Domestic Violence Protection Order - Indiana

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

Indiana requires the use of official court form PO-0100 (Petition for an Order for
Protection) for domestic violence 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.in.gov/courts/iocs/publications/po-forms/.
Do not file this document directly with the court.

INDIANA DOMESTIC VIOLENCE PROTECTION ORDER

(Template for Court Use under Ind. Code § 34-26-5-1 et seq.)

TABLE OF CONTENTS

1. Document Header
2. Definitions
3. Findings of Fact and Representations
4. Operative Injunctive Provisions
5. Respondent Obligations & Restrictions
6. Enforcement, Default & Remedies
7. Risk Allocation & Miscellaneous Provisions
8. Dispute Resolution & Jurisdiction
9. General Provisions
10. Execution & Certification Block

1. DOCUMENT HEADER

CAUSE NO.: [COURT-ASSIGNED]
IN THE [CURRENT COURT NAME]
STATE OF INDIANA

DOMESTIC VIOLENCE PROTECTION ORDER
(☐ Ex Parte ☐ Final After Hearing)

Petitioner/Protected Person(s): [PETITIONER FULL LEGAL NAME(S)]
Date of Birth: [MM/DD/YYYY]

v.

Respondent: [RESPONDENT FULL LEGAL NAME]
Date of Birth: [MM/DD/YYYY]

Effective Date: [DATE OF ISSUANCE]
Expiration Date: [DATE — DEFAULT TWO (2) YEARS AFTER ISSUANCE UNLESS THE COURT ORDERS ANOTHER DATE, per Ind. Code § 34-26-5-9(f)]

Jurisdictional Basis: Ind. Code § 34-26-5-4; acts of domestic or family violence alleged to have occurred in [COUNTY], Indiana.

2. DEFINITIONS

For purposes of this Order, the following capitalized terms have the meanings set forth below. Defined terms apply singularly or plurally, as the context requires.

“Act of Domestic or Family Violence” means an act as defined in Ind. Code § 34-6-2.1-50, including but not limited to attempting, threatening, or causing physical harm to a family or household member, placing a family or household member in fear of physical harm, or causing involuntary sexual activity; for purposes of Ind. Code § 34-26-5 the term also includes stalking (Ind. Code § 35-45-10-1) and a sex offense under Ind. Code § 35-42-4.

“Court” means the Indiana court identified in the current caption and filing packet.

“Excluded Location(s)” means any physical location listed in Section 4.2 from which Respondent is barred.

“Firearm” has the meaning ascribed in Ind. Code § 35-47-1-5.

“No-Contact Provision” refers to the prohibition in Section 4.1.

“Petitioner” includes any “Protected Person(s)” identified in Section 1.

“Respondent” means the individual identified in the Document Header against whom this Order is entered.

3. FINDINGS OF FACT AND REPRESENTATIONS

The Court, having reviewed the verified petition, supporting evidence, and (if applicable) testimony presented at hearing, FINDS:

3.1 Relationship. The parties are (check one): ☐ spouses ☐ former spouses ☐ persons who have a child in common ☐ current/former co-habitants ☐ persons in a dating relationship, within the meaning of “family or household member” under Ind. Code § 34-6-2.1-67.

3.2 Jurisdiction & Venue. The Court has jurisdiction and venue under Ind. Code § 34-26-5-4, and venue is proper in [COUNTY], Indiana.

3.3 Immediate Danger. ☐ The Court finds by a preponderance of the evidence that Petitioner and/or the minor child(ren) face an immediate and present danger of domestic or family violence.

3.4 Service/Notice. ☐ Respondent was served with notice and an opportunity to be heard on [DATE] (or) ☐ Proceeding is ex parte per Ind. Code § 34-26-5-9.

3.5 Necessity. The relief granted herein is necessary to bring about the cessation of the violence or threat thereof.

4. OPERATIVE INJUNCTIVE PROVISIONS

IT IS THEREFORE ORDERED, ADJUDGED, AND DECREED that:

4.1 No-Contact Provision. Respondent shall not directly or indirectly contact, molest, harass, threaten, follow, or communicate with Petitioner and the Protected Person(s) by any means, including in-person, telephone, electronic, social media, or through third parties.

4.2 Stay-Away Provision. Respondent shall remain at least [500] feet from:
a. Petitioner’s residence at [ADDRESS];
b. Petitioner’s place of employment at [ADDRESS];
c. The minor child(ren)’s school/daycare at [ADDRESS]; and
d. Any other Excluded Location(s): [LIST].

4.3 Exclusive Possession of Residence. ☐ Respondent shall immediately vacate the shared residence located at [ADDRESS] and is prohibited from re-entering without Court authorization.

4.4 Firearms & Deadly Weapons. Under Ind. Code § 34-26-5-9(d)(4) and (h), the Court may prohibit Respondent from using or possessing firearms, ammunition, or deadly weapons and direct their surrender for the duration of this Order. If so ordered, Respondent shall:
a. Surrender all Firearms and ammunition in Respondent’s possession to [LAW ENFORCEMENT AGENCY] within [24] hours (or as otherwise ordered by the Court);
b. File a receipt of surrender with the Court within [48] hours (or as otherwise ordered by the Court).

4.5 Parenting Time. ☐ Parenting time is temporarily suspended. ☐ Parenting time shall occur only as ordered: [DETAILS OR REFER TO SEPARATE ORDER].

4.6 Counseling/Treatment. Respondent is ordered to complete (☐ batterers’ intervention ☐ substance-abuse counseling) and file proof of enrollment within [30] days.

4.7 Duration. This Order shall remain in full force and effect until [EXPIRATION DATE] unless earlier modified or dissolved by the Court.

5. RESPONDENT OBLIGATIONS & RESTRICTIONS

5.1 Identification & Compliance. Respondent shall at all times keep a certified copy of this Order in Respondent’s possession and immediately present it to any law-enforcement officer upon request.

5.2 Transfer of Utilities/Leases. If ordered to vacate a residence, Respondent shall cooperate in transferring utilities, leases, or tenancy obligations as necessary to effectuate exclusive possession.

5.3 Prohibited Acts. Respondent shall not commit or attempt to commit any Act of Domestic or Family Violence, stalking, or harassment against Petitioner or Protected Person(s).

6. ENFORCEMENT, DEFAULT & REMEDIES

6.1 Criminal Penalties. Violation of this Order constitutes the criminal offense of invasion of privacy under Ind. Code § 35-46-1-15.1 (Class A misdemeanor; Level 6 felony if the person has a prior unrelated conviction under that subsection or for stalking under Ind. Code § 35-45-10-5).

6.2 Civil Contempt. Any violation also subjects Respondent to civil contempt sanctions, including incarceration, fines, and attorney’s fees.

6.3 Law-Enforcement Entry. This Order shall be entered into the Indiana protective order registry (Ind. Code § 5-2-9), the Indiana Data and Communication System (IDACS), and the National Crime Information Center (NCIC) pursuant to federal and state law.

6.4 Warrantless Arrest. Under Ind. Code § 35-33-1-1(a)(6), a law-enforcement officer may arrest Respondent without a warrant upon probable cause to believe Respondent has committed invasion of privacy by violating this Order.

6.5 Attorney Fees. The Court may award reasonable attorney’s fees to Petitioner for enforcement proceedings.

7. RISK ALLOCATION & MISCELLANEOUS PROVISIONS

7.1 Hold Harmless for Reporting. Any individual who in good faith reports a violation of this Order shall be immune from civil liability to the fullest extent permitted by law.

7.2 Emergency Safety. This proposed order does not create a private force-majeure rule. Contact, parenting time, and emergency safety measures are governed by the terms the Court actually enters and any later lawful modification or emergency order.

8. DISPUTE RESOLUTION & JURISDICTION

8.1 Governing Law. This Order is governed exclusively by the laws of the State of Indiana, including Ind. Code § 34-26-5-1 et seq.

8.2 Exclusive Forum. The [NAME OF COUNTY] [CIRCUIT/SUPERIOR] Court retains exclusive jurisdiction over all matters arising from or relating to this Order.

8.3 Procedure. Do not add private arbitration or a categorical jury statement without current procedural review. The Court will apply the procedure governing the protection-order case and any related family matter.

8.4 Injunctive Relief Preservation. Nothing herein limits the Court’s inherent authority to modify or extend injunctive relief as justice requires.

9. GENERAL PROVISIONS

9.1 Modification & Termination. Either party may move to modify this Order pursuant to Ind. Code § 34-26-5-9 (petition to modify), and the Court may dismiss an order under Ind. Code § 34-26-5-12, by filing a verified petition and serving the opposing party.

9.2 Severability. If any provision of this Order is found unenforceable, the remaining provisions shall remain in full force.

9.3 Integration. This document constitutes the entire Protection Order. No oral representations or other writings shall modify its terms absent further Court order.

9.4 Copies & Electronic Signatures. Certified copies and electronically signed versions of this Order shall have the same force and effect as an original.

10. EXECUTION & CERTIFICATION BLOCK

SO ORDERED this ____ day of __________, 20____, at ____ [a.m./p.m.].

______________________________________________
[JUDGE’S NAME], Judge
[NAME OF COUNTY] [CIRCUIT/SUPERIOR] Court

Attest:
______________________________________________
[COURT CLERK NAME], Clerk

Service:
☐ Petitioner in open court
☐ Respondent in open court
☐ Sheriff of [COUNTY]
☐ Indiana State Police (IDACS/NCIC entry)
☐ Other: ______________________________

[SEAL]