Domestic Violence Protection Order

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

Kansas requires the use of official Kansas Judicial Council Protection from Abuse (PFA)
forms 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 forms are available at
https://www.kjc.ks.gov/legal-forms/protection-from-abuse.
Do not file this document directly with the court.

IN THE [DISTRICT/FAMILY] COURT OF [___] COUNTY, KANSAS

Division: Family / Domestic
Case No.: ☐

DOMESTIC VIOLENCE PROTECTION ORDER

(Pursuant to the Kansas Protection from Abuse Act, Kan. Stat. Ann. § 60-3101 et seq.)

I. DOCUMENT HEADER

1. Parties
   1.1 Petitioner: [PETITIONER FULL LEGAL NAME], an individual currently residing at [ADDRESS] (“Petitioner”).
   1.2 Respondent: [RESPONDENT FULL LEGAL NAME], an individual currently residing at [ADDRESS] (“Respondent”).

2. Recitals
   A. Petitioner has filed a verified petition under the Kansas Protection from Abuse Act (“KPAA”) alleging that Respondent committed or threatened domestic violence as defined in Kan. Stat. Ann. § 60-3102.
   B. This Court has jurisdiction over the parties and the subject matter pursuant to Kan. Stat. Ann. §§ 60-3104 & -3107, and venue is proper in [___] County, Kansas.
   C. Good cause having been shown, the Court finds that immediate protection is necessary to prevent further abuse.

3. Effective Date & Term
   3.1 Effective Date: Upon filing and service, or as otherwise specified in Section 8.2.
   3.2 Expiration Date: ☐ (no later than one year from issuance unless extended per § 60-3107).

TABLE OF CONTENTS

I. Document Header
II. Definitions
III. Findings of Fact
IV. Operative Protective Provisions
V. Enforcement & Service Provisions
VI. Violation Penalties Notice
VII. Modification, Extension & Termination
VIII. General Provisions
IX. Execution Block

II. DEFINITIONS

For purposes of this Order, capitalized terms shall have the meanings set forth below.

“Awarded Residence” – The dwelling located at [ADDRESS] awarded exclusively to Petitioner under Section 4.3.

“Communication” – Any contact by telephone, text, e-mail, social media, written note, or third-party intermediary, whether direct or indirect.

“Firearm” – Any weapon defined in 18 U.S.C. § 921(a)(3) or Kan. Stat. Ann. § 21-6301.

“Protected Persons” – Collectively, Petitioner, [MINOR CHILD(REN) FULL NAMES & DOBs], and any other individuals specifically listed in Section 4.1.

III. FINDINGS OF FACT

1. Respondent and Petitioner are [relationship—e.g., spouses / former intimate partners / parents of child(ren)].
2. On or about [DATE(S)], Respondent [brief summary of abusive conduct].
3. Such conduct constitutes “abuse” within the meaning of Kan. Stat. Ann. § 60-3102(a).
4. Immediate issuance of this Order is necessary to protect Petitioner and other Protected Persons from further harm.

IV. OPERATIVE PROTECTIVE PROVISIONS

4.1 No Contact. Respondent SHALL NOT:
(a) Initiate or engage in any Communication with any Protected Person, except as specifically permitted in Section 4.6;
(b) Come within ☐ feet/meters of any Protected Person, the Awarded Residence, place of employment, educational facility, daycare, or any other location listed here: ☐.

4.2 Stay-Away & Exclusion. Respondent is ORDERED to remain at least ☐ feet/meters away from the Awarded Residence and any temporary residence of Protected Persons.

4.3 Exclusive Use of Residence. Petitioner is awarded exclusive use and possession of the Awarded Residence. Respondent shall vacate the premises no later than [TIME] on [DATE] and may remove personal clothing and effects only in the presence of a law-enforcement officer.

4.4 Firearms & Dangerous Weapons.
(a) Pursuant to Kan. Stat. Ann. § 60-3107(b), Respondent SHALL IMMEDIATELY surrender all Firearms and ammunition in Respondent’s possession to [LAW-ENFORCEMENT AGENCY] within 24 hours of service of this Order and file proof of surrender with the Court within 48 hours.
(b) Respondent is prohibited from purchasing, receiving, or possessing any Firearm for the duration of this Order.

4.5 Temporary Custody, Parenting Time & Support.
(a) Custody of the minor child(ren) is temporarily granted to Petitioner as follows: [Specify legal and physical custody arrangement].
(b) Supervised parenting time for Respondent, if any, shall occur at [LOCATION] on [DAYS/TIMES] under the supervision of [NAME/AGENCY].
(c) Child support shall be paid in the amount of $[___] per [week/month] through the Kansas Payment Center commencing [DATE].

4.6 Limited, Court-Monitored Communication. Communication between the parties shall be limited to (i) matters concerning the minor child(ren) and (ii) conducted exclusively via [Court-approved application/e-mail], and only as necessary to effectuate parenting-time logistics.

4.7 Counseling & Intervention Programs. Respondent is ORDERED to complete a certified batterer intervention program within [___] days and file proof of enrollment within [___] days of this Order.

V. ENFORCEMENT & SERVICE PROVISIONS

5.1 Law-Enforcement Authority. This Order shall be enforced by any Kansas law-enforcement officer with jurisdiction. Officers shall arrest Respondent without warrant upon probable cause of a violation pursuant to Kan. Stat. Ann. § 22-2401(c)(1).

5.2 Entry into State & Federal Databases. The Clerk shall transmit a copy of this Order to the Kansas Protection Order Portal (KPOPS) and the National Crime Information Center (NCIC) within 24 hours of issuance.

5.3 Service on Respondent. Personal service shall be effected by the [SHERIFF/PROCESS SERVER] no later than [DATE], and proof of service shall be filed forthwith.

VI. VIOLATION PENALTIES NOTICE

“Violation of this Protection Order, or any provision thereof, is a Class A person misdemeanor under Kan. Stat. Ann. § 21-5924. A second or subsequent conviction within five (5) years of a prior conviction is a severity level 6, person felony. Federal law 18 U.S.C. § 922(g)(8) and § 2265 also impose criminal penalties, including potential imprisonment and fines.”

VII. MODIFICATION, EXTENSION & TERMINATION

7.1 Either party may request modification or dismissal by filing a verified motion pursuant to Kan. Stat. Ann. § 60-3107(a).
7.2 Extensions. Upon motion filed prior to expiration, the Court may extend this Order for one additional year or enter a permanent order as permitted by § 60-3107(b).
7.3 Termination. This Order shall remain in full force and effect until the Expiration Date unless earlier dissolved by further order of this Court.

VIII. GENERAL PROVISIONS

8.1 Governing Law. This Order is governed by the laws of the State of Kansas, including but not limited to the KPAA, and shall be construed accordingly.
8.2 Effective Date on Oral Pronouncement. If this Order is orally pronounced in open court, it is enforceable immediately; the written form is entered nunc pro tunc to the time of pronouncement.
8.3 Severability. If any provision of this Order is held invalid, the remaining provisions shall remain in full force and effect.
8.4 No Waiver. The failure to enforce any term shall not constitute a waiver of future enforcement of that or any other term.
8.5 Copies & Electronic Signatures. Certified copies and electronically-signed counterparts of this Order shall have the same force and effect as an original.

IX. EXECUTION BLOCK

Ordered and Adjudged this ___ day of __________, 20__ in [CITY], Kansas.

____________________________________
[JUDGE’S PRINTED NAME]
Judge of the District Court, ☐ Judicial District

Attest:
____________________________________
Clerk of the Court

[Seal]

ACKNOWLEDGMENT OF SERVICE & RECEIPT BY RESPONDENT

I, [RESPONDENT NAME], acknowledge receipt of this Protection Order and understand its terms and the penalties for violation.

____________________________________ Date: __________
Respondent’s Signature

(Notary Acknowledgment, if required)