Form Ujs-091b - Notice Of Hearing And Summons To Appear (Domestic Abuse) 2014
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1STATE OF SOUTH DAKOTA
)
IN CIRCUIT COURT
)
COUNTY OF ____________________
)
______________ JUDICIAL CIRCUIT
________________________________,
TPO NO: ___________________________
Petitioner
NOTICE OF HEARING AND
-vs-
SUMMONS TO APPEAR
(DOMESTIC ABUSE)
________________________________,
Respondent
TO THE PARTIES:
YOU ARE NOTIFIED that a Petition and Affidavit has been filed with this Court seeking a Protection Order
against you according to the provisions of the South Dakota Protection from Domestic Abuse Act, SDCL ch.
25-10. A copy of the Petition and Affidavit together with a copy of an Ex Parte Temporary Order of Protection,
if one has been issued, is attached to this summons and is served upon you.
Temporary Order of Protection denied. Hearing only.
There will be a hearing on the Petitioner’s Petition on the _____ day of ___________________, 20_____,
at ________ __.M., in the _________________ County Courthouse, in __________________ (courtroom), in
________________________, South Dakota.
IF YOU FAIL TO APPEAR AT THE HEARING AND ANSWER THE PETITION, AN ORDER OF PROTECTION
MAY BE ENTERED AGAINST YOU AS REQUESTED.
Service of this notice is authorized on any day including
Sunday.
DATED: _______________________________
Judge
Attest_______________________, Clerk of Courts
by___________________, Deputy
ACKNOWLEDGMENT OF PERSONAL SERVICE
I acknowledge receipt of a copy of this Notice of Hearing.
Petitioner
Date
Respondent
Date
UNDER A PERMANENT PROTECTION ORDER: You may be subject to the following federal laws: (1) Effective
immediately, you may not possess, carry, ship or transport any firearm or ammunition that has been transported
in interstate or foreign commerce while this Protection Order is in effect. Title 18 United States Code Section
922(g)(8). (2) If you violate this Protection Order and are convicted of an offense of domestic violence, you may
be forbidden for life from possessing, carrying, shipping or transporting, any firearm or ammunition that has
been transported in interstate or foreign commerce. Title 18 United States Code Section 922(g)(9). Violation of
these federal laws carries a maximum penalty of ten years in prison, a $250,000 fine, or both.
Form UJS-091B (Domestic Notice of Hearing) Rev. 07/14
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