Title 8
Courts and Civil Procedure — Courts

COMPLAINT FOR PROTECTION FROM ABUSE

Pursuant to chapter 8.1 of title 8 I request that the court enter an order protecting me from abuse.

(1) My full name, present street address, city and telephone number are as follows: _________________________________________

_________________________________________

(2) My former residence, at which I resided with the defendant, is as follows (street address and city): _________________________________________

_________________________________________

(3) My former residence is a house

    I own _________________________________________
    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 _________________________________________

(4) The full name, present street address, city and telephone number of the person causing me abuse (the defendant) are as follows: _________________________________________

_________________________________________

(5) On or about ____________ , without cause or provocation I suffered abuse when the defendant:

_____ 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: _________________________________________

(6) I ask that: _________________________________________

_____ 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.

(7) I have not sought protection from abuse from any other judge of the district court arising out of the same facts or circumstances alleged in this complaint.

____________                                           ____________
   (Signature)                                          (Date)     

Subscribed and sworn to before me in ____________ in the County of ____________ in the state of Rhode Island, this ________ day of ____________ A.D. 20_____ .

______________    
Notary Public      

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

ATTORNEY CERTIFICATE
Signed: _______________
Attorney for Plaintiff
Address: ______________
     ______________
        Date: ___________ , 20__

(TEMPORARY) ORDER PURSUANT TO CHAPTER
______ 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____ .

ENTER: __________ PER ORDER: __________

Judge __________   Clerk __________

Presented by: _________________________________________
Attorney for Plaintiff

History of Section.
P.L. 1985, ch. 492, § 2; P.L. 1988, ch. 539, § 4; P.L. 1989, ch. 78, § 2; P.L. 1995, ch. 145, § 1; P.L. 2021, ch. 77, § 4, effective June 23, 2021; P.L. 2021, ch. 78, § 4, effective June 23, 2021.