Form 17-1

NOTICE: THIS DOCUMENT
CONTAINS SENSITIVE DATA

[Caption. See § 3 of the Introduction in volume 1 of this manual.]

An Application for a Protective Order

1.Discovery
TRCP 190.1

1.Discovery

Discovery in this case is intended to be conducted under [level 2/level 3] of rule 190 of the Texas Rules of Civil Procedure. [If level 3, see form 5-1.]

Preservation of Evidence: Respondent is put on notice to preserve and not destroy, conceal, or alter any evidence or potential evidence relevant to the issues in this case, including tangible documents or items in Respondent’s pos­session or subject to Respondent’s control and electronic documents, files, or other data generated by or stored on Respondent’s home computer, work com­puter, storage media, portable systems, electronic devices, online repositories, or cell phone.

2.Objection to Assignment of Case to Associate Judge
§ 201.005

2.Objection to Assignment of Case to Associate Judge

Applicant objects to the assignment of this matter to an associate judge for a trial on the merits or presiding at a jury trial.

3.Parties
§§ 82.004(1), (2), 152.209(a), (e)

3.Parties

3.A.No Child Custody Proceeding Involved or No Party Resides Outside Texas
§§ 82.004(1), (2), 152.209(a)

This Application for a Protective Order is brought [by [name of appli­cant], Applicant, who is a resident of [county] County, Texas/on behalf of [name], Applicant, by a prosecuting attorney for [county] County, Texas/on behalf of [name], Applicant, a resident of [county] County, Texas, by an attor­ney employed by the Texas Department of Family and Protective Services]. [The last three numbers of Applicant’s driver’s license number are [[numbers]/not available at this time]./Applicant has not been issued a driver’s license.] [The last three numbers of Applicant’s Social Security number are [[numbers]/not available at this time]./Applicant has not been issued a Social Security number.] This Application for a Protective Order is brought for the protection of [name[s]], who [is/are] resident[s] of [county] County, Texas. Respondent is [name of respondent], who resides in [county] County, Texas.

3.B.Child Custody Proceeding Involved; Party Resides Outside Texas; Identifying Information Disclosed
§ 152.209(a)

This Application for a Protective Order is brought [by [name of appli­cant], Applicant, who is a resident of [county] County, Texas/on behalf of [name], Applicant, by a prosecuting attorney for [county] County, Texas/on behalf of [name], Applicant, a resident of [county] County, Texas, by an attor­ney employed by the Texas Department of Family and Protective Services]. [The last three numbers of Applicant’s driver’s license number are [[numbers]/not available at this time]./Applicant has not been issued a driver’s license.] [The last three numbers of Applicant’s Social Security number are [[numbers]/not available at this time]./Applicant has not been issued a Social Security number.] This Application for a Protective Order is brought for the protection of [name[s]], who [is/are] resident[s] of [county] County, Texas. Information required by section 152.209(a) of the Texas Family Code is provided in the affidavit attached as Exhibit [exhibit number/letter]. Respondent is [name of respondent], who resides in [county] County, Texas.

3.C.Child Custody Proceeding Involved; Party Resides Outside Texas; Nondisclosure of Identifying Information and Request for Sealing
§ 152.209(e)

This Application for a Protective Order is brought [by [initials of appli­cant], Applicant, who is a resident of Texas/on behalf of [initials of applicant] by a prosecuting attorney for a county in the state of Texas/on behalf of [initials of applicant], a resident of Texas, by an attorney employed by the Texas Department of Family and Protective Services]. This Application for a Protec­tive Order is brought for the protection of [initials of person[s] to be protected], who [is/are] resident[s] of [county] County, Texas. Information required by section 152.209(a) of the Texas Family Code is provided in the affidavit attached as Exhibit [exhibit number/letter]. Applicant believes the disclosure of this identifying information would jeopardize the health, safety, or liberty of Applicant or the child[ren] named herein. Accordingly, Applicant requests that the identifying information set forth in the affidavit attached as Exhibit [exhibit number/letter] be and remain sealed and not disclosed by any means to the other party or the public unless the Court orders the disclosure to be made after a hearing in which the Court takes into consideration the health, safety, and lib­erty of the party and the child[ren] and determines that the disclosure is in the interest of justice. Respondent is [name of respondent], who resides in [county] County, Texas.

3.D.Title IV-D Agency Services
§ 82.004(5)

[Applicant is not receiving services from the title IV-D agency in con­nection with a child support case./Applicant is receiving services from the title IV-D agency in connection with a child support case, and the agency open case number[s] [is/are] as follows: [case number[s]].]

4.Service

4.Service

4.A.Personal

Process should be served on Respondent [include if applicable: at [address, city, state, zip]].

4.B.Substituted

Citation of Respondent by substituted service is necessary for the rea­sons stated in the affidavit attached as Exhibit [exhibit number/letter].

5.Relationship of Parties
§ 82.004(3)

5.Relationship of Parties

Applicant is [clearly state the relationship between applicant and respondent].

5.A.Former Spouses
§ 82.006

Applicant is a former spouse of Respondent, and a copy of the decree dissolving the marriage is [attached to this application as Exhibit [exhibit number/letter]/unavailable to Applicant at this time but will be filed with the Court before the hearing on the application].

5.B.Child[ren] Not under Jurisdiction
§ 82.007

The [child[ren] for whom a protective order is sought/child who has committed family violence] [is/are] not subject to the continuing jurisdiction of any court.

5.C.Child[ren] under Jurisdiction
§ 82.007

The [child[ren] for whom a protective order is sought/child who has committed family violence] [is/are] subject to the continuing jurisdiction of a court under the Texas Family Code. A copy of the court orders affecting the conservatorship, support, and possession of or access to the child[ren] is [attached to and filed with this application as Exhibit [exhibit number/letter]/unavailable to Applicant at this time but will be filed with the Court before the hearing on the application].

5.D.Dating Relationship
§ 82.002(b)(1)

Applicant and Respondent [have/had] a dating relationship as defined in section 71.0021(b) of the Texas Family Code.

5.E.Relationships with Third Party
§§ 82.002(b)(2), 71.0021(a)(1)(B)

Applicant [is/was] [married to/in a dating relationship with] an individ­ual who [is/was] [married to/in a dating relationship] with Respondent.

6.Grounds
§§ 82.004(3), 71.004, 81.0015

6.Grounds

Respondent has engaged in conduct that constitutes family violence.

Respondent, who is seeking or attempting to seek contact with the child[ren], has been convicted of or placed on deferred adjudication commu­nity supervision for [an offense under title 5 of the Texas Penal Code based on a court finding that the offense involved family violence under article 42.013 of the Texas Code of Criminal Procedure/an offense under title 6 of the Texas Penal Code], and Respondent’s parental rights with respect to the child[ren] have been terminated.

6.A.Physical Harm, etc.
§ 71.004(1)

Respondent committed acts that were intended by Respondent to result in physical harm, bodily injury, assault, or sexual assault or were threats that reasonably placed [name[s] of member[s] of family or household] in fear of imminent physical harm, bodily injury, assault, or sexual assault. Respondent’s acts therefore constitute family violence.

6.B.Child Abuse
§§ 71.004(2), 261.001(1)(C), (E), (G), (H), (I), (J), (K), (M)

Respondent committed acts of abuse toward [name[s] of child[ren] of family or household] that constitute family violence. The acts of abuse commit­ted by Respondent that constitute family violence were

physical injury that resulted in substantial harm to [name[s] of affected child[ren] of family or household] or the genuine threat of substantial harm from physical injury to [name[s] of affected child[ren] of family or household]

sexual conduct that was harmful to the mental, emotional, or physical welfare of [name[s] of affected child[ren] of family or household], [specify conduct]

compelling or encouraging the child to engage in sexual conduct as defined by section 43.01 of the Texas Penal Code including compelling or encouraging the child in a manner that constitutes an offense of trafficking of persons under section 20A.02(a)(7) or (8), of the Texas Penal Code, prostitution under 43.02(b), or compelling prostitution under section 43.05(a)(2) [specify con­duct]

causing, permitting, encouraging, engaging in, or allowing the photographing, filming, or depicting of the child when Respondent knew or should have known that the resulting photograph, film, or depiction of the child was obscene as defined by section 43.21 of the Texas Penal Code or pornographic

the current use by Respondent of a controlled substance as defined by chapter 481 of the Texas Health and Safety Code in a manner or to the extent that the use resulted in physical, mental, or emotional injury to a child

causing, expressly permitting, or encouraging a child to use a controlled sub­stance as defined in chapter 481 of the Texas Health and Safety Code

causing, permitting, encouraging, engaging in, or allowing a sexual perfor­mance by a child as defined by section 43.25 of the Texas Penal Code

forcing or coercing a child to enter into a marriage

6.C.Stalking
§ 85.022(b)(5)

Respondent’s conduct was reasonably likely to harass, annoy, alarm, abuse, torment, or embarrass [Applicant/[name[s] of member[s] of family or household]/Applicant and [name[s] of member[s] of family or household]].

6.D.Communicating through Attorney or Appointee
§ 85.022(b)(2)(C)

Good cause exists for prohibiting Respondent from communicating with [Applicant/[name[s] of member[s] of family or household]/Applicant or [name[s] of member[s] of family or household]] except through Respondent’s attorney or a person appointed by the Court, as requested below.

6.E.Vacating Residence
§ 85.021(2)

The residence at [address, city, state] is [owned/leased] [jointly by Applicant and Respondent/by Applicant/by Respondent, and Respondent has an obligation to support [Applicant/Applicant’s child[ren]]].

7.Application Filed after Expiration of Previously Rendered Protective Order
§ 82.008(a)

7.Application Filed after Expiration of Previously Rendered Protective Order

This application is filed after a previously rendered protective order expired. A copy of the expired protective order is [attached to this application as Exhibit [exhibit number/letter]/unavailable to Applicant but will be filed with the Court before the hearing on the application].

7.A.Description of Violation of Expired Protective Order
§ 82.008(a)(2)(A), (3)

Respondent has violated a previously rendered protective order by com­mitting an act prohibited by that order while the order protecting Applicant was in effect. The previously rendered protective order has expired after the date the violation occurred.

Respondent has violated the expired protective order in the following manner: [describe violation of the expired protective order]. Respondent’s vio­lation[s] of the expired order [has/have] not been grounds for any other order protecting Applicant that has been issued or requested under subtitle B, title 4, of the Texas Family Code.

7.B.Description of Threatened Harm That Reasonably Places Applicant in Fear
§ 82.008(a)(2)(B)

Respondent has threatened to harm Applicant in the following manner: [describe respondent’s threats of imminent physical harm, bodily injury, assault, or sexual assault against applicant].

8.Application Filed before Expiration of Previously Rendered Protective Order
§ 82.0085

8.Application Filed before Expiration of Previously Rendered Protective Order

A previously rendered protective order protecting Applicant is currently in effect. The previously rendered protective order is due to expire on [date of expiration]. A copy of the protective order is [attached to this application as Exhibit [exhibit number/letter]/unavailable to Applicant but will be filed with the Court before the hearing on the application].

Respondent has threatened to harm Applicant in the following manner: [describe respondent’s threats of imminent physical harm, bodily injury, assault, or sexual assault against applicant].

9.Request for Order
§ 82.004(4)

9.Request for Protective Order

In this application, “Protected Person” means [Applicant/[name[s] of member[s] of family or household]/Applicant and [name[s] of member[s] of family or household]]. [If any specific relief is not intended to apply to all the identified protected persons, the relevant person[s] must be specifically named in the particular request.]

Applicant requests the Court, after notice and hearing, to issue its pro­tective order:

9.A.Family Violence
§ 85.022(b)(1)

1.Prohibiting Respondent from committing family violence as defined in section 71.004 of the Texas Family Code.

2.Prohibiting Respondent from doing any act [include if dating vio­lence: other than a defensive measure to protect Respondent] that is intended to result in physical harm, bodily injury, assault, or sexual assault against [any] Protected Person.

3.Prohibiting Respondent from doing any act [include if dating vio­lence: other than a defensive measure to protect Respondent] that is a threat that reasonably places [any] Protected Person in fear of imminent physical harm, bodily injury, assault, or sexual assault.

4.Prohibiting Respondent from committing abuse of a child of the family or household as defined by Texas Family Code section 261.001(1)(C), (E), (G), (H), (I), (J), (K), and (M). [If specific acts of child abuse are to be addressed in the order, list the acts intended to be covered.]

9.B.Communicating
§ 85.022(b)(2)(A)

5.Prohibiting Respondent from communicating directly with [any] Protected Person in a threatening or harassing manner.

9.C.Communicating
§ 85.022(b)(2)(B)

6.Prohibiting Respondent from communicating a threat through any person to [any] Protected Person.

9.D.Communicating
§ 85.022(b)(2)(C)

7.On a finding of good cause, prohibiting Respondent from commu­nicating in any manner with [any] Protected Person except through Respon­dent’s attorney or a person appointed by the Court.

9.E.Stalking
§ 85.022(b)(5)

8.Prohibiting Respondent from engaging in conduct directed specifi­cally toward [any] Protected Person, including following [the] Protected Per­son, that is reasonably likely to harass, annoy, alarm, abuse, torment, or embarrass [the] Protected Person.

9.F.Going Near Protected Persons

9.Prohibiting Respondent from going to or near, or within [specify distance] of, any location where [any] Protected Person is known by Respon­dent to be and from remaining within [specify distance] after Respondent becomes aware of [the] Protected Person’s presence.

9.G.Going to Residence or Business
§ 85.022(b)(3)

10.Prohibiting Respondent from going to or near the residence[s] or place[s] of employment or business of [any] Protected Person. Applicant requests the Court to specifically prohibit Respondent from going to or near [specify location[s] prohibited] [include if applicable: and to specifically require Respondent to maintain a distance of [specify the minimum distance[s] from the location[s] that respondent must maintain] therefrom].

9.H.Going to Child[ren]’s Residence, Child Care Facility, or School
§ 85.022(b)(4)

11.Prohibiting Respondent from going to or near the residence[s], child care [facility/facilities], or school[s] [name[s] of child[ren] protected under the order] normally attend[s] or in which [name[s]] normally reside[s]. Applicant requests the Court to specifically prohibit Respondent from going to or near [specify location[s] prohibited] [include if applicable: and to maintain a distance of [specify the minimum distance[s] from the location[s] that respon­dent must maintain] therefrom].

9.I.Removing Child[ren]
§ 85.021(1)(A)

12.Prohibiting Respondent from removing [name[s] of child[ren] of family or household] from the [possession of [name]/jurisdiction of the Court].

9.J.Harming Animal
§ 85.022(b)(7)

13.Prohibiting Respondent from harming, threatening, or interfering with the care, custody, or control of a pet, companion animal, or assistance ani­mal, as defined by section 121.002 of the Texas Human Resources Code, that is possessed by or in the actual or constructive care of [any] Protected Person.

9.K.Disposing of Property
§ 85.021(1)(B)

14.Prohibiting Respondent from transferring, encumbering, or other­wise disposing of property mutually owned or leased by the parties, except when in the ordinary course of business.

9.L.Possessing Firearm or Ammunition
§§ 85.022(b)(6), 85.026

15.Prohibiting Respondent from possessing a firearm or ammunition unless Respondent is a peace officer, as defined by section 1.07 of the Texas Penal Code, actively engaged in employment as a sworn, full-time paid employee of a state agency or political subdivision.

9.M.Interfering with Use of Residence

16.Prohibiting Respondent from interfering with Applicant’s use of the residence located at [address, city, state], including but not limited to dis­connecting utilities or telephone service or causing such services to be discon­nected.

9.N.Suspension of Handgun License
§ 85.022(d)

17.Suspending Respondent’s license to carry a handgun issued under subchapter H, chapter 411, of the Texas Government Code.

9.O.Exclusive Use of Residence
§ 85.021(2)

18.Granting Applicant exclusive possession of the parties’ residence [include if applicable: and ordering Respondent to vacate the residence].

9.P.Treatment or Counseling
§ 85.022(a)(1)–(3)

19.Requiring Respondent to complete a battering intervention and pre­vention program or counseling as provided by section 85.022(a) of the Texas Family Code.

9.Q.Use of Property
§ 85.021(5)

20.Awarding Applicant exclusive use and possession of the following property, which is [community property/jointly [owned/leased]]: [describe property].

9.R.Possession of Child[ren]
§ 85.021(3)

21.Granting Applicant exclusive possession of the child[ren], [name[s]], and specifying the terms of Respondent’s access to the child[ren].

9.S.Support
§ 85.021(4)

22.Ordering Respondent to pay support for [name[s] of applicant and/or child[ren] entitled to support].

9.T.Other Acts
§ 85.022(a)

9.U.Accompaniment by Law Enforcement Officer
§ 86.004

Applicant requests the Court to render a written order to the [sheriff/chief of police/constable] to provide a law enforcement officer from the department of the [sheriff/chief of police/constable] to accompany Applicant to the parties’ residence, to inform Respondent that the Court has ordered Respondent excluded from the residence, to protect Applicant while Applicant takes possession of the residence and Respondent takes possession of Respon­dent’s necessary personal property, and, if Respondent refuses to vacate the residence, to remove Respondent from the residence and arrest Respondent for violating the Court’s order.

10.Request for Order for More Than Two Years
§ 85.025(a–1)

10.Request for Order Exceeding Two Years

10.A.Commission of Felony
§ 85.025(a–1)(1)

Respondent committed an act constituting a felony offense involving family violence against [Applicant/[name[s] of member[s] of family or house­hold]/Applicant and [name[s] of member[s] of family or household]].

10.B.Serious Bodily Injury
§ 85.025(a–1)(2)

Respondent caused serious bodily injury to [Applicant/[name[s] of member[s] of family or household]/Applicant and [name[s] of member[s] of family or household]].

10.C.Previous Protective Orders
§ 85.025(a–1)(3)

Respondent was the subject of two or more previous protective orders rendered to protect the same person or persons who are seeking protection in this application, and the previous protective orders were rendered by a court after a finding by the court that Respondent had committed family violence and was likely to commit family violence in the future.

10.D.Request for Extended Term

Applicant therefore requests that the term of the protective order exceed two years.

11.Request for Order Separating Wireless Telephone Service Account
§ 85.0225

11.Request for Order Separating Wireless Telephone Service Account

Respondent is the account holder for the wireless telephone service account that includes the following telephone number[s], which [is/are] pri­marily used by [Applicant/a child who is in Applicant’s care or custody/Appli­cant or a child who is in Applicant’s care or custody]: [specify telephone number[s]].

[Name of wireless telephone service provider], whose registered agent is [name, address, city, state, zip], is the wireless telephone service provider for the account.

Applicant requests the Court to order the separation of [the/each] listed wireless telephone number from Respondent’s wireless telephone service account and that the Court issue an order directing [name of wireless telephone service provider] to transfer the billing responsibilities and rights to [the/each] listed wireless telephone number to Applicant in accordance with the provi­sions of section 608.001 of the Texas Business and Commerce Code.

12.Request for Temporary Ex Parte Order
§§ 83.001–.007

12.Request for Temporary Ex Parte Order

Before the filing of this application, Respondent has engaged in conduct that constitutes family violence. [Specify in detail facts constituting family vio­lence.] There is an immediate need for the protective order requested in this application.

Based on the conduct of Respondent as alleged, Applicant reasonably fears that there is a clear and present danger of family violence, which will cause Applicant immediate and irreparable injury, loss, and damage, for which Applicant has no adequate remedy at law.

Applicant therefore requests the Court to issue a temporary ex parte order immediately for the protection of Protected Person[s]:

12.A.Family Violence
§ 85.022(b)(1)

1.Prohibiting Respondent from committing family violence as defined in section 71.004 of the Texas Family Code.

2.Prohibiting Respondent from doing any act [include if dating vio­lence: other than a defensive measure to protect Respondent] that is intended to result in physical harm, bodily injury, assault, or sexual assault against [any] Protected Person.

3.Prohibiting Respondent from doing any act [include if dating vio­lence: other than a defensive measure to protect Respondent] that is a threat that reasonably places [any] Protected Person in fear of imminent physical harm, bodily injury, assault, or sexual assault.

4.Prohibiting Respondent from committing abuse of a child of the family or household as defined by Texas Family Code section 261.001(1)(C), (E), (G), (H), (I), (J), (K), and (M). [If specific acts of child abuse are to be addressed in the order, list the acts intended to be covered.]

12.B.Communicating
§ 85.022(b)(2)(A)

5.Prohibiting Respondent from communicating directly with [any] Protected Person in a threatening or harassing manner.

12.C.Communicating
§ 85.022(b)(2)(B)

6.Prohibiting Respondent from communicating a threat through any person to [any] Protected Person.

12.D.Communicating
§ 85.022(b)(2)(C)

7.On a finding of good cause, prohibiting Respondent from commu­nicating in any manner with [any] Protected Person except through Respon­dent’s attorney or a person appointed by the Court.

12.E.Stalking
§ 85.022(b)(5)

8.Prohibiting Respondent from engaging in conduct directed specifi­cally toward [any] Protected Person, including following [the] Protected Per­son, that is reasonably likely to harass, annoy, alarm, abuse, torment, or embarrass [the] Protected Person.

12.F.   Going Near Protected Persons

9.Prohibiting Respondent from going to or near, or within [specify distance] of, any location where [any] Protected Person is known by Respon­dent to be and from remaining within [specify distance] after Respondent becomes aware of [the] Protected Person’s presence.

12.G.Going to Residence or Business
§ 85.022(b)(3)

10.Prohibiting Respondent from going to or near the residence[s] or place[s] of employment or business of [any] Protected Person. Applicant requests the Court to specifically prohibit Respondent from going to or near [specify location[s] prohibited] [include if applicable: and to specifically require Respondent to maintain a distance of [specify the minimum distance[s] from the location[s] that respondent must maintain] therefrom].

12.H.Going to Child[ren]’s Residence, Child Care Facility, or School
§ 85.022(b)(4)

11.Prohibiting Respondent from going to or near the residence[s], child care [facility/facilities], or school[s] [name[s] of child[ren] protected under the order] normally attend[s] or in which [name[s]] normally reside[s]. Applicant requests the Court to specifically prohibit Respondent from going to or near [specify location[s] prohibited] [include if applicable: and to maintain a distance of [specify the minimum distance[s] from the location[s] that respon­dent must maintain] therefrom].

12.I.Removing Child[ren]
§ 85.021(1)(A)

12.Prohibiting Respondent from removing [name[s] of child[ren] of family or household] from the [possession of [name]/jurisdiction of the Court].

12.J.Harming Animal
§ 85.022(b)(7)

13.Prohibiting Respondent from harming, threatening, or interfering with the care, custody, or control of a pet, companion animal, or assistance ani­mal, as defined by section 121.002 of the Texas Human Resources Code, that is possessed by or in the actual or constructive care of [any] Protected Person.

12.K.Disposing of Property
§ 85.021(1)(B)

14.Prohibiting Respondent from transferring, encumbering, or other­wise disposing of property mutually owned or leased by the parties, except when in the ordinary course of business.

12.L.Possessing Firearm or Ammunition
§§ 85.022(b)(6), 85.026

15.Prohibiting Respondent from possessing a firearm or ammunition unless Respondent is a peace officer, as defined by section 1.07 of the Texas Penal Code, actively engaged in employment as a sworn, full-time paid employee of a state agency or political subdivision.

12.M.Interfering with Use of Residence

16.Prohibiting Respondent from interfering with Applicant’s use of the residence located at [address, city, state], including but not limited to dis­connecting utilities or telephone service or causing such services to be discon­nected.

12.N.Exclusive Use of Residence
§ 85.021(2)

17.Granting Applicant exclusive possession of the parties’ residence [include if applicable: and ordering Respondent to vacate the residence].

12.O.Other Acts
§ 85.022(a)

12.P.Accompaniment by Law Enforcement Officer
§ 86.003

Applicant requests the Court to render a written order to the [sheriff/constable/chief of police] to provide a law enforcement officer from the department of the [sheriff/constable/chief of police] to accompany Applicant to the parties’ residence, to inform Respondent that the Court has ordered Respondent excluded from the residence, to protect Applicant while Applicant takes possession of the residence, and to protect Applicant if Respondent refuses to vacate the residence while Applicant takes possession of Applicant’s necessary personal property.

12.Q.Waiver of Bond
§ 83.003

Applicant requests the Court to dispense with the necessity of a bond.

13.Best Interest
§ 85.001(b)

13.Best Interest

The protective order requested is in the best interest of the family, household, or member of the family or household.

14.Confidential Information
§ 82.011

14.Confidential Information

Applicant requests the Court to enter an order requiring Applicant to dis­close [his/her] mailing address to the Court, to designate a person to receive on behalf of Applicant any notice or documents filed with the Court related to the application, and to disclose the designated person’s mailing address to the Court. Applicant further requests the Court to order the clerk of the Court to strike Applicant’s mailing address from the public records of the Court, if applicable, maintain a confidential record of Applicant’s mailing address for use only by the Court, and prohibit the release of the information to Respon­dent.

15.Attorney’s Fees and Costs
§§ 81.003–.006

15.Attorney’s Fees and Costs

The Court should assess against [name of respondent] a reasonable attorney’s fee as compensation for [name of attorney], and judgment should be rendered in favor of [this attorney/[county] County, Texas,/the State of Texas] against [name of respondent].

Applicant requests that Respondent be ordered to pay reasonable attor­ney’s fees, the $16 protective order fee, the cost of service of the protective order, the costs of court, and all other fees, charges, or expenses incurred in connection with the protective order [before the sixtieth day after the date the order is rendered/on or before [date]].

16.Prayer

16.Prayer

16.A.Required in All Applications

Applicant prays that notice of this Application for a Protective Order issue as required by law and that the Court enter the protective order[s] as requested in this application.

16.B.Ex Parte Order

Applicant further prays that the Court immediately issue a temporary protective order, ex parte, in conformity with the allegations stated above, pro­hibiting Respondent from the acts [include if applicable: and ordering Respon­dent to do the acts] set forth above until a hearing can be held.

16.C.Required
§§ 84.001–.002

Applicant prays that a hearing be held no later than the fourteenth day after the date this application is filed; that, after notice and hearing, the Court grant the relief requested above; and that the Court dispense with the necessity of a bond.

Applicant prays for attorney’s fees, costs, charges, and expenses.

Applicant prays for general relief.

   
[Name]
Attorney for Applicant
State Bar No.:
[Email address]
[Address]
[Telephone]
[Fax]

17.Notice of Hearing
§ 84.001(a)

IT IS ORDERED that the hearing on the Application for a Protective Order is set before the Court at [time] on [date].

All participants, including Respondent, [name], are ORDERED to appear on the date and at the time set for the hearing physically in the court­room of this Court at [address, city], Texas. Participants may appear before the Court by other means only if permitted by court order. The Court’s designated contact information [is [court’s designated contact information]/can be found at [specify where the court publishes this information]].

All participants, including Respondent, [name], are ORDERED to appear on the date and at the time set for the hearing by [state method, e.g., Zoom, telephone] using the following information: [information for accessing meeting, e.g., Zoom meeting ID and passcode, conference call number]. Partic­ipants may appear before the Court by other means only if permitted by court order. The Court’s designated contact information [is [court’s designated con­tact information]/can be found at [specify where the court publishes this infor­mation]]. Any participant who cannot participate by the electronic means set forth in this notice, has a technological issue preventing effective electronic participation, or needs assistance joining the hearing is ORDERED to contact the Court as soon as the issue is discovered.

All participants, [including/except] Respondent, [name], are ORDERED to appear on the date and at the time set for the hearing either physically in the courtroom of this Court at [address, city], Texas, or by [state method, e.g., Zoom, telephone] using the following information: [information for accessing meeting, e.g., Zoom meeting ID and passcode, conference call number]. [Include if applicable: Respondent is ORDERED to appear on the date and at the time set for the hearing physically in the courtroom described above.] Par­ticipants may appear before the Court by other means only if permitted by court order. The Court’s designated contact information [is [court’s designated contact information]/can be found at [specify where the court publishes this information]]. Any participant who cannot appear physically in the courtroom and who cannot participate by the electronic means set forth in this notice, has a technological issue preventing effective electronic participation, or needs assistance joining the hearing is ORDERED to contact the Court as soon as the issue is discovered.

Failure to appear as directed may result in sanctions being entered, up to and including default judgment or dismissal of claims.

Instructions for submitting evidence: [See the Court’s instructions attached to this notice./See the Court’s instructions available at [specify where the court publishes this information].]

Additional instructions for participating in the hearing: [None/See the Court’s instructions attached to this notice./See the Court’s instructions avail­able at [specify where the court publishes this information].]

The purpose of this hearing is to determine whether the relief requested in the Application for a Protective Order should be granted.

SIGNED on ________________________________.

   
JUDGE PRESIDING

18.Affidavit in Support of Ex Parte Order
§§ 82.009, 83.006

Affidavit in Support of Ex Parte Relief

I, [name of applicant], am the applicant in the above Application for a Protective Order. [I am above the age of eighteen years/I am under the age of eighteen years, and I am seeking protection from dating violence]. I am fully competent to make this affidavit. The facts and circumstances alleged are true to the best of my knowledge and belief.

   
[Name of applicant]

SIGNED under oath before me on ______________________________.

   
Notary Public, State of Texas