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Form Ujs-121g - Motion To Modify Permanent Protection Order , (Stalking Or Physical Injury) - State Of South Dakota

STATE OF SOUTH DAKOTA

)

IN CIRCUIT COURT

)

COUNTY OF ______________

)

________________ JUDICIAL CIRCUIT

Petitioner,

TPO NO.____________________

-vs-

MOTION TO MODIFY PERMANENT

PROTECTION ORDER

(STALKING OR PHYSICAL INJURY)

Respondent

□

I am the Petitioner who originally petitioned the Court for a Permanent Protection Order.

□

I am the Respondent and the one against whom the Permanent Protection Order was granted.

I am requesting that the Court change certain terms in the Permanent Order of Protection. (Describe what

you would like changed in the previous Permanent Order of Protection.)

Describe why you want the Permanent Order of Protection changed:

On this _______ day of _____________, __________, I swear or affirm under oath that the information I

have provided in this Motion to Modify is true and correct to the best of my knowledge. I believe I am

entitled to the changes I have requested. I am asking for this modification for valid reasons and am not

attempting to harass the other party, and am not attempting to abuse or delay the court process or any

other legal action.

Petitioner

Signed and sworn to before me on this

day of

Notary Public/Deputy Clerk of Courts

Commission Expires:

(SEAL)

Form UJS-121G (Stalking Motion to Modify Permanent Order) Rev. 05/08

Form Ujs-121g - Motion To Modify Permanent Protection Order , (Stalking Or Physical Injury) - State Of South Dakota