Domestic Violence Protection Order - District of Columbia
Before use: The applicant files a petition and affidavit asking the court to issue a civil protection order. This draft sets out proposed order terms for the court to consider. See https://www.dccourts.gov/court-resources/search-forms/petition-and-affidavit-civil-protection-order.
Superior Court of the District of Columbia
Domestic Violence Division
Civil Protection Order (CPO) Template
(Draft for Attorney Customization)
TABLE OF CONTENTS
I. Document Header
II. Definitions
III. Operative Provisions (Injunctive Relief)
IV. Representations & Warranties (Court Findings & Respondent Acknowledgments)
V. Covenants & Restrictions
VI. Default & Remedies (Violation Penalties & Enforcement)
VII. Risk Allocation (Intentionally Omitted—Not Applicable)
VIII. Dispute Resolution & Governing Law
IX. General Provisions
X. Execution Block
XI. Mandatory Notices & Law-Enforcement Information Sheet (Attachment A)
I. DOCUMENT HEADER
-
Case Caption
- Court: Superior Court of the District of Columbia, Domestic Violence Division
- Case No.: [CASE NUMBER]
- Petitioner / Protected Party: [PETITIONER FULL LEGAL NAME]
- Respondent / Restrained Party: [RESPONDENT FULL LEGAL NAME]
-
Effective Date
This Civil Protection Order (“Order”) is entered and effective as of [EFFECTIVE DATE] pursuant to D.C. Code § 16-1005. -
Jurisdiction & Venue
The Court has subject-matter jurisdiction under D.C. Code § 16-1005 and personal jurisdiction over the Respondent because [BASIS FOR PERSONAL JURISDICTION—e.g., residence, service within D.C., minimum contacts]. -
Recitals
A. On [DATE OF PETITION], Petitioner filed a Verified Petition alleging that Respondent committed or threatened to commit an intrafamily offense as defined in D.C. Code § 16-1001(8).
B. A hearing was held on [HEARING DATE(S)], at which the Court received testimony and evidence.
C. The Court finds good cause to believe that Respondent has committed or threatened to commit a criminal offense against Petitioner (or an animal Petitioner owns, possesses, or controls), which is the standard for issuance of a civil protection order under D.C. Code § 16-1005(c).
II. DEFINITIONS
For purposes of this Order, the following capitalized terms shall have the meanings set forth below:
- “Court” means the Superior Court of the District of Columbia, Domestic Violence Division.
- “Petitioner” or “Protected Party” means [PETITIONER FULL LEGAL NAME] and any minor child or other person specifically protected herein.
- “Respondent” or “Restrained Party” means [RESPONDENT FULL LEGAL NAME].
- “Minor Child(ren)” means the following individuals under 18 years of age: [LIST OF CHILDREN]
- “Proscribed Conduct” means any act prohibited by Section III of this Order, including but not limited to threats, harassment, stalking, assault, or any intrafamily offense enumerated in D.C. Code § 16-1001(8).
- “Firearm” includes any weapon defined as a “firearm” under D.C. Code § 7-2501.01(9).
- “Law-Enforcement Agency” means the Metropolitan Police Department (“MPD”) or any other agency with jurisdiction to enforce this Order.
III. OPERATIVE PROVISIONS (INJUNCTIVE RELIEF)
Pursuant to D.C. Code § 16-1005(c), IT IS HEREBY ORDERED THAT:
-
No Contact
Respondent shall not assault, threaten, harass, follow, interfere with, or contact Petitioner, directly or indirectly, by any means—including in person, telephone, electronic communication, social media, or through third parties—except as expressly permitted herein. -
Stay-Away
Respondent shall stay at least [100] feet from:
a. Petitioner;
b. Petitioner’s residence at [ADDRESS] (if confidential, state “confidential address on file”);
c. Petitioner’s workplace at [ADDRESS];
d. The Minor Child(ren)’s school(s) and/or daycare(s) at [ADDRESSES]; and
e. Any other location where Petitioner is known to frequent, including [SPECIFY]. -
Vacate Order
Respondent shall immediately vacate and remain away from the shared residence located at [ADDRESS] no later than [TIME, DATE] and may remove personal belongings only under law-enforcement escort at a date and time arranged through MPD. -
Temporary Custody / Visitation (select if applicable)
a. Temporary legal and physical custody of the Minor Child(ren) is awarded to Petitioner.
b. Supervised visitation, if any, shall occur [TERMS, LOCATION, SUPERVISING AGENCY].
c. Respondent shall not remove the Minor Child(ren) from the District of Columbia without prior written Court approval. -
Financial Relief (select if applicable)
a. Respondent shall pay temporary child support in the amount of $[AMOUNT] per [week/month] commencing [DATE] in accordance with D.C. Child Support Guidelines.
b. Respondent shall pay emergency household expenses in the amount of $[AMOUNT] as listed in Attachment [#]. -
Counseling / Treatment
Respondent is ORDERED to enroll in and complete [BATTERER INTERVENTION PROGRAM / SUBSTANCE ABUSE TREATMENT] approved by the Court and shall provide proof of enrollment within [7] days and proof of completion within [X] days of program end. -
Firearms Surrender
Pursuant to D.C. Code § 16-1005(c)(10), Respondent shall relinquish possession of all Firearms and ammunition and is prohibited from possessing, controlling, purchasing, or receiving any Firearm or ammunition while this Order is in effect. Respondent shall surrender all Firearms, ammunition, and firearm registration certificates to MPD no later than [TIME/DEADLINE SET BY COURT—e.g., within 24 hours of service] and shall file proof of surrender (or an affidavit of non-possession) with the Court by [DATE/TIME SET BY COURT]. -
Duration
This Order shall remain in effect for [SPECIFY PERIOD—NOT TO EXCEED TWO YEARS] from the Effective Date, unless modified, extended, or vacated by further Court order. -
Full Faith & Credit
This Order is enforceable throughout the United States pursuant to 18 U.S.C. § 2265.
IV. REPRESENTATIONS & WARRANTIES (Court Findings & Respondent Acknowledgments)
-
Findings of Fact
The Court incorporates by reference the findings stated on the record at the hearing held on [HEARING DATE]. -
Capacity
The Court finds Respondent was present in person / by counsel, was afforded due process, and is competent to understand the terms of this Order. -
Respondent Acknowledgment
Respondent acknowledges receipt of this Order in open court and understands that violation of any provision may result in arrest and criminal prosecution.
V. COVENANTS & RESTRICTIONS
-
Affirmative Covenants
a. Respondent shall comply with all counseling, treatment, and support obligations set forth herein.
b. Respondent shall return or transfer to Petitioner any essential personal property specified in Attachment [#] no later than [DATE], under MPD escort if requested. -
Negative Covenants
Respondent shall not:
a. Engage in Proscribed Conduct;
b. Possess any Firearm or ammunition;
c. Access, attempt to access, or disrupt Petitioner’s digital accounts, utilities, or financial instruments;
d. Incur joint debt or cancel utilities or insurance covering Petitioner without Court approval. -
Notice of Order
Once personally served with or given actual notice of this Order, Respondent must comply with every provision. No additional notice or cure period applies to a violation. (D.C. Code § 16-1005(g-1).)
VI. DEFAULT & REMEDIES (VIOLATION PENALTIES & ENFORCEMENT)
-
Criminal Penalties
Violation of this Order is punishable as criminal contempt under D.C. Code § 16-1005(f) and is separately chargeable as a misdemeanor under D.C. Code § 16-1005(g). Upon conviction under either, the penalty is imprisonment for not more than 180 days, a fine of not more than the amount set forth in D.C. Code § 22-3571.01 (currently $1,000 for an offense punishable by up to 180 days’ imprisonment), or both. No person may be found to have violated this Order unless personally served with or given actual notice of it (D.C. Code § 16-1005(g-1)). -
Civil Contempt
The Court retains jurisdiction to enforce this Order through civil contempt proceedings, fines, or additional injunctive relief. -
Warrantless Arrest Authority
A law-enforcement officer may arrest Respondent without a warrant where the officer has probable cause to believe Respondent has committed an intrafamily offense, pursuant to D.C. Code § 23-581(a-1). Where the intrafamily offense resulted in physical injury (including physical pain or illness) or caused or was intended to cause reasonable fear of imminent serious physical injury or death, arrest is mandatory under D.C. Code § 16-1031(a). -
Attorney’s Fees and Costs
☐ As relief in this Order under D.C. Code § 16-1005(c)(8), the Court awards costs of $[AMOUNT] and attorney fees of $[AMOUNT] to [PARTY], payable by [PARTY] by [DATE].
VII. RISK ALLOCATION
Intentionally omitted. Indemnification provisions, limitation of liability, and insurance requirements are not applicable to a court-issued protection order.
VIII. DISPUTE RESOLUTION & GOVERNING LAW
-
Governing Law
This Order is governed by, and interpreted in accordance with, the laws of the District of Columbia and applicable federal law. -
Exclusive Forum
Any motion to modify, extend, or enforce this Order shall be filed in the Superior Court of the District of Columbia, Domestic Violence Division. -
Arbitration & Jury Trial
Arbitration is not available, and jury trial is not applicable to proceedings to modify or enforce this Order. -
Injunctive Relief Preservation
The equitable and injunctive remedies provided herein are cumulative and not exclusive of any other remedy available at law.
IX. GENERAL PROVISIONS
-
Modification
Upon motion of any party to the original proceeding, the Court may extend, modify, or vacate this Order for good cause shown, pursuant to D.C. Code § 16-1005(d-1)(1). A finding that the Order has been violated is not necessary for a finding of good cause to modify or extend it. -
Severability
If any provision of this Order is held invalid, the remaining provisions shall remain in full force and effect. -
Integration
This Order constitutes the entire civil protection order between the parties and supersedes all prior oral or written rulings on the same relief, except as incorporated by reference. -
Service & Dissemination
The Clerk shall:
a. Provide certified copies to Petitioner, Respondent, MPD, and the National Crime Information Center (NCIC) Protection Order File; and
b. Maintain the original Order in the Court file. -
Electronic Signatures & Counterparts
This Order may be signed electronically by the Judge and issued in counterpart originals.
X. EXECUTION BLOCK
Entered this ___ day of __________, 20___.
____________________________________
[JUDGE’S PRINTED NAME]
Judge, Superior Court of the District of Columbia
Domestic Violence Division
XI. ATTACHMENT A
Mandatory Notices & Law-Enforcement Information Sheet
-
Notice to Respondent
“You have been served with a Civil Protection Order. Violation of this Order’s firearm or ammunition restrictions may be prosecuted under D.C. Code § 16-1005(f) or (g). Violation of any term of this Order may result in immediate arrest.” -
Law-Enforcement Identifiers
- Respondent’s DOB: [MM/DD/YYYY]
- Respondent’s SSN (last 4 digits): [XXXX]
- Respondent’s Physical Description: [HEIGHT/WEIGHT/HAIR/EYE]
- Known Firearms: [MAKE/MODEL/SERIAL]
- NCIC Order Number: [TO BE ASSIGNED BY CLERK/MPD]
Prepared by: [ATTORNEY NAME], D.C. Bar No. [BAR NUMBER]
Address: [FIRM ADDRESS] • Phone: [PHONE] • Email: [EMAIL]
About this template
- Last updated
- November 1, 2026
- Jurisdiction
- District of Columbia
- Category
- Family Law
Legal authority
- D.C. Code § 16-1001 (definitions; intrafamily offense)
- D.C. Code § 16-1003 (petition for civil protection order)
- D.C. Code § 16-1004 (temporary protection order)
- D.C. Code § 16-1005 (hearing; civil protection order; duration; enforcement)
- D.C. Code § 16-1031 (mandatory arrest for intrafamily offense)
- D.C. Code § 23-581(a-1) (warrantless arrest for intrafamily offense)
- D.C. Code § 7-2501.01(9) (definition of firearm)
- D.C. Code § 22-3571.01 (fine schedule)
- 18 U.S.C. § 2265 (full faith and credit)
Family law covers the paperwork that shapes divorce, custody, child support, adoption, guardianship, and other family matters. These filings are emotional and high-stakes, and they also have to meet strict procedural rules for service, financial disclosure, and parenting plans. Clean, accurate paperwork keeps the focus on getting a workable outcome for the family instead of getting derailed by technical problems that delay hearings or force amended filings.
Not legal advice
This template is provided for informational purposes. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Checked against the law it cites
The statutes this template relies on are listed under Legal authority.
D.C. Courts Petition and Affidavit for Civil Protection Order (checked October 28, 2026): "You can use this form to ask the court to issue a civil protection order against someone who has threatened or harmed you."
D.C. Courts, Domestic Violence Division (checked October 30, 2026): "The Domestic Violence Division handles cases where people are experiencing abuse, threats, or stalking"
D.C. Code § 16-1005(c)(8) (checked October 30, 2026): "(8) Awards costs and attorney fees;"
D.C. Code § 16-1005(f)(1) (checked October 30, 2026): "(f)(1) Violation of any temporary protection order or civil protection order issued under this subchapter, or violation in the District of Columbia of any valid foreign protection order, as that term is defined in subchapter IV of this chapter, or respondent's failure to appear as required by subsection (a) of this section, shall be punishable as criminal contempt."
Draft your Domestic Violence Protection Order in the editor
Answer a few questions, let the AI editor draft each section from your answers, review it, and download Word and PDF. $99 one time, or $249 per month for every document and every Ezel app.