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

Missouri requires the use of official court form AA40 (Petition for a Court Order of
Protection — Adult) 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.courts.mo.gov/file.jsp?id=537.
Do not file this document directly with the court.

MISSOURI DOMESTIC VIOLENCE – FULL ORDER OF PROTECTION

(Template – Court-Issued Order)

TABLE OF CONTENTS

1. Document Header
2. Findings & Jurisdictional Recitals
3. Definitions
4. Operative Provisions
   4.1 Prohibited Conduct
   4.2 Stay-Away & No-Contact Requirements
   4.3 Firearms & Ammunition Surrender
   4.4 Exclusive Possession of Residence
   4.5 Custody, Visitation & Child Support (If Applicable)
   4.6 Additional Court-Ordered Relief
5. Enforcement Mechanisms & Penalties for Violation
6. Modification, Extension & Termination
7. Service & Notice Requirements
8. General Provisions
9. Execution Block

1. DOCUMENT HEADER

IN THE CIRCUIT COURT OF THE ☐ JUDICIAL CIRCUIT
FAMILY COURT DIVISION – STATE OF MISSOURI
County: [COUNTY]
Case No.: [___]

Petitioner/Protected Person(s): [FULL LEGAL NAME(S)]
v.
Respondent: [FULL LEGAL NAME] — DOB: [MM/DD/YYYY] — SSN (last 4): [___]

Effective Date: _______________
Expiration Date: _______________ (not to exceed one (1) year unless extended per § 455.040.3 RSMo.)

2. FINDINGS & JURISDICTIONAL RECITALS

The Court, having reviewed the verified petition, evidence, and testimony presented at the hearing held on ________________, makes the following findings by a preponderance of the evidence pursuant to § 455.040 RSMo.:

1. Venue and jurisdiction are proper in this Court.
2. Respondent was duly served with the Petition and notice of hearing as required by § 455.045 RSMo.
3. Respondent has committed, or threatens to commit, domestic violence, stalking, or abuse against Petitioner and/or minor children as defined in § 455.010(1), (13) RSMo.
4. Issuance of this Full Order of Protection is necessary to prevent further abuse and is in the best interests of the parties and any minor child(ren) involved.

3. DEFINITIONS

For purposes of this Order:
“Abuse” means any act of domestic violence, stalking, or coercive control as set forth in § 455.010 RSMo.
“Court” means the Circuit Court of [COUNTY] County, Missouri.
“Firearm” includes any weapon that is capable of expelling a projectile by action of an explosive (§ 571.010(15) RSMo.).
“Protected Address” means any residence, school, place of employment, or other location specifically identified in Section 4 below.
“Respondent” refers to the individual identified in the Document Header against whom this Order is entered.

4. OPERATIVE PROVISIONS

4.1 Prohibited Conduct

Respondent SHALL NOT:
a. Abuse, harass, stalk, intimidate, threaten, or in any way interfere with the personal liberty of Petitioner or the minor child(ren);
b. Use, attempt to use, or threaten to use physical force that would reasonably be expected to cause bodily injury.

4.2 Stay-Away & No-Contact Requirements

Respondent SHALL:
1. Maintain a minimum distance of ☐ feet from Petitioner, the minor child(ren), and each Protected Address at all times;
2. Refrain from any direct or indirect contact with Petitioner, including but not limited to in-person, telephone, text, email, social media, third-party communication, or surveillance.

4.3 Firearms & Ammunition Surrender

1. Pursuant to § 455.050.1(2) & § 571.060.1(1) RSMo., Respondent is PROHIBITED from possessing, purchasing, or receiving any firearms or ammunition for the duration of this Order.
2. Respondent SHALL, within [48] hours of service of this Order, surrender all firearms, ammunition, and concealed-carry permits to [LAW ENFORCEMENT AGENCY] and file proof of compliance with the Court no later than [72] hours thereafter.

4.4 Exclusive Possession of Residence

Petitioner is hereby granted exclusive possession of the residence located at [ADDRESS]. Respondent SHALL immediately vacate the premises and may return only once, in the presence of law enforcement, within [72] hours to retrieve personal belongings.

4.5 Custody, Visitation & Child Support (If Applicable)

1. Temporary legal and physical custody of the minor child(ren) [NAME(S), DOB(s)] is awarded to Petitioner.
2. Supervised visitation, if any, shall occur at [LOCATION] under the supervision of [SUPERVISOR/AGENCY] and in accordance with the schedule attached as Exhibit A.
3. Child support is ordered in the amount of $[___] per month, effective [DATE], payable through the Missouri Family Support Payment Center.

4.6 Additional Court-Ordered Relief

Respondent SHALL:
a. Attend and successfully complete a certified Batterer Intervention Program within [___] days of entry of this Order and file proof of enrollment and completion.
b. Pay court costs and fees totaling $[___] pursuant to § 455.027 RSMo.

5. ENFORCEMENT MECHANISMS & PENALTIES FOR VIOLATION

1. Law enforcement officers SHALL enforce this Order statewide and SHALL arrest Respondent upon probable cause of any violation, per § 455.085.1 RSMo.
2. Violation of this Order constitutes a Class A misdemeanor for a first offense. Subsequent offenses within five (5) years are felonies pursuant to § 455.085.3 RSMo.
3. Each prohibited act or contact constitutes a separate violation.

6. MODIFICATION, EXTENSION & TERMINATION

1. Either party may move to modify or terminate this Order pursuant to § 455.060 RSMo. and Missouri Supreme Court Rule 68.09.
2. Petitioner may apply, before expiration, for renewal or extension for a period up to two (2) additional years, or for a lifetime order if statutory criteria are met (§ 455.040.3 RSMo.).

7. SERVICE & NOTICE REQUIREMENTS

1. The Clerk SHALL issue and forward certified copies of this Order for service on Respondent as required by § 455.045 RSMo.
2. The issuing court SHALL forward the Order to MULES/NCIC within twenty-four (24) hours for entry into the statewide law-enforcement registry.

8. GENERAL PROVISIONS

1. This Order is effective immediately upon entry and remains valid and enforceable in all 50 states, the District of Columbia, tribal lands, and U.S. territories under 18 U.S.C. § 2265.
2. Any conflicting prior orders are hereby superseded to the extent they are inconsistent with the terms herein.
3. If any provision of this Order is held invalid, the remaining provisions shall remain in full force and effect.

9. EXECUTION BLOCK

SO ORDERED this ____ day of ________________, 20____.

________________________________________
Judge [FULL NAME], Circuit Judge
[COUNTY] County, Missouri

(SEAL)

ACKNOWLEDGMENT OF RESPONDENT

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

Date: ____________ Signature: ______________________________

SHERIFF’S RETURN OF SERVICE

I certify that I served the above Order on Respondent as follows:
Date & Time: ____________
Manner of Service: ___________________________________________
Location: ____________________________________

______________________________
Deputy/Officer (Print & Sign)