4-970

STATE OF NEW MEXICO

COUNTY OF _____________________________

________________ JUDICIAL DISTRICT

________________________________________

Petitioner

v.                                                                                                          No. ______________

________________________________________

Respondent

STIPULATED ORDER OF PROTECTION

AGAINST RESPONDENT¹

This is not an order of protection under

18 U.S.C. Section 922

THIS MATTER came before the court upon agreement of the parties to the entry of an order.

The court, having determined that it has legal jurisdiction over the parties and the subject matter, FINDS, CONCLUDES AND ORDERS:

1.         NOTICE AND APPEARANCES

This order was entered on stipulation of the parties in a proceeding that does not satisfy the requirements of 18 U.S.C. Section 922.²

2.         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 364 days and a fine of up to $1,000.

            B.        You may be found to be in contempt.

            C.        If you are not a citizen of the United States, entry of this order may have a negative effect on your application for residency or citizenship.

3.         DOMESTIC ABUSE PROHIBITED

The respondent shall not abuse the petitioner or members of the petitioner's household.

"Abuse" means any incident by respondent against the petitioner or petitioner's household member resulting in (1) physical harm; (2) severe emotional distress; (3) bodily injury or assault; (4) a threat by respondent causing imminent fear of bodily injury to petitioner or petitioner's household member; (5) criminal trespass; (6) criminal damage to property; (7) repeatedly driving by petitioner's or petitioner's 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.

Respondent shall not ask or cause other persons to abuse the petitioner or petitioner's household members.

4.         CONTACT PROHIBITIONS

Respondent shall stay _________ yards away from the petitioner and the petitioner's home and workplace at all times, unless at a public place, where the respondent shall remain __________ yards away from the petitioner except as specifically permitted by this order.

Respondent shall not telephone, talk to, visit or contact petitioner 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 parties may attend joint counseling sessions at the counselor's discretion.

(Unless the court has entered an order sealing petitioner's address, include the address of residence and employment for the petitioner.)

Respondent's addresses:

            ________________________________        (home address)

            ________________________________        (work address)

            ________________________________        (city)

            ________________________________        (if applicable, tribe or pueblo)

             ________________________________        (state and zip code)

Petitioner's addresses

            ________________________________        (home address)

            ________________________________        (work address)

            ________________________________        (city)

            ________________________________        (if applicable, tribe or pueblo)

             ________________________________        (state and zip code)

5. COUNSELING

            [ ]        Petitioner shall attend and complete counseling at _______________, contacting that office within five (5) days. The petitioner shall participate in, attend and complete counseling as recommended by the named agency.

            [ ]        Respondent shall attend and complete 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: ________________________________

___________________________________________________________.

6.         CUSTODY³

            [ ]        The court's orders regarding the minor [child] [children] of the parties are found in the Custody, Support and Division of Property Attachment⁴ of this Order of Protection.

7.         PROVISIONS RELATING TO SUPPORT³

[ ]        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.

8.         PROPERTY, DEBTS, PAYMENTS OF MONEY³

            [ ]        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.

9.         ADDITIONAL ORDERS

            [ ]        Review hearing. The parties are ordered to appear for a review hearing on the _____ day of _______________, ________, at _________ (a.m.) (p.m.).

Any party ordered to attend counseling shall bring proof of counseling to the review hearing.

IT IS FURTHER ORDERED⁴: _______________________________________

_______________________________________________________________

______________________________________________________________.

10.       PETITIONER SHALL NOT CAUSE VIOLATION

While this order of protection is in effect, the petitioner should refrain from any act that would cause the respondent to violate this order. This provision is not intended to and does not create a mutual order of protection.

11.       EFFECTIVE DATE OF ORDER; EXTENSION; MODIFICATION

This order is effective upon filing with the clerk of the court.

This order [with the exception of the orders in the Custody, Support and Division of Property Attachment] shall continue until ___________________ (date), or until modified or rescinded by the court.

12.       NOT TO BE ENTERED IN FEDERAL REGISTRY

This order shall not be entered into a national domestic violence registry or other national information system.

13.       NOTICE TO LAW ENFORCEMENT AGENCIES

ANY LAW ENFORCEMENT OFFICER SHALL USE ANY LAWFUL MEANS TO ENFORCE THIS ORDER.

            [ ]        Respondent 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.

14.       NOTICE TO PETITIONER AND RESPONDENT

This order does not serve as a divorce and does not permanently resolve child custody or support issues.

15.       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 affects of this order as stated in Paragraph 2.

            _____________________________              ____________________________

Petitioner's signatureRespondent's signature

            _____________________________              ____________________________

Petitioner's counsel, if anyRespondent's counsel, if any

            _____________________________              ____________________________

DateDate

16.       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

[ ]        A copy of this order was [ ] hand delivered [ ] faxed [ ] mailed to

[ ] respondent [ ] respondent's counsel on __________________ (date).⁵

[ ]        A copy of this order was [ ] hand delivered [ ] faxed [ ] mailed to

[ ] petitioner [ ] petitioner's counsel on __________________ (date).

________________________________

Signed

USE NOTES

1.         This form may be used if the parties stipulate to an order of protection against the respondent without any findings of abuse.

2.         This order may be entered only upon stipulation of the parties without a hearing on the issue of abuse. If a hearing is held on the issue of abuse, use Form 4-965. If a hearing is held on other matters, Form 4-967 may be attached to this order.

3.         See Form 4-967, "Custody, Support and Division of Property Attachment".

4.         If appropriate, an order providing for restitution may be included in this paragraph.

5.         Respondent may be served at the time this order is issued. If respondent is not present at the time this order is issued, service upon respondent shall be made by delivering a copy to the party. See Section 40-13-6(A) NMSA 1978.

[Effective September 17, 2007.]