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PETITION FOR PEACE ORDER (SOUC1TUD DE U R E DE PAZ)
. 'OTE: Fill in Ihefollcw. 'r-g. c1:ec1:in the appropriate boxes. Ifyo Illeed additional papa.:;.s rhe clerk.)
NOTA: ilene 10 siguienteY llmjUe las am las apro iadas Si necesitQ mas ,:1 cretano-J
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Ib: 1';:;13003:50::1 . e rl2:es sa eli' w ci:ec3< ell . ill apply) ce bs . t=: e:; l2s fec.has indi::a:!as ab2jO.. ta'<jue
meo 10 que COlRspanda.) 0 DC.' g (pa (21)0 punching (dar un pUfietazo)0 hoking (- s' ar)O .lapping (dar bofuladas)
s.'loo"' .g (is:p=r 02;Je or c:her offense (or a:tem ) (\iolaci6n' o. de" OUt'- g w': o' (go'
-I:: o' ;e: ) Osto! bi:I_ (27':-' Dsno,ing(e puja) 2TGS-m-, (2.::0 0
s:aJcing (3C .0) 0 detaining ",.tins 'ill (;etener conL-a :3 voluoad) 0 rrespass (=:::J.11aC en:;; sin aUlorizaci' n) 0 mal: io s
. n of property (destrud6n n:aliciosa de la p pie ad) _
oother ( tro)I-- _
T:'e de of ",ha happened are (Describe l1'jur:es State the dJ:le(s) and p 'acefs) 1< hUl! :lIese !Soccm-ed. Be as speCIfic as you ccn):
UlS de a]-s de 10 quesucedio so 'Descn" lu:or.a Dlga fteJ.s..':.!edw.syd lu 0 ["g-'..T-J i!-.:.e ac.r ac s. EJperi, L!!Je!o uds posib:e.-}.
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2. I know of the following court cases in olving the Respondent and me 'Cesos nle d mlr.1.- alIos cr.:e <:stamos involucrlldos cl Derr.andado y yo):
Com: (Tn""".I) Kmd o:'Case 1T:1'" rle am Y=Filed (AJ;o ;>tt=dD) R5"Jl:s cr Status you blo....) (Ra;1ado 0 csrzrlo eel <=0,
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3. Describe all other harm the Respoadent has caused} ou and give date( ), ifknown
D=andado yeo q efcc 3 0 sabe..) _
se Ie orOoe al De;n- 6!"0 C[.re):
y ofthe ac listed in paragraph 1 agili .'0 :::I:::3 ci zmrnac:: - meter lin . 0 de l:Js
E a:g 'Wi {;4f11/'-'I
e fiHn f, es an u: costs. (Pague los
cx:ific relief to:ra especifica): _
To pay
o Other
NOT to can c a em t 0 contact, 0 . '0 s:: ponga en con:<!clo ni irate
't!:. 'OT to go to th residence') at .'0 \'2}' ala re510enCla ...........
a} a a 12 es:uel:3 0 escuelas eo) --::-:----:;--:----,----,---:-:_-=----,--_-:----:---,----,-_-:-: _
est of my knowledge,
.... 7"',,...... ,silie:-)' c::C=er.)
I solemnly affirm under the penalties of perjury that lhe contents of thi
informati0Y;::/ ente 03.0 pe!'.J!cq,e!j;...io ql:cel COl:" de
f::> Dat: Fe:l-.al
onCE TO PETITIO, ffiR (VI L OLICIT. TE)
AEj indi idual who knowingly p ovides false infonnalion in a Pe lion for Pea e Or er is guilty of a misdemeanor and on
on ietion is subject to a fine not exceeding 1,000 or imprisonment not exceedin<;> 90 da or both. (Cualq ieT p=na que <!
52 iendas propoTcio:lC mformaCl6n falsa c;n una Solici d de Orden de paz es culpable de un eli n:eI:L:r y 21 un falla de c Ipabi11dad es3
S'Jj=ta a U:l<! multa no mayor de SI, 0 encarcelamicn:o durarrc no mas de 90 dias a ambos. )
DC 01 BL (Rev. 2/2003) (TR 111 011)
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PETITION FOR PROTECTION/PEACE ORDER Page L Of 12:-
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CONTINUATION SHEET
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