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Idea Transcript
IN THE CIRCUIT COURT OF THE TWELFTH JUDICIAL CIRCUIT IN AND FOR SARASOTA COUNTY, FLORIDA IN THE COUNTY COURT IN AND FOR SARASOTA COUNTY, FLORIDA
DIVISION:
CASE NUMBER:
CIVIL PLAINTIFF:
VS. DEFENDANT
AFFIDAVIT DESCRIBING VIOLATION OF INJUNCTION FOR PROTECTION AGAINST DOMESTIC VIOLENCE/REPEAT VIOLENCE STATE OF FLORIDA COUNTY OF _______________________ I, __________________________________________, the Petitioner in the above-styled case, do hereby swear and affirm that the following statements are true: 1. _________________________________________, the Respondent in the above-styled case, violated the Injunction for Protection Against Domestic Violence entered on _______________________________________. 2. The Respondent violated the injunction for protection on (dates): __________________ _____________________________________________________________________. 3. Specifically, the Respondent violated the Injunction for Protection Against Domestic Violence in the following manner: (Describe below in detail anything the Respondent did or said that was in violation of the injunction. Be as specific as possible, including a description of the Respondent’s conduct, time of the violation(s) and the location where the violation(s) occurred.) _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ FILED FOR RECORD STAMP
Civil/Violinj.doc Revised 9/2000
AFFIDAVIT DESCRIBING VIOLATION OF INJUCTION FOR PROTECTION AGAINST DOMESTIC VIOLENCE/REPEAT VIOLENCE
(Page 2 of 2) 4. I have checked all, if any, of the statements below which apply to my situation. ________ Respondent violated the injunction by refusing to vacate the dwelling previously shared by the parties. ________ Respondent violated the injunction by going to the Petitioner’s residence, school, place of employment or a specified place frequented regularly by the Petitioner and any named family or household member. ________ Respondent violated the injunction by committing an act of domestic violence against the Petitioner. ________ Respondent violated the injunction by using an intentional and unlawful threat, word or act to do violence to the Petitioner. ________ Respondent violated the injunction by telephoning, contacting or communicating with the Petitioner directly or indirectly, when such communication was not allowed by the injunction.