Form 4-970 NMRA
Form 4-970. Stipulated order of protection.
________________ Judicial District
________________ County, New Mexico
Case No. ______________________
Order of Protection
[ ] Amended Order
PROTECTED PARTY ([ ] PETITIONER [ ] RESPONDENT)
PROTECTED PARTY IDENTIFIERS
First
Middle
Last
Date of Birth of Protected Party
And/or on behalf of minor family member(s): (list name and
DOB)
Other Protected Persons/DOB
_________________________________________________
________________________________________________
_________________________________________________
________________________________________________
V.
RESTRAINED PARTY
RESTRAINED PARTY IDENTIFIERS
SEX
RACE
DOB
HT
WT
First
Middle
Last
EYES
HAIR
SOCIAL SECURITY #
Not used in New Mexico
Relationship to Protected Party:
_________________
DRIVERS LICENSE #
STATE
EXP DATE
__________________________________________
Restrained Party’s Address
__________________________________________
Distinguishing Features _____________________________
__________________________________________
________________________________________________
CAUTION:
[ ] Weapon Involved
[ ] Credible Threat. Firearm Delivery Ordered.
THE COURT HEREBY FINDS:
That it has jurisdiction over the parties and subject matter, and the Restrained Party has been provided with reasonable notice and
opportunity to be heard.
[ ]
Additional findings of this order follow on succeeding pages.
THE COURT HEREBY ORDERS:
[ ]
That the above named Restrained Party be restrained from committing further acts of abuse or threats of abuse.
[ ]
That the above named Restrained Party be restrained from any contact with the Protected Party.
[ ]
Additional terms of this order are as set forth on succeeding pages.
The terms of this order shall be effective until
,
.
WARNINGS TO THE RESTRAINED PARTY:
This order shall be enforced, even without registration, by the courts of any state, the District of Columbia, any U.S. Territory, and
may be enforced by Tribal Lands under 18 U.S.C. Section 2265. Crossing state, territorial, or tribal boundaries to violate this order
may result in federal imprisonment under 18 U.S.C. Section 2262.
As a result of this order, it is unlawful for you to possess or purchase ammunition or a firearm, including a rifle, pistol or revolver,
under 18 U.S.C. Section 922(g)(8) and NMSA 1978, Section 30-7-16, and may be unlawful under 18 U.S.C. Section 921(a)(32). If
you have any questions whether federal law makes it illegal for you to possess or purchase a firearm, you should consult an
attorney.
Only the court can change this order.
Page 1 of ____
Judge’s signature on last page
ADDITIONAL PAGES1 OF STIPULATED ORDER OF PROTECTION
The court further FINDS, CONCLUDES AND ORDERS:
1.
FINDING OF CREDIBLE THREAT
[ ]
The restrained party presents a credible threat to the physical safety of the
protected party or a member of the protected party’s household.
[ ]
The restrained party presents a credible threat to the physical safety of the
protected party, who is a household member.
[ ]
The restrained party shall, within forty-eight (48) hours, deliver any firearm in that
party’s possession, care, custody, or control to a law enforcement agency, law
enforcement officer, or federal firearms licensee while the order of protection is in effect,
and shall refrain from purchasing, receiving, or possessing or attempting to purchase,
receive, or possess any firearm while the order of protection is in effect.
[ ]
The restrained party is responsible for ensuring that the firearm delivery receipt is
filed in this case within seventy-two (72) hours of entry of this order.
2.
NOTICE, APPEARANCES AND STATUS
This order was entered on stipulation of the parties.
[ ]
The relationship of the parties is that of an “intimate partner” as defined in 18
U.S.C. Section 921(a)(32). (See 3 below.) This order may be entered into a federal
firearms database.
[ ]
The petitioner was present.
[ ]
The petitioner was represented by counsel.
[ ]
The respondent was present.
[ ]
The respondent was represented by counsel.
3.
EFFECT OF STIPULATION TO ORDER OF PROTECTION
Violation of this order can have serious consequences, including:
A.
If you violate the terms of this order, you may be charged with a misdemeanor,
which is punishable by imprisonment of up to three hundred and sixty-four (364) days
and a fine of up to one thousand dollars ($1,000.00) or both. You may be found to be in
contempt of court.
B.
If you receive, transport, or possess a firearm or destructive device while the
order of protection is in effect, you may be charged with a misdemeanor, which is
punishable by imprisonment for up to three hundred and sixty-four (364) days and a fine
of up to one thousand dollars ($1,000.00).
C.
If you are the spouse or former spouse of the other party, an individual who
cohabitates with or has cohabitated with the other party, or if you and the other party
have had a child together, federal law prohibits you from possessing or transporting
firearms or ammunition while this order is in effect. If you have a firearm or ammunition,
you should immediately dispose of the firearm or ammunition. Violation of this law is a
federal crime punishable by imprisonment for up to ten (10) years and a fine of up to
two hundred and fifty thousand dollars ($250,000.00). 18 U.S.C. § 922, et seq.
D.
If you are not a citizen of the United States, violation of this order will have a
negative effect on your application for residency or citizenship.
4.
DOMESTIC ABUSE PROHIBITED
The restrained party shall not abuse the protected party or members of the protected
party’s household. “Abuse” means any incident by one party against the other party or
another household member resulting in (1) physical harm; (2) severe emotional distress;
(3) bodily injury or assault; (4) a threat causing imminent fear of bodily injury to the other
party or any household member; (5) criminal trespass; (6) criminal damage to property;
(7) repeatedly driving by the protected party’s or a household members’ residence or
work place; (8) telephone harassment; (9) stalking; (10) harassment; or (11) harm or
threatened harm to children in any manner set forth above.
The restrained party shall not ask or cause other persons to abuse the other party or
any other household members.
5.
CONTACT PROHIBITIONS
The restrained party shall stay one hundred (100) yards away from the protected party
and the protected party’s home and work place at all times, unless at a public place,
where the restrained party shall remain twenty-five (25) yards away from the protected
party except as specifically permitted by this order.
The restrained party shall not telephone, talk to, visit, or contact the protected party in
any way except as follows:
(check only applicable paragraphs)
[ ]
The parties may contact each other by telephone regarding medical emergencies
of minor children;
[ ]
________________________________________________________________
_____________________________________________________________________.
[ ]
The restrained party shall not post or cause another to post anything about the
protected party on any form of social media, including, but not limited to, Facebook,
Twitter, Instagram, or Snapchat. This prohibition includes posts about the protected
party’s family members, significant other, and children.
[ ]
The parties may attend joint counseling sessions at the counselor’s discretion.
(Unless the court has entered an order sealing the protected party’s address,
include it below.)
Protected party’s addresses:
________________________________________ (home address)
________________________________________ (work address)
________________________________________ (city)
________________________________________ (if applicable, tribe or pueblo)
________________________________________ (state and zip code)
6.
COUNSELING
[ ]
The petitioner shall attend counseling at __________________, contacting that
office within five (5) days. The petitioner shall participate in, attend, and complete
counseling as recommended by the named agency.
[ ]
The respondent shall attend counseling at __________________, contacting that
office within five (5) days. The respondent shall participate in, attend, and complete
counseling as recommended by the named agency.
[ ]
The petitioner shall report to __________________ for a [ ] drug [and] [ ] alcohol
screen by ______________, __________ (date) with the results returned to this court.
[ ]
The respondent shall report to __________________ for a [ ] drug [and] [ ]
alcohol screen by ______________, __________ (date) with the results returned to this
court.
[ ]
Other counseling requirements: ______________________________________.
7.
CUSTODY2
[ ]
The court’s orders regarding the minor [child] [children] of the parties are found in
the Custody, Support and Division of Property Attachment of this order of protection.
8.
PROVISIONS RELATING TO SUPPORT2
[ ]
The court's orders regarding support issues for the parties are found in the
Custody, Support and Division of Property Attachment of this order of protection.
9.
PROPERTY, DEBTS, PAYMENT OF MONEY2
[ ]
The court's orders regarding property, debts, and payment of money are
addressed in the Custody, Support and Division of Property Attachment of this order of
protection.
10.
ADDITIONAL ORDERS
[ ]
Review hearing. The parties are ordered to appear for a review hearing on the
____________ day of ______________, __________, at ____________ (a.m.) (p.m.).
Failure to appear may result in the issuance of a bench warrant for your arrest or
dismissal of this order.
Any party ordered to attend counseling shall bring proof of counseling to the review
hearing.
IT IS FURTHER ORDERED3:
______________________________________________________________________
______________________________________________________________________
_____________________________________________________________________.
11.
PROTECTED PARTY SHALL NOT CAUSE VIOLATION
While this order of protection is in effect, the protected party should refrain from any act
that would cause the restrained party to violate this order. This provision is not intended
to and does not create a mutual order of protection. Under NMSA 1978, Section 40-13-
6(D), only the restrained party can be arrested for violation of this order.
12.
NOTICE TO LAW ENFORCEMENT AGENCIES
ANY LAW ENFORCEMENT OFFICER SHALL USE ANY LAWFUL MEANS TO
ENFORCE THIS ORDER.
[ ]
_____________ (name) is ordered to surrender all keys to the residence to law
enforcement officers.
[ ]
Law enforcement officers or ________ shall be present during any property
exchange.
[ ]
This order supersedes prior orders in __________________ County, State of
__________________, Cause No. __________________ to the extent that there are
contradictory provisions.
13.
NOTICE TO PARTIES
This order does not serve as a divorce and does not permanently resolve child custody
or support issues.
14.
AGREEMENT OF PARTIES
Without admitting that domestic abuse has occurred, the parties stipulate to the entry of
this order and affirm that they have read and do understand the effects of this order as
stated in Paragraph 3.
______________________________
Protected party’s signature
______________________________
Restrained party’s signature
______________________________
Protected party’s counsel, if any
______________________________
Restrained party’s counsel, if any
______________________________
Date
______________________________
Date
15.
RECOMMENDATIONS
I have:
[ ]
reviewed the pleading for order of protection;
[ ]
prepared this order as my recommendation to the district court judge regarding
disposition of requests for order of protection.
_______________________________________
Signed
_______________________________________
Domestic Violence Commissioner
Court's telephone number: ______________
SO ORDERED.
_____________________________
_
District Judge
_____________________________________
__
DATE
[ ]
A copy of this order was [ ] hand delivered [ ] faxed [ ] mailed to [ ] the restrained
party [ ] the restrained party’s counsel on ______________ (date).3
[ ]
A copy of this order was [ ] hand delivered [ ] faxed [ ] mailed to [ ] the protected
party [ ] the protected party’s counsel on __________________ (date).
__________________________________
Signed
__________________________________
Title