Sexual Assault Protection Order Petition

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CIVIL COVER SHEET This civil cover sheet and the information contained herein neither replaces nor supplements the filings and service of pleadings or other papers as required by law. This form, approved by the Wyoming Supreme Court, is required for the use of the Clerk of Court for the purpose of initiating the civil docket sheet. (SEE INSTRUCTIONS ON THE SECOND PAGE OF THIS FORM)

I. CAPTION ______Plaintiff Name and Current Address Docket # ______v.

______Defendant.

II. NATURE OF SUIT (Place an “X” in One Box Only) GENERAL CIVIL OTHER CIVIL DISSOLUTION CONTRACT OF MARRIAGE PROBATE □ Appointment/Removal of a Fiduciary

□ Business Organization Litigation □ Divorce w/Minor Children □ Ancillary Admin/Foreign Prob □ Arbitration Award Confirmation □ Com. Const. Contract Litigation □ Divorce w/o Minor Children □ Decree of Title Distribution □ Birth Certificate Amendment/Establishment □ Contract Other (not Debt Collection) □ Judicial Separation □ Determination of Heirship □ Debt Collection □ Annulment □ Letters of Administration □ Declaratory Judgment □ Estate Unspecified □ Emancipation of Minor

TORT DOMESTIC RELATIONS □ Summary Probate □ False or Frivolous Lien

□ PI or WD - Environmental or Toxic Tort □ Custody/Parental Visitation □ Testate/Intestate Estate □ Foreign Judgment □ PI or WD - Fed Employer Liability Act □ Grandparental Visitation □ Will Only Filings □ Foreign Protection Order/Foreign Stalking Order □ PI or WD - Medical Malpractice □ Paternity □ Trust Matters □ Forfeiture of Property □ PI or WD - Product Liability □ Child Support/Parental Contribution □ Guardianship □ Governmental Action Environmental Case □ PI or WD - Vehicular □ Child Support w/ Paternity □ Conservatorship □ Injunction □ Personal Injury Unspecified □ UIFSA w/Paternity □ Guardian & Conservatorship □ Material Witness/Foreign Subpoena

□ Property Damage □ UIFSA □ Name Change

□ Tort Unspecified □ Dom Register Foreign Judgment ADOPTION □ Involuntary Hospitalization

□ Wrongful Termination of Employment □ TPR State/DFS □ Adoption □ Public Nuisance □ TPR Family/Private □ Confidential Intermediary □ Specific Relief □ Structured Settlement Protection Act □ Successor to Civil Trust Appointment

CIRCUIT COURT PROPERTY □ Transcript of Judgment

□ Small Claims □ Property with Mineral Rights □ Writ of Habeas Corpus □ Forcible Entry and Detainer □ Property w/o Mineral Rights □ Writ of Mandamus □ Stalking Protection Order □ Writ of Replevin □ Family Violence Protection Order □ Unspecified Sexual Assault Protection Order

III. RELATED CASE(S) IF ANY (see instructions) Docket No. ______Judge ______Court (if different) ______Docket No. ______Judge ______Court (if different) ______

IV. $ AMOUNT IN CONTROVERSY, (estimated) (see instructions) $______

______SIGNATURE OF ATTORNEY OF RECORD OR PRO SE LITIGANT DATE INSTRUCTIONS FOR APPLYING FOR A SEXUAL ASSAULT PROTECTION ORDER IN WYOMING

A sexual assault protection order is a civil order issued by the court on behalf of a sexual assault victim. The order can require the alleged perpetrator to stay away from the victim or place(s) where the victim lives or works and to have no further contact with the victim.

Any person 18 or older who is a victim of sexual assault – including a single incident – may petition the court to obtain the order. Victims under 18 need a parent or guardian to petition on their behalf. A third party may also file on behalf of a vulnerable adult or any other adult who cannot file due to age, disability, health or inaccessibility.

The sexual assault protection order is designed for victims who do not meet the “household member” requirement with the person who sexually assaulted them to qualify for a domestic violence protection order. If you are considering petitioning for a sexual assault protection order, you should meet with a sexual assault advocate or a lawyer to discuss the different available remedies and challenges with the various orders.

A Sexual Assault Protection Order may also be obtained as part of a criminal case. If a victim reports the sexual assault to law enforcement and the assailant is being prosecuted, a judge may order the perpetrator to keep the assailant away from the victim when they are released from custody.

Petitioning the court for a Sexual Assault Protection Order does not guarantee your safety or that the alleged perpetrator or Respondent will comply with the terms of such an order. For help in developing a safety plan or about protection orders and how to get one, contact your local domestic violence program (see Crisis Intervention in the Yellow Pages) or call the Wyoming Coalition Against Domestic Violence and Sexual Assault at (800) 990-3877 or Wyoming Division of Victim’s Services at (888)996-8816 or the National Domestic Violence Hotline at (800) 799-SAFE (7233) or (512) 453-8117 (multi-lingual advocates are available); TTY: (800) 787-3224.

Read all the instructions before completing forms to ensure that you qualify to seek a sexual assault protection order in Wyoming. YOU DON’T NEED TO FILL OUT EVERY FORM. ONLY FILL OUT THE INFORMATION SHEET AND THE PETITION. Keep the other forms, as you may need them at a later date.

Definitions for Sexual Assault Order of Protection Wyo. Stat. § 7-3-506

(i) “Court” means the Circuit Court * * * in the County where an alleged victim of sexual assault resides or where the alleged perpetrator of the sexual assault is found;

(ii) “Order of Protection” means a court order granted for the protection of a victim of sexual assault;

(iii) “Sexual assault” means conduct as defined by W.S.§ 6-2-302, 6-2-303, 6-2-314 through 6-2-318, which state:

Sexual assault in the first degree:ia) Any actor who inflicts sexual intrusion on a victim commits a sexual assault in the first degree if: (i) The actor causes submission of the victim through the actual application, reasonably calculated to cause submission of the victim, of physical force or forcible confinement; (ii) The actor causes submission of the victim by threat of death, serious bodily injury,

Instructions for Sexual Assault Forms Page 1 of 5 July 1, 2015 extreme physical pain or kidnapping to be inflicted on anyone and the victim reasonably believes that the actor has the present ability to execute these threats; (iii) The victim is physically helpless, and the actor knows or reasonably should know that the victim is physically helpless and that the victim has not consented; or (iv) The actor knows or reasonably should know that the victim through a mental illness, mental deficiency or developmental disability is incapable of appraising the nature of the victim's conduct; or an attempt or conspiracy to commit such act.

Sexual assault in the second degree:ii (a) Any actor who inflicts sexual intrusion on a victim commits sexual assault in the second degree if, under circumstances not constituting sexual assault in the first degree: (i) The actor causes submission of the victim by threatening to retaliate in the future against the victim or the victim's spouse, parents, brothers, sisters or children, and the victim reasonably believes the actor will execute this threat. "To retaliate" includes threats of kidnapping, death, serious bodily injury or extreme physical pain; (ii) The actor causes submission of the victim by any means that would prevent resistance by a victim of ordinary resolution; (iii) The actor administers, or knows that someone else administered to the victim, without the prior knowledge or consent of the victim, any substance which substantially impairs the victim's power to appraise or control his conduct; (iv) The actor knows or should reasonably know that the victim submits erroneously believing the actor to be the victim's spouse; (vi) The actor is in a position of authority over the victim and uses this position of authority to cause the victim to submit; (vii) The actor is an employee, independent contractor or volunteer of a state, county, city or town, or privately operated adult or juvenile correctional system, including but not limited to jails, penal institutions, detention centers, juvenile residential or rehabilitative facilities, adult community correctional facilities or secure treatment facilities and the victim is known or should be known by the actor to be a resident of such facility or under supervision of the correctional system; or (viii) The actor inflicts sexual intrusion in treatment or examination of a victim for purposes or in a manner substantially inconsistent with reasonable medical practices. (b) A person is guilty of sexual assault in the second degree if he subjects another person to sexual contact and causes serious bodily injury to the victim under any of the circumstances listed in W.S. 6-2-302(a)(i) through (iv) or paragraphs (a)(i) through (vii) of this section; or an attempt or conspiracy to commit such act.

Sexual abuse of a minor in the first degreeiii a) An actor commits the crime of sexual abuse of a minor in the first degree if: (i) Being sixteen (16) years of age or older, the actor inflicts sexual intrusion on a victim who is less than thirteen (13) years of age; (ii) Being eighteen (18) years of age or older, the actor inflicts sexual intrusion on a victim who is less than eighteen (18) years of age, and the actor is the victim's legal guardian or an individual specified in W.S. 6-4-402; (iii) Being eighteen (18) years of age or older, the actor inflicts sexual intrusion on a victim who is less than sixteen (16) years of age and the actor occupies a position of authority in relation to the victim. (b) Except as provided in subsection (c) of this section, a person convicted under subsection (a) of this section is subject to imprisonment for not more than fifty (50) years, unless the person convicted qualifies under W.S. 6-2-306(e). (c) A person convicted under paragraph (a)(i) of this section, where the actor is at least twenty-one (21) years of age, is subject to imprisonment for not less than twenty-five (25) years nor more than fifty (50) years, unless the person convicted qualified under W.S. 6-2-306(e); or an attempt or conspiracy to commit such act.

Sexual abuse of a minor in the second degree:iv (a) Except under circumstance constituting sexual abuse of a minor in the first degree as defined by W.S. 6-2-314, an actor commits the crime of sexual abuse of a minor in the second degree if: (i) Being seventeen (17) years of age or older, the actor inflicts sexual intrusion on a victim who is thirteen (13) through fifteen (15) years of age, and the victim is at least four (4) years younger than the actor; (ii) Being sixteen (16) years of age or older, the actor engages in sexual contact of a victim who is less than thirteen (13) years of age; (iii) Being eighteen (18) years of age or older, the actor engages in sexual contact with a victim who is less than eighteen (18) years of age and the

Instructions for Sexual Assault Forms Page 2 of 5 July 1, 2015 actor is the victim’s legal guardian or an individual specified in W.S. 6-4-402; or (iv) Being eighteen (18) years of age or older the actor engages in sexual contact with a victim who is less than sixteen (16) years of age and the actor occupies a position of authority in relation to the victim.

Sexual abuse of a minor in the third degree: Except under circumstance constituting sexual abuse of a minor in the first or second degree as defined by W.S. 6-2-314 and 6-2-315, an actor commits the crime of sexual abuse of a minor in the third degree if: (i) Being seventeen (17) years of age or older, the actor engages in sexual contact with a victim who is thirteen (13) through fifteen (15) years of age, and the victim is at least four (4) years younger than the actor; (ii) Being twenty (20) years of age or older, the actor engages in sexual intrusion with a victim who is either sixteen (16) or seventeen (17) years of age, and the victim is at least four (4) years younger than the actor, and the actor occupies a position of authority in relation to the victim; (iii) Being less than sixteen (16) years of age, the actor inflicts sexual intrusion on a victim who is less than thirteen (13) years of age, and the victim is at least three (3) years younger than the actor; or (iv) Being seventeen (17) years of age or older, the actor knowingly takes immodest, immoral or indecent liberties with a victim who is less than seventeen (17) years of age and the victim is at least four (4) years younger than the actor;v or an attempt or conspiracy to commit such act.

Sexual abuse of a minor in the fourth degree: Except under circumstances constituting sexual abuse of a minor in the first, second, third degree as defined by W.S. 6-2-314 through 6-2-316, an actor commits the crime of sexual abuse of a minor in the fourth degree if: (i) Being less than sixteen (16) years of age, the actor engages in sexual contact with a victim who is less than thirteen (13) years of age, and the victim is at least three (3) years younger than the actor; or (ii) Being twenty (20) years of age or older, the actor engages in sexual contact with a victim who is either sixteen (16) or seventeen (17) years of age, and the victim is at least four (4) years younger than the actor, and the actor occupies a position of authority in relation to the victim;vi or an attempt or conspiracy to commit such act.

Soliciting to engage in illicit sexual relations: Defined as conduct, except under circumstances constituting sexual assault in the first, second or third degree as defined by W.S. 6-2-302 through 6-2-304, or sexual abuse of a minor in the first, second, third or fourth degree as defined by W.S. 6-2-314 through 6-2-317, by anyone who has reached the age of majority and who solicits, procures or knowingly encourages anyone less than the age of fourteen (14) years, or a person purported to be less than the age of fourteen (14) years, to engage in sexual intrusion as defined in W.S. 6-2-301;vii or an attempt or conspiracy to commit such act.

INSTRUCTIONS FOR COMPLETING THE PETITION FOR A SEXUAL ASSAULT ORDER OF PROTECTION

Numbers to these instructions correspond to the same numbers on the Petition for Sexual Assault Protection Order. READ THESE INSTRUCTIONS CAREFULLY.

YOU MUST BE AS THOROUGH, COMPLETE, AND DETAILED AS POSSIBLE. THE COURT MAY NOT GIVE YOU AN ORDER OF PROTECTION IF THERE IS NOT ENOUGH INFORMATION. YOU MUST APPEAR AT THE HEARING OR YOUR REQUEST FOR A SEXUAL ASSAULT PROTECTION ORDER MAY BE DENIED.

Instructions for Sexual Assault Forms Page 3 of 5 July 1, 2015 Top of page for Petition for Sexual Assault Protection Order If you are filing this petition requesting the protection order, you are the Petitioner.

Respondent is the person against whom an order is sought and the person alleged to be the perpetrator.

Caption: The caption is the top section of the petition stating the name of the Petitioner, Respondent, court and identifying the case number.

(a) Print or type in your name: FIRST, MIDDLE, LAST as Petitioner.

(b) Print or type in Respondent’s (alleged perpetrator's) name: FIRST, MIDDLE, LAST.

1-6. Identify yourself and why you qualify for this petition.

7. Describe the Respondent's course of conduct that you believe constitutes sexual assault. Be detailed and as complete as possible.

8-10. Set forth the specific relief you desire from the Court including locations with addresses you wish to have the court order the Respondent to avoid and, if appropriate, on the lines indicated, set forth the names of others you wish to have included in the Order of Protection.

11. Respondent's Personal Information:

This section of the document is for the Court’s information in order to identify the Respondent and to have the Respondent served with the petition by law enforcement officials.

Fill in the Respondent’s information with name, address, employment and address of employment, together with other descriptive information requested.

You must date, sign and verify the Petition before a notary public or clerk of court where the petition is to be filed.

PROCEDURE FOR SEXUAL ASSAULT ORDER OF PROTECTION

1. The petition is filed with the Court and if the Court finds there is a clear and present danger of continued sexual assault or other serious physical adverse consequences, an “Ex parte” Temporary Order of Protection will be issued and served on the Respondent. An ex parte order is an order that is entered after the court considers the Petitioner's information only. The Respondent will get notice of the allegations and will have an opportunity to be heard by the court at the hearing.

2. You should be prepared to present witnesses and other evidence to prove the sexual assault allegations at the hearing whenever possible. If the Respondent does not receive notice of the hearing from the Sheriff at least twenty-four (24) hours before the hearing the hearing may be rescheduled to a later date. You may have to contact the clerk of the circuit court where you filed the petition to make sure that the Respondent received proper notice of the hearing. The Ex parte Temporary Order of Protection will include terms the Court deems necessary and sufficient to protect the Petitioner and other persons and will contain a date and time within seventy-two (72) hours, or as soon thereafter as the matter may be heard, for a hearing on the petition.

3. If the Court finds from the evidence at the hearing that sexual assault has occurred, an Order of Protection will be issued for up to six months, containing terms and conditions prohibiting further contact and/or sexual assault.

Instructions for Sexual Assault Forms Page 4 of 5 July 1, 2015 DURATION OF ORDERS

If the judge gives you a Sexual Assault Protection Order, it will be in effect for up to six months and you may ask the court to extend the order upon a showing of good cause that a clear and present danger to the victim continues to exist, for additional periods of time not to exceed one year each. The Respondent may object to the extension and another hearing may be set. Judges may differ on what they consider "good cause." In the event you desire an extension of the Order of Protection, the request for extension must be filed prior to the expiration of the existing order and must contain information for the Court to consider in determining whether to extend the existing order. It is recommended that you not wait until the last minute to ask for an extension. You may want to contact an attorney for advice prior to filing for an extension.

EMERGENCY ASSISTANCE BY LAW ENFORCEMENT:

A victim of sexual assault may request the assistance of law enforcement agencies which may take necessary steps to protect the victim including advisement of the remedies in Wyoming Statutes §7-3-506 through 7-3-511, advising the victim, when appropriate, of the procedure for initiating a sexual assault action or criminal proceedings and providing for or arranging for transportation of the victim to a medical facility or place of shelter.

i Wyo. Stat. §6-2-302 ii Wyo. Stat. §6-2-303 iii Wyo. Stat. §6-2-314 iv Wyo. Stat. §6-2-315 v Wyo. Stat. §6-2-316 vi Wyo. Stat. §6-2-317 vii Wyo. Stat. §6-2-318

Instructions for Sexual Assault Forms Page 5 of 5 July 1, 2015 Information Sheet - Petitioner

PLEASE PRINT the name of the Petitioner. In addition, you must supply the following information for the Court’s use. Items indicated in BOLD and Italics are required.

THIS PAGE IS CONFIDENTIAL AND RELEASED ONLY TO LAW ENFORCEMENT

PETITIONER: (LAST NAME) (FIRST NAME) (Middle Initial)

CONTACT PHONE NUMBER:

Home Address

Mailing Address (if different)

Employment Address

Date of Birth Gender Race

Age Height Weight Glasses

Hair Color Eye Color Facial Hair

Scars, Tattoos, other Markings

This form requires you to provide certain sensitive information, including social security numbers, driver’s license numbers, military identification numbers, identification card numbers, date of birth and names of minor children. This information must be provided and will be retained by the Court as part of the official record in this case. However, this information will be kept under seal, which means that it will not, under any circumstances, be made available to the public. While the file in this case may be accessed by the public, the public may only view a “redacted” copy of documents containing sensitive information. “Redacted” documents will not show social security numbers, driver’s license numbers, military identification numbers, identification card numbers, date of birth or names of minor children.

Information Sheet Page 1 of 1 Revised June 1, 2011 Information Sheet - Respondent

PLEASE PRINT the name of the Respondent. In addition, you must supply the following information for the Court’s use. Items indicated in BOLD and Italics are required. THIS PAGE IS CONFIDENTIAL AND RELEASED ONLY TO LAW ENFORCEMENT

RESPONDENT: (LAST NAME) (FIRST NAME) (Middle Initial)

CONTACT PHONE NUMBER:

Home Address

Mailing Address (if different)

Employment Address

Date of Birth Gender Race

Age Height Weight Glasses

Hair Color Eye Color Facial Hair

Scars, Tattoos, other Markings

Information Sheet Page 1 of 1 Revised June 1, 2011 Circuit Court of the 9th Judicial District, County of Teton, State of Wyoming P.O. Box 2906, 180 South King Street, Jackson, WY 83001 (307) 733-7713

Name: Petitioner, vs. SA

Name: Respondent.

PETITION FOR SEXUAL ASSAULT PROTECTION ORDER UNDER W.S. 7-3-506 THROUGH 7-3-511

Please see Sexual Assault Protection Order packet instructions for details regarding acts which constitute sexual assault or sexual abuse of a minor that qualify the Petitioner to seek a Sexual Assault Protection Order. “Sexual Assault” means any act made criminal pursuant to W.S. §6-2-302 and §6-2-303 and §6-2-314 through §6-2-318 or an attempt or conspiracy to commit such act.

1. Petitioner is or is filing on behalf of: An adult victim of nonconsensual sexual intrusion committed by the Respondent (W.S. §6-2-302 or §6-2-303); or A minor victim of nonconsensual sexual intrusion or contact by the Respondent (W.S. §6-2-314, §6-2-315, §6-2-316 (i-iii), §6-2-317); A minor victim who is subjected to immodest, immoral or indecent liberties by the Respondent (W.S. §6-2-316 iv); A person less than fourteen (14) years of age or a person purported to be less than the age of fourteen (14) years and was solicited by the Respondent to engage in illicit sexual intrusion (W.S. §6-2-318); or A person subject to an attempt or conspiracy by the Respondent to commit any of the above referenced acts.

2. I am filing; On behalf of myself and I am 18 years or older.

On behalf of a minor who is years old. My relationship to the minor is . My name is . On behalf of a vulnerable adult defined in W.S. 35-20-102(a)(xviii) or any other adult who because of age, disability, health or inaccessibility, cannot file the petition. My relationship with this adult is . My name is . With the consent of the victim and I am a District Attorney or County Attorney.

3. This Court has jurisdiction because: Petitioner resides in the county. Respondent may be found in the county.

Sexual Assault Petition Page 1 of 4 September 1, 2015 4. Respondent’s age is . If the Respondent is under the age of 18, the name of the Respondent’s parent or legal guardianis .

5. Petitioner’s relationship to Respondentis: .

6. If the Petitioner and the Respondent are involved together in a criminal case with the same or similar allegations as set forth herein please identify the court and case number:

7. An order of protection is being requested because the Respondent did the following acts (describe the acts or series of acts, using specific dates, if possible):

(Attach additional pages if needed.)

I request this Court order (please check appropriate paragraphs below):

8. I believe that a clear and present danger of further sexual assault or of serious physical adverse consequences exists. Therefore I request an ex parte temporary order of protection be entered.

9. I request the Court order the following relief: Restrain Respondent from any further acts of sexual assault or from contacting, harassing, or threatening the victim of the alleged offense and any other person including but not limited to members of the victims family or household as named below. Contact either directly or indirectly, including, but not limited to, communication verbally in person, communication by telephone or other electronic means, written communication in any form, communication through third persons, and nonverbal communication and gestures. Prohibited contact under this paragraph includes telephone calls, mail, e-mail, texting, fax, contacting through social media using the internet or similar technology and any other form of communication.

Order Respondent not to contact the following people (state their relationship to the victim and the reason why these individuals need protection):

Sexual Assault Petition Page 2 of 4 September 1, 2015 Order Respondent to stay away from the following locations:

Home Check here if the Petitioner is requesting the Court to order the address of the Petitioner be kept confidential. School

Business

Place of employment

Daycare Other location (describe)

Restrain Respondent from attending classes attended by the petitioner at (school) If; If; this relief is requested it is done so for the following reasons:

Require the Respondent to surrender any firearm or other dangerous weapons and prohibit the Respondent from obtaining or possessing a firearm.

10. I request the following additional relief:

11. Respondent's personal information (put as much information as you know): Other names used by Respondent Home Address Mailing Address (if different)

Employment Address Date of Birth Gender Race Age Height Weight Glasses Hair Color Eye Color Facial Hair Scars, Tattoos, Other Markings Respondent's Vehicle Make Year Model Color State Licensed License Number Firearms owned or ammunition in possession of Respondent

Sexual Assault Petition Page 3 of 4 September 1, 2015 Dated this ______day of______, 20______.

______Petitioner

State of Wyoming County of

Subscribed and sworn to before me this day of ______, 20 , by .

Notary Public/Court Clerk My commission expires:

Sexual Assault Petition Page 4 of 4 September 1, 2015 Circuit Court of the 9th Judicial District, County of Teton, State of Wyoming

Case Number Court Address P.O. Box 2906, 180 South King Street, Jackson, WY 83001 Court Phone Number 307-733-7713

EX PARTE SEXUAL ASSAULT ORDER OF PROTECTION

PETITIONER PETITIONER IDENTIFIERS First Middle Last Date of Birth of Petitioner Race Sex

RESPONDENT RESPONDENT IDENTIFIERS

First Middle Last SEX RACE DOB HT WT

Respondent’s Physical Address: EYES HAIR ______DRIVERS EXP ______STATE LICENSE# DATE ______Respondent’s Mailing Address: VEH. ______COLOR PLATE# MAKE/MODEL ______EMPLOYMENT CAUTION:

Firearms Involved Firearms on Additional Information (i.e. other names used, tattoos, scars): Property ______

EXPIRATION: THIS ORDER SHALL BE IN EFFECT UNTIL FURTHER ORDER OF THE COURT.

Based upon the verified Petition, and it appearing there exists a clear and present danger of further sexual assault or of serious adverse consequences to the Petitioner or other person(s), now therefore,

1. IT IS ORDERED, that Respondent, shall immediately stay away from the Petitioner, wherever Petitioner may be, including, but not limited to, the following places:

Home School Business Place of Employment Other location (describe)

Sexual Assault EX PARTE Order Page 1 of 2 July 1, 2015 2. IT IS FURTHER ORDERED, Respondent shall not initiate contact with Petitioner in any way, either directly or indirectly, including, but not limited to, communication verbally in person, communication by telephone or other electronic means, written communication in any form, communication through third persons, and nonverbal communication and gestures. Prohibited contact under this paragraph includes telephone calls, mail, e-mail, texting, fax, contacting through social media using the internet or similar technology and any other form of communication.

3. IT IS FURTHER ORDERED, Respondent shall not personally, or through any other person or means, communicate with, contact, harass, threaten, intimidate, or otherwise interfere with Petitioner, or any of the following people:

4. IT IS FURTHER ORDERED; Respondent shall not use or possess firearms.

5. Other requirements:

The Court Orders the Parties to take Notice of the Following:

Certain provisions of the Federal Violent Crime Control and Law Enforcement Act of 1994 make it unlawful for persons subject to protection orders to possess, ship, use or transfer any firearms or ammunition. Gun Control Act, 18 U.S.C. Section 922(g)(8).

At the time this order is entered, a certified copy will be provided to the Petitioner by the Court.

This order shall be filed with the clerk of court and a copy shall be sent by the clerk to the county sheriff who shall, after service, notify the local law enforcement agency within the county in which the Petitioner resides of the existence of this order. The order shall be personally served upon the Respondent.

If Respondent fails to appear the court may award any or all of the relief requested by Petitioner.

This order applies when Respondent is served.

WARNING: The Petitioner cannot give you legal permission to violate this order. If you go near the petitioner or other protected persons, even with their consent, you may be arrested. You act at your own risk if you disregard this WARNING. If you want to modify or dismiss the order you must ask the Court. Only the Court can change this order. A willful violation of any provision of this Ex Parte Order of Protection constitutes a crime as defined by W.S.§7-3-510, can result in immediate arrest.

DATED this ______day of ______, 20____.

______JUDGE OR MAGISTRATE Sexual Assault EX PARTE Order Page 2 of 2 July 1, 2015 Circuit Court of the 9th Judicial District, County of Teton, State of Wyoming P.O. Box 180 South King Street, Jackson, WY 83001 (307) 733-7713

Name: Petitioner, vs. SA______

Name: Respondent.

ORDER TO APPEAR - Petitioner (Notice of Petition for Sexual Assault Protection Order)

TO THE ABOVE-NAMED RESPONDENT:

YOU ARE notified that a petition has been filed in this Court seeking a Sexual Assault Protection Order. A copy of the Petition together with a copy of the Ex Parte Temporary Order of Protection are attached to this Order are now served upon you. You are further notified that a hearing concerning this petition will be held on the day of , 20______, at am/pm at theTeton County Courthouse located at 180 South King Street, Jackson, Wyoming before a Judge or Magistrate of the Court. Telephone: (307) (307) 733-7713.

FURTHERMORE, you are ordered to obey all terms of any attached Order.

YOU ARE ORDERED TO APPEAR AT THIS HEARING. YOUR FAILURE TO APPEAR OR VIOLATION OF THE ATTACHED ORDER MAY RESULT IN YOUR IMMEDIATE ARREST.

DATED: .

BY THE COURT:

JUDGE – MAGISTRATE - COMMISSIONER -CLERK

Order to Appear Page 1 of 1 July 1, 2015 Circuit Court of the 9th Judicial District, County of Teton, State of Wyoming P.O. Box 180 South King Street, Jackson, WY 83001 (307) 733-7713

Name: Petitioner, vs. SA

Name: Respondent.

PROOF OF SERVICE – SEXUAL ASSAULT - PETITIONER

I, ______, being a person over the age of 18 years and not a party to the above – entitled action, hereby certify and return that I received the:

o Sexual Assault Petition o Ex Parte Order of Protection o Order to Appear/Notice of Setting on the day of , 20 , and that I served the same upon the Respondent, , by delivering to and leaving with said Respondent personally on the day of , 20 , at o’clock .M. at (address and/or city) a true copy thereof.

Sheriff

By: Deputy Sheriff

STATE OF WYOMING ) ) ss COUNTY OF )

SUBSCRIBED TO and sworn before me this _____ day of , .

Notary Public

My Commission Expires:

Proof of Service - Respondent Page 1 of 1 July 1, 2015 Circuit Court of the 9th Judicial District, County of Teton, State of Wyoming P.O. Box 180 South King Street, Jackson, WY 83001 (307) 733-7713

Name: Petitioner, vs. SA______

Name: Respondent.

ORDER TO APPEAR - Respondent (Notice of Petition for Sexual Assault Protection Order)

TO THE ABOVE-NAMED RESPONDENT:

YOU ARE notified that a petition has been filed in this Court seeking a Sexual Assault Protection Order. A copy of the Petition together with a copy of the Ex Parte Temporary Order of Protection are attached to this Order are now served upon you. You are further notified that a hearing concerning this petition will be held on the day of , 20______, at am/pm at the______County Courthouse located at 180 South King Street, Jackson, Wyoming before a Judge or Magistrate of the Court. Telephone: (307) 733-7713.

FURTHERMORE, you are ordered to obey all terms of any attached Order.

YOU ARE ORDERED TO APPEAR AT THIS HEARING. YOUR FAILURE TO APPEAR OR VIOLATION OF THE ATTACHED ORDER MAY RESULT IN YOUR IMMEDIATE ARREST.

. DATED: BY THE COURT:

JUDGE – MAGISTRATE - COMMISSIONER -CLERK

RESPONDENT'S PERSONAL INFORMATION IS ON THE NEXT PAGE

Order to Appear Page 1 of 1 July 1, 2015 Circuit Court of the 9th Judicial District, County of Teton, State of Wyoming P.O. Box 180 South King Street, Jackson, WY 83001 (307) 733-7713

Name: Petitioner, vs. SA

Name: Respondent.

PROOF OF SERVICE – SEXUAL ASSAULT - RESPONDENT

I, ______, being a person over the age of 18 years and not a party to the above – entitled action, hereby certify and return that I received the:

Sheriff

By: Deputy Sheriff

STATE OF WYOMING ) ) ss COUNTY OF )

SUBSCRIBED TO and sworn before me this _____ day of , .

Notary Public

My Commission Expires:

Proof of Service - Respondent Page 1 of 1 July 1, 2015 Circuit Court of the 9th Judicial District, County of Teton, State of Wyoming P.O. Box 180 South King Street, Jackson, WY 83001 (307) 733-7713

Case Number Court Address P.O. Box 2906, 180 South King Street, Jackson, WY 83001 Court Phone Number 307-733-7713

SEXUAL ASSAULT ORDER OF PROTECTION

PETITIONER PETITIONER IDENTIFIERS First Middle Last Date of Birth of Petitioner Race Sex

RESPONDENT RESPONDENT IDENTIFIERS

First Middle Last SEX RACE DOB HT WT

Respondent’s Physical Address: EYES HAIR ______DRIVERS EXP ______STATE LICENSE# DATE ______Respondent’s Mailing Address: VEH. ______COLOR PLATE# MAKE/MODEL ______EMPLOYMENT CAUTION:

Firearms Involved Firearms on Additional Information (i.e. other names used, tattoos, scars): Property ______

This Order shall be in effect and will expire at 12:01 a.m. on the day of , 20 , unless extended by order of the Court.

THIS MATTER was heard on , 20_____ . These parties were present:

PETITIONER RESPONDENT Appeared in person Appeared in person Did not appear and was given proper notice

______Attorney ______Attorney

THE COURT FINDS:

 This Court has jurisdiction over the parties and subject matter of this action.

 The Parties stipulate to the Court’s exercising jurisdiction in this case and the subject matter of this action.  After hearing the testimony of the parties and their witnesses, the Court finds that the Respondent’s conduct constitutes sexual assault as defined by W.S. §6-2-302, 6-2-303, 6- 2-314 through 6-2-318 and that an Order of Protection should be entered.

Sexual Assault Order of Protection Page 1 of 4 July 1, 2015 IT IS ORDERED, ADJUDGED AND DECREED AS FOLLOWS:

1. Respondent shall not have contact with Petitioner, or with any of the persons listed in Paragraph 3 below, anywhere, either directly or indirectly, including, but not limited to, communication verbally in person, communication by telephone or other electronic means, written communication in any form, communication through third persons, and nonverbal communication and gestures. Prohibited contact under this paragraph includes telephone calls, mail, e-mail, texting, fax, contacting through social media using the internet or similar technology and any other form of communication.

2. Respondent shall provide the Court with a current mailing address. While this Order is in effect, the Respondent shall promptly inform the Court in writing if that mailing address changes. Mailing of appropriate documents (for example: modification, termination or extension of this Order) to the most recent mailing address provided to the Court by the Respondent shall be considered service upon the Respondent.

IT IS FURTHER ORDERED THAT the Respondent shall comply with this Order as checked below:

3. ____ Respondent shall not personally, or through any other person or means, contact, harass, threaten, intimidate, or otherwise interfere with Petitioner, or any of the following people:

4. ____ Respondent shall not stop at, enter into, or place under surveillance any of the following locations: Home School Business Place of Employment Other Location (describe)

5. ____ Respondent shall not be at the Petitioner’s place of employment or residence. In addition, the Respondent shall not be at any other location where Petitioner may be found. The Respondent shall not place the Petitioner under surveillance.

6. Respondent is restrained from attending classes that are also attended by the Petitioner at school.

Sexual Assault Order of Protection Page 2 of 4 July 1, 2015 7. ____ Other Requirements:

8. ____ Respondent shall not use or possess firearms:

A copy of this Order shall be sent by the Clerk to the County Sheriff, who shall notify the local law enforcement agencies within the County of the existence of this Order.

The Court Orders the Parties to Take Notice of the Following:

This order will be filed with one or more local law enforcement agencies. The order shall be personally served upon the Respondent, unless the respondent or the Respondent's attorney was present when the order was issued.

This order applies immediately to the Respondent and shall remain in full force and effect until the expiration date of the order or until it is modified or terminated by this court.

Interstate violation of this order may subject the Respondent to federal criminal penalties. 18 U.S.C. §§ 2261, 2261 (A) and 2262.

This protection order is enforceable in all fifty states, the District of Columbia, tribal lands and U.S. territories, and is issued to prevent violent or threatening acts by the Respondent against the Petitioner. 18 U.S.C. § 2265.

Willful violation of this order may constitute a crime as defined by WYO. STAT. ANN. § 7- 3-510, and can result in immediate arrest and the imposition of punishment consisting of imprisonment for not more than six months and a fine of not more than seven hundred fifty dollars ($750.00). Such violation may also be dealt with as a contempt of court, which

Sexual Assault Order of Protection Page 3 of 4 July 1, 2015 may be punishable by imprisonment for up to one (1) year.

DATED this day of , 20 .

BY THE COURT

JUDGE OR MAGISTRATE

ACCEPTANCE OF SERVICE

I, ______, Respondent in this action, voluntarily accept service of the within Order of Protection, and acknowledge that I have received a true copy thereof.

Respondent's Signature

Date

CERTIFICATE OF SERVICE

____ Petitioner _____ Sheriff’s Office _____ Petitioner’s Attorney _____ Police Department _____ Respondent _____ Victim-Witness Coordinator _____ Respondent’s Attorney _____

Sexual Assault Order of Protection Page 4 of 4 July 1, 2015 Circuit Court of the 9th Judicial District, County of Teton, State of Wyoming P.O. Box 180 South King Street, Jackson, WY 83001 (307) 733-7713

Name: Petitioner, vs. SA

Name: Respondent.

MOTION TO EXTEND ORDER OF PROTECTION

I, Petitioner, request that the Court extend the Order of Protection entered on ______for the following reasons:

DATED this ______day of ______, 20 .

PETITIONER

Motion to Extend Page 1 of 1 July 1, 2015 Circuit Court of the 9th Judicial District, County of Teton, State of Wyoming P.O. Box 2906, 180 South King Street, Jackson, WY 83001 (307) 733-7713

Name: Petitioner, vs. SA

Name: Respondent.

MOTION TO MODIFY ORDER OF PROTECTION

I, Petitioner Respondent, request that the Court modify the Order of Protection entered in this case on .

The modifications requested are:

The request for modification is made for the following reasons:

______

DATED this ______day of ______, 20 .

PETITIONER RESPONDENT

Motion to Modify Page 1 of 1 July 1, 2015 Circuit Court of the 9th Judicial District, County of Teton, State of Wyoming P.O. Box 2906, 180 South King Street, Jackson, WY 83001 (307) 733-7713

Name: Petitioner, vs. SA

Name: Respondent.

MOTION TO TERMINATE ORDER OF PROTECTION

I, Petitioner Respondent, request that the Court terminate the Order of Protection entered on for the following reasons:

DATED this ______day of ______, 20____.

PETITIONER RESPONDENT

Motion to Terminate Page 1 of 1 July 1, 2015 Circuit Court of the 9th Judicial District, County of Teton, State of Wyoming P.O. Box 2906, 180 South King Street, Jackson, WY 83001 (307) 733-7713

Name: Petitioner, vs. SA

Name: Respondent.

MOTION TO DISMISS PETITION

I, Petitioner Respondent, request that the Court dismiss the Petition for Order of Protection filed ______for the following reasons:

DATED this ______day of ______, 20 .

PETITIONER RESPONDENT

Motion to Dismiss page 1 of 1 July 1, 2015 Circuit Court of the 9th Judicial District, County of Teton, State of Wyoming P.O. Box 2906, 180 South King Street, Jackson, WY 83001 (307) 733-7713

Name: Petitioner, vs. SA

Name: Respondent.

MOTION AND AFFIDAVIT FOR ORDER TO SHOW CAUSE

The Petitioner being duly sworn upon oath deposes and says: 1. I am the Petitioner in this action. 2. Respondent violated the Order of Protection entered by this Court on the day of , 20 , by the following acts:

, 3. I request the Court issue an Order to require the Respondent to appear and show cause why the Respondent should not be held in contempt for violating the Sexual Assault Order of Protection.

Dated this day of , 20 .

______PETITIONER

(Print Name) STATE OF WYOMING ) ) ss COUNTY OF )

SUBSCRIBED AND SWORN to before me this day of , 20_____. Witness my hand and official seal.

(SEAL)

______CLERK OF COURT/NOTARY

My commission expires: ______

Motion and Affidavit for Order to Show Cause Page 1 of 1 July 1, 2015