Form 17-4

NOTICE: THIS DOCUMENT
CONTAINS SENSITIVE DATA

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

Order to [Sheriff/Chief of Police/Constable] of _________, Texas

TO THE [SHERIFF/CHIEF OF POLICE/CONSTABLE] OF [jurisdiction], TEXAS:

On [date] the Court granted the Application for a Protective Order of [name of appli­cant], Applicant. The Court’s order excludes Respondent, [name of respondent], from the res­idence located at [address], [county] County, Texas.

You are ORDERED to provide a law enforcement officer from your department in accordance with section 86.003 of the Texas Family Code—

1.to accompany Applicant to the residence covered by the order;

2.to inform Respondent that the Court has ordered that Respondent be excluded from the residence;

3.to protect Applicant while Applicant takes possession of the residence; and

4.to protect Applicant if Respondent refuses to vacate the residence while Applicant takes possession of Applicant’s necessary personal property.

You are ORDERED to provide a law enforcement officer from your department in accordance with section 86.004 of the Texas Family Code—

1.to accompany Applicant to the residence covered by the order;

2.to inform Respondent that the Court has ordered that Respondent be excluded from the residence;

3.to protect Applicant while Applicant takes possession of the residence and Respondent takes possession of Respondent’s necessary personal property; and

4.if Respondent refuses to vacate the residence, you are ORDERED to remove Respondent from the residence and to arrest Respondent for violating a court order.

SIGNED on ________________________________.

   
JUDGE PRESIDING

Information about Respondent:

Name:

Home address:

Home telephone number:

Work address:

Work telephone number:

Date of birth:

Color of eyes:

Color of hair:

Height: _______ feet ________ inches

Weight:

Sex:

Race:

Personal descriptors:

Social Security number:

Driver’s license or identification number and issuing state: