Domestic Violence Protection Order

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

New York requires the use of official court forms for Family Court order of
protection proceedings, including the Family Offense Petition. This template
provides the substantive legal content to help you prepare — but you must transfer
your content to the official court forms before filing. The official forms are
available at https://ww2.nycourts.gov/forms/familycourt/domesticviolence.shtml.
Do not file this document directly with the court.

FAMILY COURT OF THE STATE OF NEW YORK

County of [COUNTY]

In the Matter of a Proceeding under Article 8 of the Family Court Act
[PETITIONER FULL LEGAL NAME],
  Petitioner,
    – against –
[RESPONDENT FULL LEGAL NAME],
  Respondent.

Docket No.: [DOCKET NO.]
Index No.: [INDEX/FILE NO.]

ORDER OF PROTECTION (DOMESTIC VIOLENCE)

Effective Date: [MM/DD/YYYY]
Expiration Date: [MM/DD/YYYY] (not to exceed the statutory maximum, see N.Y. Fam. Ct. Act § 842)

TABLE OF CONTENTS

1. Document Header
2. Definitions
3. Operative Provisions (Court-Ordered Relief)
4. Findings, Representations & Warranties
5. Covenants & Restrictions
6. Default & Remedies (Violation Consequences)
7. Risk Allocation (N/A – informational only)
8. Dispute Resolution & Governing Law
9. General Provisions
10. Execution Block & Service

1. DOCUMENT HEADER

A. Recitals

1. On [DATE OF FILING], Petitioner filed a verified petition alleging that Respondent committed one or more family offenses as defined in N.Y. Fam. Ct. Act § 812.
2. The Court has jurisdiction over the parties and subject matter pursuant to N.Y. Fam. Ct. Act §§ 812–828.
3. The Court, after due inquiry and either a hearing on the record or Respondent’s default/consent, makes the findings and issues the relief set forth herein.

2. DEFINITIONS

For purposes of this Order, the following capitalized terms shall have the meanings indicated below. Undefined capitalized terms bear their plain-language meaning.

“Child(ren)” – The minor child or children of the parties, or otherwise placed under the Court’s jurisdiction, listed in Schedule A.
“Court” – The Family Court of the State of New York, County of [COUNTY].
“Firearm” – Any weapon defined in 18 U.S.C. § 921(a)(3) and N.Y. Penal Law § 265.00(3).
“Order” – This Domestic Violence Order of Protection, as amended from time to time.
“Petitioner” – [PETITIONER FULL LEGAL NAME], together with any child(ren) or guardian(s) lawfully protected hereby.
“Respondent” – [RESPONDENT FULL LEGAL NAME].
“Residence” – The dwelling(s) set forth in Schedule B or subsequently designated in writing by Petitioner and approved by the Court.

3. OPERATIVE PROVISIONS (COURT-ORDERED RELIEF)

IT IS HEREBY ORDERED, pursuant to N.Y. Fam. Ct. Act § 842, that Respondent shall comply immediately and continuously with each of the following provisions:

3.1 Stay-Away. Respondent shall stay at least [SPECIFY] feet away from Petitioner, the Child(ren), Petitioner’s Residence, place of employment, school, and any other location listed in Schedule C.

3.2 No Contact. Respondent shall have no direct or indirect contact with Petitioner or the Child(ren), including but not limited to in-person, telephone, text, e-mail, social media, or third-party communication, except:
 (a) as expressly permitted in Paragraph 3.4 (visitation), or
 (b) for bona-fide counsel by attorneys of record concerning this action.

3.3 Exclusive Possession of Residence. Respondent is excluded from Petitioner’s Residence. Respondent shall not enter or attempt to enter the Residence or any surrounding curtilage.

3.4 Custody & Visitation. Temporary legal and physical custody of the Child(ren) is awarded to Petitioner. Supervised visitation for Respondent shall occur only:
 • at [VISITATION CENTER NAME],
 • on [DAYS/TIMES],
 • under supervision by [QUALIFIED SUPERVISOR].

3.5 Child and/or Spousal Support. Respondent shall pay temporary support of $[AMOUNT] per [WEEK/MONTH] beginning [MM/DD/YYYY] via the Support Collection Unit. This provision is without prejudice to any final determination under Article 4 of the Family Court Act.

3.6 Surrender of Firearms & Licenses. Within 24 hours of service of this Order, Respondent shall:
 (a) immediately surrender all Firearms, ammunition, and firearm licenses to [LOCAL POLICE AGENCY]; and
 (b) file proof of surrender with the Court within 48 hours thereafter. This surrender directive is authorized by N.Y. Fam. Ct. Act § 842-a (suspension/revocation of firearm license; order to surrender firearms). Continued possession of a firearm in violation of this Order may constitute criminal possession of a firearm under N.Y. Penal Law § 265.01-b (class E felony), and willful disobedience of the Order may be prosecuted as criminal contempt under N.Y. Penal Law § 215.50.

3.7 Treatment Programs. Respondent shall enroll in and complete, at Respondent’s expense, a certified [BATTERER’S INTERVENTION PROGRAM / SUBSTANCE-ABUSE PROGRAM] and shall file proof of enrollment within [10] days.

3.8 Law-Enforcement Entry & Registry. Pursuant to N.Y. Fam. Ct. Act § 168, the Clerk shall file a copy of this Order with the sheriff's office or police department in the county (or city) where Petitioner resides, and the Order shall be entered in the statewide computerized registry of orders of protection maintained under N.Y. Executive Law § 221-a (accessible via NYSPIN/NCIC). Any police officer is authorized and directed to arrest Respondent upon probable cause of a violation hereof.

3.9 Compliance Monitoring. Respondent shall appear for compliance reviews on [DATES] or as otherwise directed by the Court.

4. FINDINGS, REPRESENTATIONS & WARRANTIES

4.1 Findings of Fact. The Court finds that Respondent committed the following family offense(s): [ASSAULT / MENACING / HARASSMENT / STALKING / CRIMINAL MISCHIEF / OTHER].
4.2 Best-Interests Determination. The relief granted herein is necessary to ensure the safety and welfare of Petitioner and the Child(ren).
4.3 Material Disclosure. Each party affirmed on the record that all material facts relevant to risk assessment were fully disclosed to the Court.

5. COVENANTS & RESTRICTIONS

Respondent shall:
(a) obey all conditions of this Order;
(b) immediately update the Court and Petitioner’s counsel of any change in residence, telephone number, or employment; and
(c) not commit any further family offense against Petitioner or the Child(ren).

Petitioner shall:
(d) promptly provide Respondent with notice of any change in Residence that alters the geographic parameters of Paragraph 3.1.

6. DEFAULT & REMEDIES (VIOLATION CONSEQUENCES)

6.1 Civil & Criminal Contempt. A knowing violation of this Order may subject Respondent to immediate arrest, prosecution for criminal contempt under N.Y. Penal Law § 215.50 (a class A misdemeanor punishable by up to one year in jail), and/or commitment to jail for up to six months for each violation under the Family Court's contempt power in N.Y. Fam. Ct. Act § 846-a. Aggravated or repeat violations may be charged as felony criminal contempt under N.Y. Penal Law §§ 215.51–215.52.
6.2 Notice to Respondent. YOU ARE HEREBY NOTIFIED that violating this Order is a crime, even if the protected person invites or permits contact. Only the Court can modify or terminate this Order.

7. RISK ALLOCATION

8. DISPUTE RESOLUTION & GOVERNING LAW

8.1 Governing Law. This Order is governed by the laws of the State of New York, including but not limited to N.Y. Fam. Ct. Act §§ 812–846 and applicable federal statutes.
8.2 Forum Selection. Exclusive jurisdiction and venue for any proceeding to modify, extend, or enforce this Order lie with the Family Court of the State of New York, County of [COUNTY].
8.3 Arbitration & Jury Trial. Arbitration is unavailable, and jury trial is not applicable in Family Court protection-order proceedings.

9. GENERAL PROVISIONS

9.1 Modification / Termination. Either party may, upon written motion and notice, seek to modify, extend, or vacate this Order pursuant to N.Y. Fam. Ct. Act § 842.
9.2 Severability. If any provision of this Order is held invalid, the remaining provisions shall remain in full force and effect.
9.3 Full Faith & Credit. This Order shall be accorded full faith and credit in all U.S. jurisdictions under 18 U.S.C. § 2265.
9.4 Electronic Signatures. An electronic or facsimile signature of the Court shall have the same force and effect as an original.

10. EXECUTION BLOCK & SERVICE

IT IS SO ORDERED.

DATED: [MM/DD/YYYY]                 
[CITY], New York

_______________________________________
HON. [NAME OF JUDGE]
Judge of the Family Court

[COURT SEAL]

ACKNOWLEDGMENT OF RECEIPT BY RESPONDENT
I, [RESPONDENT NAME], acknowledge receipt of a certified copy of this Order on [MM/DD/YYYY] at [TIME].
Signature: ________________________

CERTIFICATE OF SERVICE
I, [NAME], certify that on [MM/DD/YYYY] I personally served a true copy of this Order upon Respondent by [METHOD], in accordance with N.Y. Fam. Ct. Act § 153-b.
Signature: ________________________  Title: [PROCESS SERVER / LAW ENFORCEMENT]  Date: _________

SCHEDULE A – Child(ren) Covered by This Order

SCHEDULE B – Residence(s) Under Protection

SCHEDULE C – Additional Stay-Away Locations

(List any daycare, relative’s home, or other location requiring protection.)