Domestic Violence Protection Order

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

Iowa requires the use of official court Rule 17.10 — Form 11 (Petition for Relief from
Domestic Abuse) for domestic abuse protection order petitions. 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.iowacourts.gov/for-the-public/court-forms.
Do not file this document directly with the court.

IOWA DISTRICT COURT FOR [COUNTY] COUNTY

IN RE THE MATTER OF
[PETITIONER FULL LEGAL NAME],
Petitioner/Protected Party,

and

[RESPONDENT FULL LEGAL NAME],
Respondent/Defendant.

Case No.: [___]
Civil Domestic Abuse Protective Order
(Iowa Code ch. 236)

[Effective as of] [EFFECTIVE DATE]

TABLE OF CONTENTS

1. Document Header …………………………………………………………………… 2
2. Definitions …………………………………………………………………………… 3
3. Operative Provisions (Orders of Protection) ……………………………………… 4
4. Representations & Warranties ……………………………………………………… 7
5. Covenants & Restrictions …………………………………………………………… 7
6. Default & Remedies ………………………………………………………………… 8
7. Risk Allocation ……………………………………………………………………… 9
8. Dispute Resolution …………………………………………………………………… 9
9. General Provisions …………………………………………………………………… 10
10. Execution Block ……………………………………………………………………… 11

1. DOCUMENT HEADER

1.1 Recitals.
A. On [PETITION FILE DATE], Petitioner filed a verified Petition pursuant to Iowa Code ch. 236 alleging that Respondent committed acts of domestic abuse as defined in Iowa Code § 236.2.
B. The Court finds it has subject-matter jurisdiction over this proceeding and personal jurisdiction over the parties.
C. A hearing was held on [HEARING DATE] with due notice to all parties. Respondent [appeared/did not appear].
D. Based on the record, statutory criteria, and the best interests of any minor child(ren), the Court enters the following Protective Order.

1.2 Governing Law. This Order is entered under and shall be interpreted in accordance with Iowa Code ch. 236 and applicable federal law, including 18 U.S.C. § 2265 (full faith and credit for protection orders).

1.3 Jurisdiction & Venue. Venue is proper in the Iowa District Court for [COUNTY] County pursuant to Iowa Code § 236.3(3).

2. DEFINITIONS

As used in this Order:

“Domestic Abuse” means an assault as defined in Iowa Code § 708.1 between family or household members as set forth in Iowa Code § 236.2(2).

“Protected Parties” means Petitioner and any minor child(ren) or other person(s) specifically listed in Section 3.1(B).

“Respondent” means the individual identified in the caption of this Order.

“Residence” means the dwelling located at [ADDRESS] or any subsequent dwelling awarded exclusively to Petitioner herein.

“Stay-Away Distance” means at least [100/300/500] yards (or greater as specified) from the Protected Parties, their Residence, place of employment, school, or childcare facility.

3. OPERATIVE PROVISIONS (ORDERS OF PROTECTION)

3.1 No-Contact & Stay-Away.
A. Respondent shall not threaten, assault, stalk, molest, harass, or otherwise abuse any Protected Party.
B. Respondent shall remain outside the Stay-Away Distance of the Protected Parties and the locations listed below:

1. Residence: [ADDRESS]
2. Petitioner’s workplace: [ADDRESS]
3. Child(ren)’s school/daycare: [ADDRESS]
4. Other: [SPECIFY]

3.2 Communication Prohibition. Respondent shall refrain from all direct or indirect communication with any Protected Party, including but not limited to phone, text, email, social media, and third-party messaging, except as expressly allowed in Section 3.5 (custody/parenting-time exchanges) or by subsequent written Court order.

3.3 Exclusive Possession of Residence & Personal Property.
A. Petitioner is granted exclusive possession of the Residence.
B. Law enforcement shall, upon request, accompany Petitioner during retrieval of essential personal effects.
C. Respondent shall not terminate or cause the termination of any utility service to the Residence.

3.4 Firearms & Dangerous Weapons. Pursuant to 18 U.S.C. § 922(g)(8) and Iowa Code § 724.26(4), Respondent is prohibited from possessing, shipping, receiving, or transporting any firearm, ammunition, or dangerous weapon for the duration of this Order. Respondent shall surrender all such items to [LAW-ENFORCEMENT AGENCY] within [24] hours of service of this Order and file proof of surrender within [48] hours.

3.5 Temporary Custody, Parenting-Time, and Support.
A. Petitioner is awarded temporary legal and physical custody of the following minor child(ren): [NAMES & DOBs].
B. Any visitation shall occur only as follows: [supervised/neutral-exchange location], subject to agreement of the parties or further Court order.
C. Child support is set at [$____] per month beginning [DATE] and shall be paid through the Iowa Child Support Recovery Unit.

3.6 Counseling & Intervention Programs. Respondent shall successfully complete [Batterers’ Education Program] approved under Iowa Code § 708.2B within [X] days.

3.7 Law-Enforcement Assistance. Any Iowa peace officer is authorized to enforce this Order, accompany any Protected Party to ensure safety, and effect immediate arrest for violations pursuant to Iowa Code § 664A.4(2).

3.8 Duration. This Protective Order shall remain in full force until [EXPIRATION DATE not to exceed one (1) year absent extension per Iowa Code § 236.5(2)], unless modified or terminated earlier by the Court.

3.9 Service & Entry into Databases.
A. The Clerk of Court shall promptly forward a certified copy of this Order to the [COUNTY] Sheriff for personal service on Respondent.
B. The Sheriff shall enter the Order into the Iowa On-Line Warrants and Articles (IOWA) system and the NCIC Protection Order File within twenty-four (24) hours of service.

3.10 Federal Full Faith & Credit. This Order is valid and enforceable in all fifty states, the District of Columbia, tribal lands, and U.S. territories pursuant to 18 U.S.C. § 2265.

4. REPRESENTATIONS & WARRANTIES

4.1 Petitioner’s Verification. Petitioner represents under penalty of perjury that the factual statements in the underlying Petition are true, correct, and complete to the best of Petitioner’s knowledge.

4.2 Court’s Findings. The Court finds by a preponderance of the evidence that Respondent committed domestic abuse and that the relief granted herein is necessary to protect the safety of the Protected Parties.

5. COVENANTS & RESTRICTIONS

5.1 Respondent shall strictly comply with each provision of Section 3.

5.2 Respondent shall immediately notify the Court and Petitioner, through counsel if represented, of any change in residence, phone number, or employment within seventy-two (72) hours.

5.3 Respondent shall not interfere with or diminish any utility, insurance, or financial service primarily used or enjoyed by Petitioner or the minor child(ren).

6. DEFAULT & REMEDIES

6.1 Violation as Criminal Offense. A knowing violation of this Order constitutes the crime described in Iowa Code § 664A.7, punishable as a simple misdemeanor for a first offense and an aggravated misdemeanor for a second or subsequent offense.

6.2 Civil Contempt. Violation shall also subject Respondent to civil contempt proceedings under Iowa Code ch. 665.

6.3 Immediate Arrest Authority. Peace officers shall, without warrant, arrest Respondent upon probable cause to believe Respondent has violated any provision of this Order, pursuant to Iowa Code § 664A.4(2).

6.4 Graduated Consequences.
A. First Violation: Mandatory arrest; possible jail term up to thirty (30) days; fine as provided by law.
B. Second Violation: Mandatory arrest; jail term up to one (1) year; fine; modification to increase restrictions or extend duration.
C. Third or Subsequent Violation: Mandatory arrest; felony prosecution where applicable; potential revocation of pre-trial release in related matters.

7. RISK ALLOCATION

7.1 Indemnification. Not applicable—this is a judicial protective order.

7.2 Liability Caps. Not applicable.

7.3 Force Majeure. Compliance with this Order is mandatory and is not excused by force majeure or impossibility.

8. DISPUTE RESOLUTION

8.1 Continuing Jurisdiction. The Iowa District Court for [COUNTY] County retains exclusive jurisdiction to modify, extend, or terminate this Order in accordance with Iowa Code § 236.5.

8.2 No Arbitration. Arbitration is unavailable for matters arising under this Order.

8.3 No Jury. Family-court matters relating to this Order shall be heard by the Court without a jury.

8.4 Preservation of Injunctive Relief. The injunctive nature of this Order is primary and shall not be stayed pending appeal absent a specific supersedeas bond and Court order.

9. GENERAL PROVISIONS

9.1 Amendment & Extension. Either party may move to modify or extend this Order prior to its expiration under Iowa Code § 236.5(1).

9.2 Severability. If any provision of this Order is held invalid, the remaining provisions shall remain in full force to the maximum extent permitted by law.

9.3 Integration. This document represents the entire protective relief ordered; any oral assurances have no legal effect unless reduced to writing and entered by the Court.

9.4 Conflicting Orders. Where another court order conflicts with this Order, the more restrictive provisions controlling safety shall govern, consistent with Iowa Code § 664A.7(5).

9.5 Copies & Electronic Signatures. Certified electronic copies and electronically-signed counterparts shall be treated as originals for all purposes, including full faith and credit enforcement.

10. EXECUTION BLOCK

SO ORDERED.

Dated: [DATE]

________________________________________
Hon. [JUDGE NAME]
Judge, Iowa District Court
[County] County, Iowa

ATTEST:
________________________________________
Clerk of Court / Designee

Approved as to Form:

PETITIONER:
________________________________________
[PETITIONER NAME]
Address: [___]
Phone: [___]

RESPONDENT (acknowledgment of service only):
________________________________________
[RESPONDENT NAME]

ATTORNEY FOR PETITIONER (if any):
________________________________________
[ATTY NAME], AT000☐
Firm: [___]
Address: [___]
Phone: [___]
Email: [___]

NOTARY (if required for Petitioner’s affidavit):
State of Iowa, County of ☐
Subscribed and sworn before me on [DATE].
________________________________________
Notary Public

NOTICE TO RESPONDENT

1. You are subject to immediate arrest for any violation of this Order.
2. Federal law 18 U.S.C. § 922(g)(8) makes it a crime to possess firearms or ammunition while this Order is in effect.
3. This Order is enforceable nationwide under 18 U.S.C. § 2265.
4. Violation may result in fines, jail, and federal prosecution.