Domestic Violence Protection Order

IMPORTANT: THIS IS A PREPARATION GUIDE — NOT THE OFFICIAL COURT FORM

Georgia requires the use of official court form SC-26 (Petition for Temporary
Protective Order) for family violence protective order petitions under O.C.G.A.
§ 19-13-1 et seq. This template provides the substantive legal content to help you
prepare — but you must transfer your content to the official form before filing.
The official form is available at
https://www.gsccca.org/file/family-violence-forms.
Do not file this document directly with the court.

DISCLAIMER
This template is provided for general informational purposes only and does not constitute legal advice. Use of this document does not create an attorney-client relationship. Practitioners must verify all statutory references, conform the template to the specific facts of the case, and comply with all local court rules and filing requirements before use.

FAMILY VIOLENCE PROTECTIVE ORDER

(Georgia – O.C.G.A. § 19-13-1 et seq.)

STATE OF GEORGIA
COUNTY OF ☐

IN THE SUPERIOR COURT OF [___] COUNTY
FAMILY DIVISION

Civil Action File No. [___]

PETITIONER: [Petitioner Full Legal Name],
Address: [___]

v.

RESPONDENT: [Respondent Full Legal Name],
Address: [___]

TABLE OF CONTENTS

I. Document Header
II. Definitions
III. Findings & Jurisdictional Recitals
IV. Operative Protective Provisions
V. Firearm & Weapons Restrictions
VI. Child-Related Relief (Custody, Visitation & Support)
VII. Mutual Property & Financial Provisions
VIII. Law-Enforcement Duties & Service
IX. Violation, Penalties & Enforcement
X. Modification, Renewal & Termination
XI. General Provisions
XII. Execution & Certification

I. DOCUMENT HEADER

1. Title: Family Violence Protective Order (“Order”).
2. Effective Date: Upon entry on the docket, [DATE].
3. Governing Law & Venue: Georgia Family Violence Act, O.C.G.A. § 19-13-1 et seq.; exclusive venue in the Superior Court of [COUNTY] County, State of Georgia (“Court”).
4. Case Origin: Verified Petition filed [DATE] by Petitioner alleging acts of family violence pursuant to O.C.G.A. § 19-13-3.

II. DEFINITIONS

For purposes of this Order, capitalized terms have the meanings below:

1. “Court” – The Superior Court of [COUNTY] County, Georgia, Family Division.
2. “Family Violence” – As defined in O.C.G.A. § 19-13-1, including any felony or certain misdemeanor offenses committed by one household or family member against another.
3. “Minor Child(ren)” – The parties’ child or children under 18 listed in Schedule A.
4. “No-Contact Provision” – A mandate prohibiting all direct and indirect contact, including electronic, telephonic, or third-party contact.
5. “Protected Address” – Any residence, workplace, school, or other location specifically listed in Schedule B.
6. “Firearm” – Any weapon covered by 18 U.S.C. § 921(a)(3) and O.C.G.A. § 16-11-131(a).
7. “Respondent” – [Respondent Full Legal Name], the party against whom relief is ordered.
8. “Petitioner” – [Petitioner Full Legal Name], the protected party.

III. FINDINGS & JURISDICTIONAL RECITALS

1. The Court has personal jurisdiction over Respondent by virtue of residence, service of process, or acts constituting family violence within Georgia.
2. Proper notice and an opportunity to be heard were provided, satisfying due-process requirements under O.C.G.A. § 19-13-3 and applicable court rules.
3. The Court finds by a preponderance of the evidence that Respondent committed acts of family violence against Petitioner on or about [DATE(S)] and that such acts are likely to recur unless restrained.
4. Issuance of this Order is necessary to prevent future acts of family violence and to ensure the safety and welfare of Petitioner and any Minor Child(ren).

IV. OPERATIVE PROTECTIVE PROVISIONS

1. No-Contact & Stay-Away
   a. Respondent shall have no contact with Petitioner, directly or indirectly, except as expressly permitted herein.
   b. Respondent shall stay at least [500] feet from Petitioner, Minor Child(ren), and any Protected Address.

2. Prohibited Conduct
   Respondent is enjoined from harassing, stalking, following, surveilling, intimidating, or engaging in any violent or threatening behavior toward Petitioner.

3. Exclusive Use & Possession of Residence
   Petitioner is granted exclusive use and possession of the shared residence located at [ADDRESS]. Respondent shall vacate said residence no later than [TIME], [DATE], leaving undisturbed Petitioner’s personal property.

4. Temporary Support (if applicable)
   Respondent shall pay temporary child support/spousal support in the amount of $[___] per [week/month], commencing [DATE], pursuant to O.C.G.A. § 19-13-4(a)(4).

5. Counseling/Treatment
   Respondent shall enroll in and complete a certified Family Violence Intervention Program within [30] days and shall provide proof of enrollment to the Court within [10] days of enrollment.

V. FIREARM & WEAPONS RESTRICTIONS

1. Pursuant to O.C.G.A. § 19-13-4(a)(7), Respondent is prohibited from receiving, possessing, or transporting any Firearm for the duration of this Order.
2. Respondent shall surrender all Firearms and ammunition in Respondent’s possession to the [Sheriff of COUNTY County] or a licensed Federal Firearms Dealer within [24] hours of service of this Order and shall file proof of surrender within [48] hours thereafter.

VI. CHILD-RELATED RELIEF

1. Temporary Custody
   a. Petitioner is awarded temporary sole legal and physical custody of the Minor Child(ren) identified in Schedule A.
   b. Respondent shall have supervised visitation only, as arranged through [Supervising Agency/Person] and pursuant to the schedule in Schedule C.

2. Relocation/School Notification
   Petitioner may relocate the Minor Child(ren) within the State of Georgia without further order, provided written notice is given to Respondent [10] days in advance.

VII. MUTUAL PROPERTY & FINANCIAL PROVISIONS

1. Personal Property Retrieval
   Respondent may retrieve necessary clothing and personal effects only in the presence of a law-enforcement officer on [DATE/TIME or “as scheduled by the Sheriff’s Office”].

2. Shared Financial Obligations
   The parties shall continue to make minimum payments on jointly titled debts listed in Schedule D to preserve credit standing pending further order.

VIII. LAW-ENFORCEMENT DUTIES & SERVICE

1. A certified copy of this Order shall be served forthwith on Respondent by the [Sheriff’s Office], which shall enter the Order into the Georgia Protective Order Registry as required by O.C.G.A. § 19-13-3(d).
2. Law-enforcement officers shall arrest Respondent, without necessity of a warrant, upon probable cause to believe Respondent has violated any provision of this Order.

IX. VIOLATION, PENALTIES & ENFORCEMENT

1. Criminal Penalties
   Violation of this Order constitutes a misdemeanor of a high and aggravated nature under O.C.G.A. § 16-5-95 and may result in arrest and prosecution.

2. Civil Contempt
   The Court retains jurisdiction to punish Respondent for civil or criminal contempt, including incarceration of up to 20 days per offense and/or monetary fines.

3. Duration
   This Order shall remain in full force for [___] months/years from the Effective Date unless earlier modified, extended, or vacated by the Court.

X. MODIFICATION, RENEWAL & TERMINATION

1. Either party may file a written motion for modification or dissolution pursuant to O.C.G.A. § 19-13-4(c), with notice to the opposing party.
2. Petitioner may seek renewal by filing a verified motion no less than 30 days prior to expiration, upon which the Court may extend the Order for an additional period not to exceed three years, or permanently if warranted.

XI. GENERAL PROVISIONS

1. Severability
   Should any provision of this Order be held invalid, the remainder shall remain enforceable.

2. Supersession
   This Order supersedes all prior temporary or ex parte protective orders entered in this action.

3. No Waiver
   Failure by Petitioner or law-enforcement to act upon a violation shall not constitute waiver of any right to enforcement later.

4. Copies & Notice
   Certified copies shall be furnished to Petitioner, Respondent, counsel of record, the Sheriff’s Office, and any designated school or workplace listed in Schedule B.

XII. EXECUTION & CERTIFICATION

Entered this ___ day of __________, 20__.

_____________________________________
[JUDGE NAME],
Judge, Superior Court of [COUNTY] County, Georgia

[COURT SEAL]

Attest: ___________________________________
[Clerk Name], Clerk of Court

SERVICE AND ACKNOWLEDGMENT

I certify that I have served a true copy of this Order on Respondent as follows:

Date of Service: __________
Method of Service: ☐ Personal ☐ Certified Mail ☐ Other ☐

_____________________________________
[Deputy Sheriff/Process Server]

Respondent’s Acknowledgment of Receipt (optional):

_____________________________________
[Respondent Signature & Date]

SCHEDULES

• Schedule A – Minor Child(ren) Information
• Schedule B – Protected Addresses & Locations
• Schedule C – Supervised Visitation Schedule
• Schedule D – Joint Financial Obligations

END OF DOCUMENT