Magistrate Court Order Protection From Domestic Abuse Act Form
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3STATE OF SOUTH CAROLINA
)
IN THE FAMILY COURT
)
_____ JUDICIAL CIRCUIT
COUNTY OF _____________________________
)
)
MAGISTRATE COURT ORDER
)
PROTECTION FROM DOMESTIC ABUSE ACT
Petitioner, )
(For Use By Magistrate Court Judges)
)
vs.
)
DOCKET NO.
)
Judge:
)
Attorney for Petitioner:
Respondent. )
Attorney for Respondent:
PETITIONER IDENTIFIERS
RESPONDENT IDENTIFIERS
SEX *
RACE *
DOB*
Date of Birth of Petitioner
EYES
HAIR
SOCIAL SECURITY #
And/or on behalf of minor family member(s) or other
Protected persons: (list name and DOB)
HEIGHT
WEIGHT
DRIVERS LICENSE #
STATE
Relationship to Petitioner:
Respondent’s Address
CAUTION:
*Indicates required information for entry into NCIC
Weapon Present on Respondent’s Property
Weapon Involved
Access to weapons
THE COURT HEREBY FINDS:
That it has jurisdiction over the parties and subject matter,
Respondent has been provided with reasonable notice and opportunity to be heard.
Additional findings of this order are as set forth below.
THE COURT HEREBY ORDERS:
That the above named Respondent be restrained from committing further acts of abuse or threats of abuse.
The terms of the this order shall be effective until
,
.
WARNINGS TO RESPONDENT;
This order shall be enforced in any county of South Carolina and by the courts of any state, District of
Columbia, any U. S. Territory, and may be enforced by Tribal Lands (18 U.S.C. Section 2265). Crossing state,
territorial, or tribal boundaries to violate this order may result in federal imprisonment (18 U.S.C. Section 2262).
State and federal law provides penalties for possessing, transporting, shipping, or receiving any firearm or
ammunition (18 U.S.C. Section 922).
Only the Court can change this order.
For Additional Information Call:
Phone Number – Clerk of Court
Phone Number - Sherriff
Page 1 of 3
SCCA 745 (4/2009)
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