Rhode Island General Laws Title 8. Courts and Civil Procedure--Courts § 8-8.1-6. Form of complaint

Defendant owns __________

We jointly own _

My former residence is an apartment

There is no lease __________

My name is on lease and defendant's is not __________

Defendant's name is on lease and mine is not __________

Both our names are on lease __________

__________Threatened or harmed with a weapon:

(type of weapon used: __________)

__________Attempted to cause me physical harm;

__________Caused me physical harm;

__________Placed me in fear of imminent physical harm;

__________Caused me to engage involuntarily in sexual relations by force, threat of force, or duress specifically, the defendant: __________

__________The court order that the defendant be restrained and enjoined from contacting, assaulting, molesting or otherwise interfering with the plaintiff at home, on the street or elsewhere.

__________The court order the defendant to immediately leave the household which is located at ____________________

I request that the above relief be ordered without notice because it clearly appears from specific facts shown by affidavit or by the verified complaint that I will suffer immediate and irreparable injury, loss, or damage before notice can be served and a hearing had thereon. I understand that the court will schedule a hearing no later than twenty-one (21) days after such order is entered on the question of continuing such temporary order.

Note: If this complaint is filed by an attorney, the attorney's certificate should appear below:

__________OF THE G.L. OF R.I.

Upon consideration of plaintiff's complaint, (and having found that immediate and irreparable injury, loss or damage will result to the plaintiff before a notice can be served and a hearing had thereon) it is ORDERED:

__________That the defendant is restrained and enjoined from contacting, assaulting, molesting, or otherwise interfering with plaintiff at home, on the street or elsewhere.

__________That the defendant vacate forthwith the household located at ____________________

A hearing on the continuation of this ORDER will be held at the District Court, __________County, __________Division, at (A.M.) (P.M.) on __________. If the defendant wishes to be heard, she/he will be heard at that time. If she/he does not appear at that time, this ORDER shall remain in effect.

This ORDER is effective forthwith, and will remain in effect until the time and date of the above-mentioned hearing.

A copy of this ORDER shall be transmitted to the appropriate local law enforcement agency forthwith, and shall be served in-hand on the defendant herein.

ENTERED as an Order of Court this __________ day of __________ A.D. 20 ___.