Domestic Violence Protection Order

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

Nevada requires the use of official court forms for domestic violence temporary
protection order (TPO) applications. This template provides the substantive legal
content to help you prepare — but you must transfer your content to the official
forms before filing. The official forms are available at
https://selfhelp.nvcourts.gov/self-help/temporary-protection-orders/domestic-violence.
Do not file this document directly with the court.

[COURT NAME]

STATE OF NEVADA, FAMILY DIVISION
[COUNTY] COUNTY

ORDER FOR PROTECTION AGAINST DOMESTIC VIOLENCE

(Temporary and/or Extended Pursuant to NRS 33.018 – 33.080)

Case No.: [___]

Department No.: [___]

I. DOCUMENT HEADER

1. Parties
   1.1 Petitioner/Protected Party: [PETITIONER FULL NAME] (“Petitioner”).
   1.2 Respondent/Adverse Party: [RESPONDENT FULL NAME] (“Respondent”).

2. Recitals
   WHEREAS, Petitioner has filed a Verified Application alleging acts constituting “Domestic Violence” as that term is defined in NRS 33.018; and
   WHEREAS, this Court, having reviewed the pleadings, evidence, and sworn testimony (if any), finds good cause to issue injunctive relief pursuant to NRS 33.020 and 33.030;

3. Effective Date & Jurisdiction
   This Order is effective on the date signed below and is governed exclusively by the laws of the State of Nevada. The Family Division of this Court retains jurisdiction to modify and enforce the Order.

II. DEFINITIONS

For purposes of this Order:
“Court” means the [COURT NAME], Family Division.
“Contact” includes, without limitation, personal, telephonic, electronic, written, or third-party communication.
“Residence” means any dwelling, temporary or permanent, in which Petitioner resides or will reside.
“Protected Child(ren)” means the minor child(ren) identified in § III.3, if any.

III. OPERATIVE PROVISIONS

1. No-Contact Provision
   Respondent shall have no Contact with Petitioner, directly or indirectly, including through third parties, social media, or electronic means.

2. Stay-Away Provision
   Respondent shall remain at least [DISTANCE IN FEET/YARDS] from:
   (a) Petitioner;
   (b) Petitioner’s Residence located at [ADDRESS—OPTION TO SEAL];
   (c) Petitioner’s place of employment/education at [ADDRESS]; and
   (d) Any other location subsequently disclosed in writing by Petitioner and filed under seal with the Court.

3. Child-Related Relief (if applicable)
   3.1 The following minor child(ren) are included in this Order: [NAME(S) & DOB(S)].
   3.2 Temporary Custody: Petitioner is awarded sole physical custody pending further order.
   3.3 Exchange/Supervised Visitation terms (if ordered): [SPECIFY OR “NONE”].

4. Firearms & Dangerous Weapons
   Respondent shall immediately surrender all firearms, ammunition, and dangerous weapons in Respondent’s possession to [LAW ENFORCEMENT AGENCY] and file proof of surrender within 24 hours.

5. Treatment / Batterer’s Intervention Program
   Respondent is ORDERED to enroll in and complete a court-approved domestic-violence intervention program within [X] days, providing written proof of enrollment/completion.

6. Law-Enforcement Entry
   Law-enforcement officers are authorized to accompany Petitioner to residence or place of employment to secure personal belongings or to enforce this Order.

7. Service of Order
   7.1 The Clerk shall provide certified copies of this Order to:
   • Petitioner (or counsel)
   • Appropriate Law-Enforcement Agency for NCIC entry
   • Respondent (via personal service)
   7.2 This Order is valid statewide and is entitled to full faith and credit under 18 U.S.C. § 2265.

IV. REPRESENTATIONS & WARRANTIES

1. Court’s Findings
   1.1 The Court has personal and subject-matter jurisdiction;
   1.2 Petitioner has shown by [preponderance of evidence / reasonable grounds] that domestic violence has occurred or is likely to occur;
   1.3 Less restrictive alternatives are inadequate to ensure safety.

2. Parties’ Representations
   2.1 Petitioner affirms under penalty of perjury that the allegations are true and complete.
   2.2 Respondent, if present, affirms understanding of the Order and its consequences.

V. COVENANTS & RESTRICTIONS

1. Respondent covenants not to:
   (a) Harass, intimidate, threaten, or harm Petitioner or Protected Child(ren);
   (b) Interfere with Petitioner’s peaceful possession of animals, property, or utilities;
   (c) Destroy, conceal, or dispose of jointly owned or Petitioner’s property.

2. Compliance Monitoring
   The Court may schedule review hearings and require Respondent to appear and demonstrate compliance.

VI. DEFAULT & REMEDIES

1. Violation Consequences
   1.1 Any knowing or intentional violation of this Order constitutes:
   • Contempt of Court; and/or
   • A criminal offense under NRS 33.100 (misdemeanor or felony depending on prior convictions).
   1.2 Law-enforcement officers shall arrest Respondent upon probable cause of violation per NRS 171.137.

2. Attorneys’ Fees & Costs
   The prevailing party in any enforcement proceeding may recover reasonable attorneys’ fees and costs upon motion and showing of necessity.

VII. RISK ALLOCATION

Indemnification, limitation of liability, and insurance provisions are not applicable to this family-law protective Order. Nothing herein restricts statutory immunity afforded to law-enforcement officers executing this Order.

VIII. DISPUTE RESOLUTION

1. Governing Law
   This Order is governed by Nevada law, including but not limited to NRS 33.018–33.080.

2. Forum Selection
   Exclusive jurisdiction and venue lie in the Family Division of the [COURT NAME] for all matters arising from this Order.

3. Arbitration & Jury Trial
   Family-law protective-order proceedings are not subject to arbitration, and no jury trial right attaches.

4. Injunctive Relief Preservation
   The equitable remedies herein are cumulative and non-exclusive.

IX. GENERAL PROVISIONS

1. Modification / Termination
   Either party may file a motion to modify or dissolve this Order pursuant to NRS 33.080. The moving party bears the burden of proof.

2. Severability
   Should any provision be deemed unenforceable, the remainder shall remain in full force.

3. Integration
   This Order constitutes the complete directive of the Court on the matters addressed; any prior temporary orders are superseded.

4. Copies & Electronic Signatures
   Certified electronic copies and signatures have the same force as originals.

X. EXECUTION BLOCK

IT IS SO ORDERED.

Dated: ___ / ___ / 20___

________________________________________
[JUDGE NAME]
Judge, [COURT NAME] – Family Division

Petitioner Acknowledgment
I have read this Order, understand its terms, and agree to abide by it.

________________________________________
[PETITIONER SIGNATURE]  Date: ___ / ___ / 20___

Respondent Acknowledgment (if present)
I have received a copy of this Order, understand its terms, and acknowledge that any violation may result in arrest and prosecution.

________________________________________
[RESPONDENT SIGNATURE]  Date: ___ / ___ / 20___

Notary / Clerk Verification (if required)
State of Nevada )
County of ☐ ) ss.

Subscribed and sworn before me on ___ / ___ / 20___ by the individual(s) above.

________________________________________
Notary Public / Clerk of Court

My commission expires: _____________

TABLE OF CONTENTS

I. Document Header – p.1
II. Definitions – p.1
III. Operative Provisions – p.2
IV. Representations & Warranties – p.3
V. Covenants & Restrictions – p.3
VI. Default & Remedies – p.3
VII. Risk Allocation – p.4
VIII. Dispute Resolution – p.4
IX. General Provisions – p.4
X. Execution Block – p.5