaint.
(8) That the court award me support for my minor children as
required by law for a period not to exceed ninety (90) days.
(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. 20]]]]]]]].
Notary Public
Note: If this complaint is filed by an attorney, the
attorney'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 shall
suffice 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 TITLE
GENERAL LAWS OF RHODE ISLAND
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
.
]]]]]] That the plaintiff, being the
[husband] [wife] of the defendant, be and [s]he
hereby is awarded temporary custody of the minor child[ren], to wit,
.
]]]]]] That the defendant pay to the plaintiff the
support of the minor child(ren) the sum of $]]]]]] per ]]]]]].
]]]]]] That
A hearing on the continuation of this ORDER will be held at
the family court, ]]]]]]]]]]]]]]]]]]]] County, at ]]]]]]]]]] [A.M.]
[P.M.] on ]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]. If the defendant
wishes 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 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. 20].
History of Section.
(P.L. 1982, ch. 389, § 1; P.L. 1985, ch. 372, § 1; P.L. 1988, ch.
539, § 2; P.L. 1989, ch. 78, § 1; P.L. 1991, ch. 221, § 1; P.L.
1995, ch. 170, § 1.)
