8.962 Motion for Injunction

VERIFIED MOTION FOR CHAPTER 39 INJUNCTION FOR PROTECTION AGAINST ANY ACT OF CHILD ABUSE OR DOMESTIC VIOLENCE

Movant ( ) Department of Children and Family Services ( ) law enforcement officer ( ) state attorney ( ) responsible person ( ) the court on its own motion, .....(name)....., .....(address)....., requests this court under section 39.504, Florida Statutes, to issue an injunction against Respondent, .....(name)....., .....(address)......

1. The minor child(ren) subject to this request is/are:

Name                                        Birth date
................................................ ................
................................................ ................
................................................ ................
................................................ ................

2. Reasonable cause for the issuance of an injunction exists based on the following .....(evidence of child abuse or domestic violence and/or recent overt act(s) or failure(s) to act that provide a basis that there is a reasonable likelihood that such abuse or offense will occur)......

3. ..... Respondent, .....(name)..... was noticed of the hearing on this motion on .....(date)......

..... Movant requests that an injunction be issued without notice to Respondent because the children are in imminent danger in that

.....(explain why there would be immediate danger and irreparable harm if Respondent is given notice).....

4. Respondent, .....(name and address)..... can be identified by the following:

Race ..... Gender: ..... Male ..... Female
Birth date .......... Ht. ..... Wt. .....
Eye color .......... Hair color ..........
Distinguishing marks or scars ......................................
Vehicle: make, model, and year ....................................
Color .............................................................................
Tag number ...................................................................

Wherefore, Movant requests that the court enter an injunction under Chapter 39, Florida Statutes, to protect the minor child(ren) against any act of abuse or domestic violence and order Respondent to do the following:

..... a. Refrain from further child abuse of the minor child(ren) or exposure of the minor child(ren) to acts of domestic violence.

..... b. Participate in a specialized treatment program including ...........

..... c. Have limited contact with the child(ren) as follows:

..... Supervised visitation with the child(ren). The visitation shall be supervised at all times by the department or an adult approved by the department or the court. The visitation shall occur on a schedule agreed by the parties and at the department’s office, a supervised visitation center, or another place agreed by the parties. The frequency of the visitation shall be ...........

..... No contact with the child(ren) at home, school, work, or wherever the child(ren) may be found except as otherwise provided by this motion.

..... d. Pay $..... ( ) weekly ( ) biweekly ( ) monthly temporary support for the ( ) child(ren) ( ) family members.

..... e. Pay the cost of medical, psychiatric and psychological treatment for ( ) the child(ren) ( ) family members incurred as a result of the offenses described in this motion.

..... f. Vacate the home in which .....(child(ren)’s name(s))..... reside(s) and not return until further order of the court.

..... g. Due to any domestic violence described in this motion, Movant also request[s] the court to:

..... Award exclusive use and possession of the dwelling to the caregiver, .....(name).....

..... Exclude Respondent from the residence, ..... (address)..... of the caregiver, .....(name).....

..... Award temporary custody of the child(ren) to the caregiver, .....(name).....

..... Other requests .................................................. I certify that a copy of this document was ..... mailed

..... faxed and mailed ..... hand delivered to the person(s) listed below on .....(date)..... or ..... was not delivered to the person(s) listed below because ..........

Other party or his/her attorney:
Name: ..........
Address: ...........
Fax Number: ..........

I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this verified motion and that punishment for knowingly making a false statement includes fines and/or imprisonment.

.....Moving Party.....

STATE OF FLORIDA
COUNTY OF ..........

Sworn to or affirmed and signed before me on .....(date)..... by .....(name).....

___________________
NOTARY PUBLIC OR
DEPUTY CLERK

Print, type, or stamp name of notary or clerk

..... Personally known
..... Produced Identification
Type of identification produced ...........

If the party filing this motion is represented by an attorney, the attorney must complete the following:

I, the undersigned attorney for Movant hereby certify that the following efforts have been made to give notice: .....(efforts made or if none made, state why).....

___________________
.....(attorney’s name).....
.....(address and telephone number).....
.....(Florida Bar number).....