Domestic Violence Protection Order

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

Tennessee requires the use of official AOC form AOC-POR-1F (Petition for Order of
Protection) 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.tncourts.gov/programs/self-help-center/forms/order-protection-forms.
Do not file this document directly with the court.

IN THE [INSERT COURT TYPE] COURT FOR [INSERT COUNTY] COUNTY, TENNESSEE

Docket No.: [___]

[PETITIONER FULL NAME],
 Petitioner / Protected Party

v.

[RESPONDENT FULL NAME],
 Respondent / Restrained Party

TEMPORARY ❑ FINAL ❑

ORDER OF PROTECTION
(issued pursuant to Tenn. Code Ann. § 36-3-601 et seq.)

TABLE OF CONTENTS

I. Document Header
II. Definitions
III. Findings of Fact & Jurisdictional Statements
IV. Operative Injunctive Provisions
V. Additional Relief Granted
VI. Notice, Service, & Enforcement Mechanisms
VII. Duration, Modification, & Termination
VIII. General Provisions
IX. Execution & Certification

I. DOCUMENT HEADER

1. Effective Date  This Order is effective immediately upon pronouncement from the bench on [DATE] and shall be entered nunc pro tunc to that date.
2. Statutory Authority  Issued under Tenn. Code Ann. §§ 36-3-605, -606, and 18 U.S.C. § 922(g)(8).
3. Jurisdiction & Venue  The Court finds venue proper in [COUNTY] County pursuant to Tenn. Code Ann. § 36-3-602(c).

II. DEFINITIONS

For purposes of this Order:
“Court” means the [INSERT COURT TYPE] Court for [INSERT COUNTY] County, Tennessee.
“Petitioner” means the above-named individual(s) seeking protection.
“Respondent” means the above-named individual(s) against whom protection is sought.
“Minor Child(ren)” means [NAME(S) & DOB(S)] who are under eighteen (18) years of age and in the custody or care of the Petitioner.
“Prohibited Conduct” means any act enumerated in Section IV below.
“Protected Location(s)” means the residences, workplaces, schools, and other locations listed in Section IV(1)(b).

III. FINDINGS OF FACT & JURISDICTIONAL STATEMENTS

1. Notice & Appearance
 a. Respondent ❑ appeared with counsel ❑ appeared pro se ❑ failed to appear after being duly served on [DATE].
 b. Adequate notice of the hearing was provided as required by Tenn. Code Ann. § 36-3-605(c).

2. Domestic Abuse Finding  The Court finds by a preponderance of the evidence that Respondent committed domestic abuse as defined in Tenn. Code Ann. § 36-3-601(4) against Petitioner on or about [DATE], including but not limited to: [BRIEF FACTUAL FINDINGS].
3. Immediate & Present Danger  The Court further finds that good cause exists to believe Respondent poses an immediate and present danger of continued abuse, warranting the injunctive relief ordered herein.
4. Firearms & Ammunition  Respondent received actual notice that possession of firearms while subject to this Order is prohibited under 18 U.S.C. § 922(g)(8).

IV. OPERATIVE INJUNCTIVE PROVISIONS

[CHECK ALL THAT APPLY – strike or add subparts as necessary]

1. No Contact & Stay-Away
 a. Respondent SHALL NOT assault, threaten, abuse, follow, harass, or interfere with the Petitioner or Minor Child(ren), directly or indirectly, by any means, including electronic or third-party communications.
 b. Respondent SHALL STAY AT LEAST ☐ yards away from the Petitioner, the Minor Child(ren), and the following locations:
   i. Protected Residence(s): [ADDRESS(ES)]
   ii. Protected Workplace(s): [ADDRESS(ES)]
   iii. Protected School(s)/Daycare(s): [ADDRESS(ES)]

2. Exclusive Possession of Residence
 Petitioner is awarded exclusive temporary possession of the shared residence located at [ADDRESS]. Respondent SHALL vacate the premises no later than [TIME] on [DATE] and may collect personal belongings only under law-enforcement supervision.

3. Temporary Custody & Visitation
 a. Custody of the Minor Child(ren) is temporarily awarded to ❑ Petitioner ❑ [OTHER], subject to the best interests of the child standard.
 b. Visitation with Respondent is ❑ suspended ❑ supervised as follows: [DETAIL SUPERVISION TERMS].

4. Support & Financial Relief
 Respondent SHALL pay temporary child support/spousal support in the amount of $[___] per [WEEK/MONTH], commencing [DATE], pursuant to Tenn. Code Ann. § 36-5-101 and subject to wage withholding.

5. Firearms Dispossession
 Within forty-eight (48) hours of the issuance of this Order, Respondent SHALL dispossess, by any lawful means (such as transferring possession to a third party who is not prohibited from possessing firearms), all firearms in Respondent’s possession, and is prohibited from possessing a firearm for so long as this Order or any successive order of protection remains in effect (Tenn. Code Ann. § 36-3-625(a)–(b); 18 U.S.C. § 922(g)(8)). Respondent SHALL complete and return to the Court the Affidavit of Firearm Dispossession form (available from the court clerk or the Administrative Office of the Courts). Knowingly failing to surrender or transfer all firearms as required is a separate Class A misdemeanor (Tenn. Code Ann. § 36-3-625(h)).

6. Mandatory Counseling
 Respondent SHALL enroll in and complete a certified batterer’s intervention program approved by the Tennessee Domestic Violence State Coordinating Council within [___] days.

7. Mutual Orders Prohibited
 No mutual protective relief is granted because the Court finds no sufficient evidence that Petitioner committed domestic abuse as defined by Tenn. Code Ann. § 36-3-601(4).

V. ADDITIONAL RELIEF GRANTED

1. Law-Enforcement Assistance  Law-enforcement officers are directed to:
 a. Accompany Petitioner to retrieve personal property;
 b. Serve or assist in serving this Order on Respondent;
 c. Arrest Respondent upon probable cause of violation, consistent with Tenn. Code Ann. § 36-3-611.

2. Costs & Fees  Court costs, service fees, and litigation taxes are assessed to Respondent pursuant to Tenn. Code Ann. § 36-3-617. Attorney’s fees in the amount of $[___] are likewise awarded to Petitioner and shall be reduced to judgment.

VI. NOTICE, SERVICE, & ENFORCEMENT MECHANISMS

1. Warning to Respondent
 • Violation of this Order is a Class A misdemeanor punishable by up to eleven (11) months and twenty-nine (29) days in jail and a fine of not less than $100 nor more than $2,500 (Tenn. Code Ann. § 39-13-113(g)).
 • Federal law prohibits you from possessing firearms while this Order is in effect (18 U.S.C. § 922(g)(8)).

2. Service of Order
 A certified copy of this Order SHALL be served personally on Respondent by the [SHERIFF/CONSTABLE] of [COUNTY] County forthwith.

3. Entry into TCIC & NCIC
 A copy of this Order SHALL be issued to the local law enforcement agency having jurisdiction in the area where the Petitioner resides. Upon receipt of the Order from the issuing court or clerk, that agency SHALL enter it into the Tennessee Crime Information System (TCIC) and take any necessary action to immediately transmit it to the National Crime Information Center (NCIC) (Tenn. Code Ann. § 36-3-609(e)).

VII. DURATION, MODIFICATION, & TERMINATION

1. Duration
 a. Temporary (Ex Parte) Order This Order remains in effect until [HEARING DATE] or further order of the Court, not to exceed fifteen (15) days, unless extended for good cause.
 b. Final Order Unless otherwise stated, this Order remains in effect for a fixed period not to exceed one (1) year from the Effective Date (Tenn. Code Ann. §§ 36-3-605(b), 36-3-608(a)) and may be modified upon motion and a showing of changed circumstances (§ 36-3-608(b)). If Respondent is served, afforded a hearing, and found to have violated this Order, the Court may extend it up to five (5) years for a first violation and up to ten (10) years for a second or subsequent violation (§ 36-3-605(d)).

2. Modification
 Either party may petition to modify or dissolve this Order; however, no modification shall be granted absent a finding of good cause and entry of a written order.

3. Automatic Termination
 This Order terminates upon expiration, dismissal by written order, or superseding order of a court of competent jurisdiction.

VIII. GENERAL PROVISIONS

1. Full Faith & Credit  This Order is entitled to full faith and credit in all United States jurisdictions under 18 U.S.C. § 2265.
2. Severability  If any provision of this Order is held invalid, the remaining provisions shall remain in full force to the extent permitted by law.
3. Electronic Signatures & Copies  Pursuant to Tenn. R. Civ. P. 5A, a facsimile, electronically signed, or certified copy of this Order shall be deemed an original for enforcement purposes.

IX. EXECUTION & CERTIFICATION

DATED this ___ day of ____________, 20___, at ____ ❑ a.m. ❑ p.m.

________________________________________
[JUDGE NAME], Judge
[INSERT COURT TYPE] Court for [COUNTY] County, Tennessee

Attest: ____________________________________
Clerk of Court

ACKNOWLEDGEMENT OF RESPONDENT (if present)

I acknowledge receipt of a certified copy of this Order and understand its terms and the penalties for violation.

________________________________________
Respondent Signature    Date

LAW-ENFORCEMENT RETURN OF SERVICE

I certify that I served a true and correct copy of this Order on Respondent on [DATE] at [TIME] ❑ a.m. ❑ p.m.

________________________________________
[Deputy Name & Badge No.]
[Agency], [County] County, Tennessee