COMMONWEALTH OF MASSACHUSETTS
TRIAL COURT OF THE COMMONWEALTH
[COURT DEPARTMENT]
[COURT DIVISION]
DOCKET NO.: [DOCKET NUMBER]
ABUSE PREVENTION ORDER
(Pursuant to Mass. Gen. Laws ch. 209A)
TABLE OF CONTENTS
- Document Header
- Definitions
- Operative Provisions
- Findings, Representations & Warranties
- Covenants & Restrictions
- Enforcement; Default & Remedies
- Risk Allocation (N/A)
- Dispute Resolution
- General Provisions
- Execution Block
1. DOCUMENT HEADER
This Abuse Prevention Order (“Order”) is issued by the [COURT DEPARTMENT] sitting in [COUNTY], Massachusetts, on [DATE] (the “Effective Date”) in the matter of [PETITIONER FULL LEGAL NAME] (“Petitioner”) vs. [RESPONDENT FULL LEGAL NAME] (“Respondent”).
RECITALS
A. Petitioner has filed a sworn Complaint for Protection from Abuse under Mass. Gen. Laws ch. 209A, alleging that Respondent has committed or threatened “Abuse” as defined herein.
B. The Court has jurisdiction under Mass. Gen. Laws ch. 209A §§ 2–4 and finds good cause to issue this Order to ensure the immediate safety and welfare of Petitioner and any other Protected Parties as identified below.
2. DEFINITIONS
For purposes of this Order, the following terms shall have the meanings set forth below. Defined terms appear in bold throughout this document.
- Abuse – The occurrence of any act or threatened act causing or attempting to cause physical harm, placing another in fear of imminent serious physical harm, or causing another to engage involuntarily in sexual relations by force, threat, or duress.
- Court – The [COURT DEPARTMENT, DIVISION, & LOCATION] issuing this Order.
- Firearms Identification Card (“FID Card”) – As defined in Mass. Gen. Laws ch. 140 § 129B.
- Minor Child(ren) – The minor child(ren) of the parties or in Petitioner’s care as specifically listed in Section 3.4 below.
- Order – This Abuse Prevention Order, including any attachments, schedules, and subsequent extensions or modifications issued by the Court.
- Protected Address – [ADDRESS OR “CONFIDENTIAL”]; if confidential, such address shall remain impounded pursuant to Trial Ct. Rule VIII.
- Protected Parties – Collectively, the Petitioner and any Minor Child(ren) or household members specifically identified in Section 3.4.
- Respondent – [RESPONDENT FULL LEGAL NAME], the individual against whom this Order is directed.
3. OPERATIVE PROVISIONS
3.1 Prohibition Against Abuse
Respondent SHALL NOT abuse the Petitioner or any Protected Party. Abuse includes, without limitation, any act defined in Mass. Gen. Laws ch. 209A § 1.
3.2 No Contact
Respondent SHALL NOT:
a. Directly or indirectly contact or communicate with any Protected Party by any means, including in-person, telephone, text, email, social media, or third-party conduit; and
b. Follow, surveil, or otherwise monitor any Protected Party.
3.3 Stay-Away Distance
Respondent SHALL remain at least [MINIMUM DISTANCE IN FEET / YARDS] from each Protected Party, the Protected Address, any school, childcare facility, or workplace listed in Schedule A.
3.4 Custody / Visitation
Pending further order of the Court:
• Temporary legal and physical custody of the following minor child(ren) is awarded to Petitioner:
1. [CHILD NAME, DOB]
2. [CHILD NAME, DOB]
• Any visitation by Respondent is [suspended / supervised under conditions in Schedule B].
3.5 Vacate Provision
Respondent shall immediately vacate and remain away from the dwelling located at [ADDRESS] and shall not interfere with Petitioner’s exclusive use and possession thereof.
3.6 Firearms & Licenses
Pursuant to Mass. Gen. Laws ch. 209A § 3B:
a. Respondent SHALL surrender to the [LOCAL POLICE DEPARTMENT] within 24 hours of service:
i. All firearms, rifles, shotguns, weapons, ammunition, and
ii. Any FID Card, License to Carry (“LTC”), or other firearms permits.
b. The surrendering agency shall issue a detailed receipt to Respondent and file a copy with the Court forthwith.
3.7 Term & Review
This Order shall remain in full force until [EXPIRATION DATE] unless sooner modified, extended, or vacated by the Court after notice and hearing. A review hearing is scheduled for [DATE & TIME] at [COURT LOCATION].
3.8 Service of Order
Certified copies of this Order, any suspension notice under 3.6, and all attachments shall be served on Respondent by [CONSTABLE / POLICE] forthwith and shall be entered into the Massachusetts Law Enforcement System (“CJIS”) without delay.
[// GUIDANCE: Practitioners should coordinate with the clerk-magistrate to ensure immediate electronic transmittal to the statewide registry pursuant to Standing Order 09-20.]
4. FINDINGS, REPRESENTATIONS & WARRANTIES
4.1 Findings of Fact
The Court finds, by a preponderance of the evidence, that abuse has occurred and that there is a substantial likelihood of immediate danger of further abuse.
4.2 Respondent’s Representation
Respondent is deemed to have actual notice of and is bound by the terms of this Order immediately upon service.
4.3 Survival
All findings herein shall survive any interim continuances or extensions of this Order.
5. COVENANTS & RESTRICTIONS
5.1 Affirmative Duties of Respondent
a. Compliance with all surrender requirements in Section 3.6.
b. Attendance at [BATTERER’S INTERVENTION PROGRAM / “N/A”] as further ordered.
5.2 Notice Obligations
Respondent must notify the Court in writing of any change of address within 24 hours of relocation.
6. ENFORCEMENT; DEFAULT & REMEDIES
6.1 Criminal Enforcement
Violation of any provision of this Order constitutes a criminal offense punishable by arrest without warrant under Mass. Gen. Laws ch. 209A § 7.
6.2 Contempt Proceedings
Upon motion of Petitioner or any Protected Party, the Court may initiate civil contempt proceedings for any non-criminal violation.
6.3 Attorneys’ Fees & Costs
The Court may award reasonable attorneys’ fees and costs to the prevailing party in any contempt action related to enforcement of this Order.
7. RISK ALLOCATION
[NOT APPLICABLE to abuse prevention orders; indemnification and liability caps are not relevant.]
8. DISPUTE RESOLUTION
8.1 Governing Law
This Order is governed by the laws of the Commonwealth of Massachusetts, including Mass. Gen. Laws ch. 209A.
8.2 Continuing Jurisdiction
The [COURT DEPARTMENT] retains exclusive continuing jurisdiction over all matters arising under or related to this Order.
8.3 Injunctive Relief
Nothing herein limits the Court’s inherent authority to grant additional injunctive relief or other equitable remedies required to protect the safety of Protected Parties.
9. GENERAL PROVISIONS
9.1 Modification or Termination
Either party may seek modification, extension, or termination of this Order pursuant to Mass. Gen. Laws ch. 209A § 4 by filing a written motion and providing notice to the opposing party.
9.2 Severability
Should any provision of this Order be held invalid, all remaining provisions shall remain in full force.
9.3 Integration
This Order, including Schedules A–B, constitutes the entire abuse prevention order; no prior oral or written statements are incorporated unless expressly referenced herein.
9.4 Copies & Electronic Signatures
Certified electronic copies and electronically signed counterparts of this Order are legally effective and enforceable as originals.
10. EXECUTION BLOCK
IN WITNESS WHEREOF, the Court has caused this Abuse Prevention Order to be issued and entered on the docket on the Effective Date set forth above.
Issued at: [COURTHOUSE, CITY, MA]
Date: [DATE]
Time: [TIME]
[JUDGE’S NAME], Justice
[COURT DEPARTMENT]
Attest:
Clerk-Magistrate / Assistant Clerk
ACKNOWLEDGMENT OF SERVICE
I certify that I personally served a true and attested copy of this Abuse Prevention Order on Respondent.
Date of Service: [DATE]
Time of Service: [TIME]
Signature of Server
Name & Title: [CONSTABLE/OFFICER]
Badge/ID: [BADGE]
SCHEDULE A – STAY-AWAY LOCATIONS
(Attach additional pages if necessary)
| No. | Location Name | Address | Radius (ft.) |
|---|---|---|---|
| 1 | |||
| 2 |
SCHEDULE B – SUPERVISED VISITATION PROTOCOL
[Describe exchange location, supervisor qualifications, frequency, and duration.]
[// GUIDANCE: Tailor Schedule B to comply with Probate & Family Court Standing Order 2-21 and local visitation center requirements.]
Statutory Authority: Mass. Gen. Laws ch. 209A §§ 1–7 (2023).