State of Alabama
Unified Judicial System
Part 1 of 3
Form C-2 Rev. 8/98
PETITION FOR PROTECTION FROM ABUSE Case Number
IN THE____________________________ COURT OF___________________________, ALABAMA
(Circuit or District) (Name of County)
_______________________________________V.__________________________________________
  Plaintiff(your name) Defendant (person to be restrained)
 
_________________________________
Address
_________________________________
CityStateZip Code
_________________________________
Date of Birth
_________________________________
Social Security Number
YOU MUST PROVIDE COMPLETE AND TRUTHFUL INFORMATION. IF YOU DO NOT, THE COURT MAY DISMISS ANY RESTRAINING ORDER AND MAY ALSO FIND YOU IN CONTEMPT OF COURT, WHICH IS PUNISHABLE BY A FINE AND/OR IMPRISONMENT.

I. Eligible Plaintiffs: (choose from A. or B.)

A. I am an adult seeking relief for  myself and/or  my minor child(ren) and/or  another person prevented by physical or mental incapacities from seeking a protection order.

CHECK AND FILL OUT ONLY ONE SECTION (a, b, c, d, or e):
 a. Defendant is my  spouse or  former spouse. Date of marriage___________________________________________.

        Date of Divorce (if applicable):_____________________________________________________________________.
 b. Defendant and I are adults related by blood, marriage, or adoption. What relation is the defendant to you?
        ______________________________________________.
 c. Defendant and I are common-law married and have been living together since_______________________________.
  (date)
 d. Defendant and I are  currently living in same household or are  former household members.
 e. Defendant and I are the unmarried parents of a child;

        OR
B. I am an adult relative, household member, guardian, or custodian seeking relief for;
          a minor child  a person who is physically or mentally incapacitated from seeking a protection order.
Name of person(s) filing a petition for:____________________________________________________________________.
Relationship of abused person(s) to defendant:_____________________________________________________________.

I am the plaintiff and I state that the following is true and correct:

I am filing this petition:  as an independent civil action  to be joined with Civil Action No.________________________.

         to be a part of the preliminary, final, or post-judgment relief in Civil Action No.______________________________.

         to be a part of Criminal Action No.__________________________________.
I am a resident of________________________________in,___________________________. Plaintiffs age is _________.
(County) (State)
Due to abuse or threat of abuse, I am residing in ___________________________________ County, Alabama.

The defendant is a resident of __________________________________ County, Alabama. Defendants age is _________.
Application is for:  a protection order  modification of a current protection order. I  am  am not involved in any civil litigation with the defendant. If plaintiff is involved in any litigation with the defendant, please state the county in which the litigation was brought: __________________________________________ County, Alabama.

There  are  are not pending criminal charges arising from the alleged abuse. If criminal charges were brought against the defendant, they were brought in ________________________________________ County, Alabama.

II. To Be Eligible For A Protection Order, Defendant Must Have Done One Or More Of The Following: (Check all that apply).
 Caused me bodily injury  Attempted to cause me bodily injury  Threatened to cause me bodily injury
 Placed me in fear of serious bodily injury  Caused me to engage in sexual relations by force or threat of force
 Abused a minor child  Abused a physically or mentally incapacitated person
Original-Court RecordCopy-Law EnforcementCopy-PlaintiffCopy-Defendant
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