Form CIV-752 Petition for Stalking or Sexual Assault Protective Order - Alaska

Form CIV-752 is a Alaska Court System form also known as the "Petition For Stalking Or Sexual Assault Protective Order". The latest edition of the form was released in October 1, 2013 and is available for digital filing.

Download an up-to-date Form CIV-752 in PDF-format down below or look it up on the Alaska Court System Forms website.

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IN THE DISTRICT/SUPERIOR COURT FOR THE STATE OF ALASKA
AT
)
)
Petitioner
Date of Birth
)
Male
Female
)
v.
)
CASE NO.
)
)
PETITION FOR
Respondent
Date of Birth
)
PROTECTIVE ORDER
Male
Female
)
Stalking
Sexual Assault
)
I swear or affirm under penalty of perjury that all the information I provide in this petition
is true to the best of my knowledge and belief.
I am requesting the following protective order(s). NOTE: If there is any chance you
might need protection for more than 20 days, you should request both a long-
term order (6 months) and an ex parte order (20-day). To do this, check both
boxes.
1.
an ex parte protective order (20 day order).
(This order can take effect
immediately based on only the petition and the petitioner’s testimony, without
the respondent knowing about the ex parte petition. The police will serve the ex
parte order if granted.) I certify that I
have not tried to notify the respondent that I am filing this petition.
notified or tried to notify the respondent as follows:
a long-term protective order (6 month order). (This order can only be issued
after notice to the respondent and a court hearing. This order will last for 6
months, unless the court ends it sooner. The police will notify the respondent
of the hearing.)
2. The respondent is a (check all that apply):
(former) friend
neighbor
classmate
co-worker
client or former client
correctional facility employee
legal guardian of petitioner
other (describe):
I do not know and have never been acquainted with the respondent
3. I (petitioner) am
a minor: Age ________
an adult
This is Not a Court Order
Page 1 of 5
CIV-752 (10/13)(cs)
AS 18.65.850-.870
PETITION FOR STALKING OR SEXUAL ASSAULT PROTECTIVE ORDER
Civil Rule 65.1
IN THE DISTRICT/SUPERIOR COURT FOR THE STATE OF ALASKA
AT
)
)
Petitioner
Date of Birth
)
Male
Female
)
v.
)
CASE NO.
)
)
PETITION FOR
Respondent
Date of Birth
)
PROTECTIVE ORDER
Male
Female
)
Stalking
Sexual Assault
)
I swear or affirm under penalty of perjury that all the information I provide in this petition
is true to the best of my knowledge and belief.
I am requesting the following protective order(s). NOTE: If there is any chance you
might need protection for more than 20 days, you should request both a long-
term order (6 months) and an ex parte order (20-day). To do this, check both
boxes.
1.
an ex parte protective order (20 day order).
(This order can take effect
immediately based on only the petition and the petitioner’s testimony, without
the respondent knowing about the ex parte petition. The police will serve the ex
parte order if granted.) I certify that I
have not tried to notify the respondent that I am filing this petition.
notified or tried to notify the respondent as follows:
a long-term protective order (6 month order). (This order can only be issued
after notice to the respondent and a court hearing. This order will last for 6
months, unless the court ends it sooner. The police will notify the respondent
of the hearing.)
2. The respondent is a (check all that apply):
(former) friend
neighbor
classmate
co-worker
client or former client
correctional facility employee
legal guardian of petitioner
other (describe):
I do not know and have never been acquainted with the respondent
3. I (petitioner) am
a minor: Age ________
an adult
This is Not a Court Order
Page 1 of 5
CIV-752 (10/13)(cs)
AS 18.65.850-.870
PETITION FOR STALKING OR SEXUAL ASSAULT PROTECTIVE ORDER
Civil Rule 65.1
v.
Case No.
4. The respondent is (or appears to be)
a minor: Age
an adult
5. a. Respondent has stalked or sexually assaulted me as described below and this
conduct has placed me in fear of:
death or physical injury to me
further sexual assault
the death or physical injury of the following family member of mine:
Name of family member:
Relationship to me:
b. I am afraid of physical injury or death, or further sexual assault, because
6. Description of respondent’s conduct. (Explain what respondent is doing or did,
including when, where and how often the stalking or sexual assault occurred. Be
specific. Include dates and places.)
This is Not a Court Order
Page 2 of 5
CIV-752 (10/13)(cs)
AS 18.65.850-.870
PETITION FOR STALKING OR SEXUAL ASSAULT PROTECTIVE ORDER
Civil Rule 65.1
v.
Case No.
7. I request an order from the court directing (check all that apply)
a. respondent not to follow, approach, confront, watch or stalk me in any other
way or threaten to do so.
b. respondent not to contact me by telephone, e-mail or U.S. mail or otherwise
communicate directly or indirectly by any means with me or the following
members of my household:
c. respondent to stay away from my residence.
Is this also respondent's current residence?
yes
no
Respondent’s residence is
unknown to me
within my apartment complex
approximately
feet/miles from my residence
Describe:
d. respondent to stay away from my school.
Name and location of school: 
Is this also respondent’s school?
yes
no
e. respondent to stay away from my place of employment. Name and location
of place of employment:
Is this also respondent’s place of employment?
yes
no
If yes, list the hours respondent works (if known)
f. respondent to stay away from the following places I go to:
g. respondent not to have sexual contact with me.
You do not have to provide this information if you do not want the respondent to know the
location of your school or place of employment.
This is Not a Court Order
Page 3 of 5
CIV-752 (10/13)(cs)
AS 18.65.850-.870
PETITION FOR STALKING OR SEXUAL ASSAULT PROTECTIVE ORDER
Civil Rule 65.1
v.
Case No.
8. Other cases. The following are all the pending civil cases or criminal cases, in this
or another state, involving either me or respondent (that I know of):
Type of Case
Court Location
Petitioner or Respondent
The following are other court cases (civil or criminal) involving the respondent that I
want the court to know about:
Type of Case
Court Location
Both petitioner and respondent have the responsibility to tell the court of any
criminal or civil lawsuits involving either of you that arise while a petition for
protective order is pending. AS 18.65.865(d)
9. Information about respondent (if known).
Respondent’s full legal name and any nicknames or other names used:
Respondent's mailing address:
Respondent's home phone:
Work phone:
This is Not a Court Order
Page 4 of 5
CIV-752 (10/13)(cs)
AS 18.65.850-.870
PETITION FOR STALKING OR SEXUAL ASSAULT PROTECTIVE ORDER
Civil Rule 65.1
v.
Case No.
10. Petitioner information. [The court needs your mailing address to send court papers,
including notices of hearing, to you. If you believe it is not safe for the respondent to
know where you live, write a "message" address where you can be sure you will
receive court papers. If you do not have an address and telephone number that
can safely be revealed to the respondent, ask the court clerk how you can
provide this information so that it will be kept confidential and not revealed to
the respondent. Civil Rule 65.1]
My mailing/message address
Street or Box No.
City
State
Zip
My message phone:
My full legal name:
Any nicknames or other names:
Date
Petitioner's Signature
Print Name
Subscribed and sworn to or affirmed before me at
, Alaska on
.
(date)
(SEAL)
Clerk of Court, Notary Public or other person
authorized to administer oaths
My commission expires:
This is Not a Court Order
Page 5 of 5
CIV-752 (10/13)(cs)
AS 18.65.850-.870
PETITION FOR STALKING OR SEXUAL ASSAULT PROTECTIVE ORDER
Civil Rule 65.1
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