Form OFP102 "Petitioner's Affidavit and Petition for Order for Protection" - Minnesota (English/Hmong)

What Is Form OFP102?

This is a legal form that was released by the Minnesota District Courts - a government authority operating within Minnesota. Check the official instructions before completing and submitting the form.

Form Details:

  • Released on December 1, 2015;
  • The latest edition provided by the Minnesota District Courts;
  • Easy to use and ready to print;
  • Available in Spanish;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form OFP102 by clicking the link below or browse more documents and templates provided by the Minnesota District Courts.

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Download Form OFP102 "Petitioner's Affidavit and Petition for Order for Protection" - Minnesota (English/Hmong)

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THIS FORM MUST BE COMPLETED IN ENGLISH
YUAV TSUM TEB TSAB NTAWV NO UA LUS ASKIV
State of Minnesota
District Court
Xeev Minnesota
Cheeb Tsam Tsev Hais Plaub
Judicial District:
County
Txhooj Hais Plaub
Cheeb Nroog
Court File Number:
Zauv Cim Rooj Plaub
Case Type:
Domestic Abuse
Hom Plaub Ntug
Kev Tsim Txom Hauv Vaj Tse
In the Matter of:
Qhov Xwm Txheej ntawm:
Petitioner’s Affidavit and Petition
Petitioner
(first, middle, last)
For Order for Protection
Tus Neeg Foob
(npe, npe nruab nrab, xeem)
On behalf of:
Minn. Stat. § 518B.01
Pab rau:
Neeg Foob Tsab Ntawv Pov Thawj thiab Lus Thov
Other persons needing protection (first, middle, last)
Tsab Ntawv Tiv Thaiv
Minn. Txoj cai § 518B.01
Lwm cov neeg xav tau kev tiv thaiv (npe, npe nruab nrab, xeem)
and for her/himself
thiab rau nws tus kheej
vs.
tawm tsam
Respondent (first, middle, last)
Neeg Raug Foob (npe, npe nruab nrab, xeem)
STATE OF MINNESOTA
)
XEEV MINNESOTA
) SS
COUNTY OF
)
CHEEB NROOG
(county where affidavit signed)
(lub cheeb nroog uas kos npe rau tsab ntawv pov thawj)
I, ______________________________________, state that:
I am the Petitioner (the person requesting the order) in this action. This affidavit supports my
request for an Order for Protection (OFP). (Minn. Stat. § 518B.01).
OFP102
State
ENG-HMO
Rev 12/15
www.mncourts.gov/forms
Page 1 of 21
THIS FORM MUST BE COMPLETED IN ENGLISH
YUAV TSUM TEB TSAB NTAWV NO UA LUS ASKIV
State of Minnesota
District Court
Xeev Minnesota
Cheeb Tsam Tsev Hais Plaub
Judicial District:
County
Txhooj Hais Plaub
Cheeb Nroog
Court File Number:
Zauv Cim Rooj Plaub
Case Type:
Domestic Abuse
Hom Plaub Ntug
Kev Tsim Txom Hauv Vaj Tse
In the Matter of:
Qhov Xwm Txheej ntawm:
Petitioner’s Affidavit and Petition
Petitioner
(first, middle, last)
For Order for Protection
Tus Neeg Foob
(npe, npe nruab nrab, xeem)
On behalf of:
Minn. Stat. § 518B.01
Pab rau:
Neeg Foob Tsab Ntawv Pov Thawj thiab Lus Thov
Other persons needing protection (first, middle, last)
Tsab Ntawv Tiv Thaiv
Minn. Txoj cai § 518B.01
Lwm cov neeg xav tau kev tiv thaiv (npe, npe nruab nrab, xeem)
and for her/himself
thiab rau nws tus kheej
vs.
tawm tsam
Respondent (first, middle, last)
Neeg Raug Foob (npe, npe nruab nrab, xeem)
STATE OF MINNESOTA
)
XEEV MINNESOTA
) SS
COUNTY OF
)
CHEEB NROOG
(county where affidavit signed)
(lub cheeb nroog uas kos npe rau tsab ntawv pov thawj)
I, ______________________________________, state that:
I am the Petitioner (the person requesting the order) in this action. This affidavit supports my
request for an Order for Protection (OFP). (Minn. Stat. § 518B.01).
OFP102
State
ENG-HMO
Rev 12/15
www.mncourts.gov/forms
Page 1 of 21
Kuv, ________________________________________tsa tes/tseeb lees rau lub ntuj tias:
Kuv yog Tus Neeg Foob (tus neeg thov kev pab) rau tes dej num no. Tsab ntawv pov thawj no
txhawb kuv Tsab Ntawv Tiv Thaiv (OFP). (Minn. Txoj cai § 518B.01).
1. Who needs protection?
Me (Petitioner)
My minor child(ren)
A person for whom I am the legal guardian (attach Guardianship Order)
A minor child who is not my child, but is a family or household member of mine
Other:
Leej twg yuav tsum tau kev tiv thaiv?
Kuv (Tus Neeg Foob)
Kuv tus (cov) me nyuam me
Tus neeg uas kuv muaj cai saib xyuas (rhais Tsab Ntawv Muaj Cai Saib Xyuas)
Tus me nyuam uas tsis yog kuv yug, tiam sis yog ib yim neeg los yogi b tug neeg hauv kuv
lub tsev
Lwm tus neeg:
2. Petitioner Information (You)
Name: (first, middle, last)
My address or phone is confidential. (Give the confidential information to court administration
on a separate sheet of paper.)
My Address:
City, State, Zip Code:
Telephone: (__________)
Race:____________________________ (for federal reporting purposes)
Gender:
male
female
Date of birth: (month/day/year):
Xov Xwm Txog Tus Neeg Foob (Koj)
Npe: (npe, npe nruab nrab, xeem)
Yuav tau ceev zoo kuv qhov chaw nyob los yog tus xov tooj. (Muab cov ncauj lus ceev zoo cia
no sau rau lwm nplooj ntawv cev rau chaw lis dej num hauv tsev hais plaub.)
Kuv qhov chaw nyob:
Zos, Xeev, Zauv Cim Cheeb Tsam:
Xov Tooj: (
)
Haiv Neeg:_______
(rau tsoom fwv teb chaws kev tshaj xo)
Zeej Xeeb:
txiv neej
poj niam
Hnub yug: (hlim/hnub/xyoo):
OFP102
State
Hmong
Rev 12/15
www.mncourts.gov/forms
Page 2 of 21
3. Email Notification of Service
Sau Ntawv Email Faj Seeb Txog Kev Xa Ntawv
By providing my email address below, I am indicating that I want to be notified by email
when the respondent is served with the OFP. I understand that this is the only email I will
receive from the court about the OFP unless I have signed up to receive other court notices via email.
I understand that it will only be possible for the court to notify me by email when service information
is received by the court. I understand that a technical or other error could occur preventing the
successful delivery of the email, and that I have other options to learn of the service of the OFP on
the respondent, including contacting law enforcement directly. I understand I must provide a valid
email address in order to receive this notification of service, and that THIS EMAIL ADDRESS
WILL BE SEEN BY THE RESPONDENT:
Email address: _________________________________________________________
Txoj kev qhia kuv qhov email rau nram no yog kuv qhia tias kuv xav kom sau ntawv faj seeb
qhia kuv paub thaum twg xa tsab OFP txog tus neeg raug foob. Kuv to taub tias zaum no kuv thiaj
txais tau ntawv email los ntawm lub tsev hais plaub txog tsab OFP nkaus xwb, tshwj tsis yog kuv rau
npe kom xa lwm cov ntawv faj seeb hauv tsev hais plaub hauv email rau kuv. Kuv to taub tias lub
tsev hais plaub tsuas sau ntawv email tuaj faj seeb tau rau kuv thaum twg lub tsev hais plaub txais
tau cov xov xwm kev xa ntawv. Kuv to taub tias tej zaum kuj muaj kev cov nyom los yog yuam kev
uas ua rau xa tsis tau tsab ntawv email, thiab kuv muaj lwm cov kev tshawb kom paub txog kev xa
tsab OFP rau tus neeg raug foob, xws li hu cuag tub ceev xwm ncaj qha. Kuv to taub tias kuv yuav
tsum qhia qhov email zoo thiaj li yuav txais tau tsab ntawv faj seeb txog kev xa ntawv no, thiab TUS
NEEG RAUG FOOB YUAV POM QHOV EMAIL NO.
Chaw xa ntawv Email:________________________________________________________
4. Respondent Information: (Person you want protection from)
Name: (first, middle, last)
Address:
City, State, Zip Code
Telephone: (__________)
Race:____________________________
Gender:
male
female
Date of birth:
If unknown, age or approximate age
month/day/year
If Respondent is under 18 years old, service must be made on Respondent and Respondent’s
parent or guardian. Parent or guardian name:
Parent or guardian address:
OFP102
State
Hmong
Rev 12/15
www.mncourts.gov/forms
Page 3 of 21
Xov Xwm Txog Tus Neeg Raug Foob: (Tus neeg koj xav txwv)
Npe: (npe, npe nruab nrab, xeem)
Chaw nyob:
Zos, Xeev, Zauv Cim Cheeb Tsam:
Xov Tooj: (
)
Haiv Neeg:
Zeej Xeeb:
txiv neej
poj niam
Hnub yug: ________________ Yog tsis paub, hnub nyoog los yog kwv yees hnub nyoog __
(hli/hnub/xyoo)
Yog tus neeg raug foob tsis nto hnub nyoog 18 xyoo, yuav tsum xa ntawv rau Tus Neeg Raug
Foob thiab Tus Neeg Raug Fooj leej niam leej txiv los yog tus neeg saib xyuas.
Niam Txiv los yog Tus Neeg Saib Xyuas Npe: ___________________
Niam Txiv los yog Tus Neeg Saib Xyuas Chaw Nyob: ____________________
5. List all persons needing protection, other than you.
None
Qhia tag nrho cov neeg xav tau kev tiv thaiv, dua li koj.
Tsis Muaj
Date of
Name (first, middle, last)
Race
Gender
Lives with
How is this
How is this
Birth
Npe
Haiv
Zeej
you?
person related to
person related to
(npe, npe nruab nrab, xeem)
Hnub
Neeg
Xeeb
Puas nrog koj
you?
Respondent?
Yug
nyob?
Tus neeg no
Tus neeg no
txheeb ze li cas
txheeb ze li cas
rau koj?
rau tus neeg raug
foob?
M
Yes
Txiv
Nyob
Neej
No
F
Tsis Nyob
Poj
Niam
M
Yes
Txiv
Nyob
Neej
No
F
Tsis Nyob
Poj
Niam
M
Yes
Txiv
Nyob
Neej
No
F
Tsis Nyob
Poj
Niam
M
Yes
OFP102
State
Hmong
Rev 12/15
www.mncourts.gov/forms
Page 4 of 21
Txiv
Nyob
Neej
No
F
Tsis Nyob
Poj
Niam
M
Yes
Txiv
Nyob
Neej
No
F
Tsis Nyob
Poj
Niam
6. List all minor children you and Respondent have together (biological and adopted), not listed
at #5.
None
Sau tag nrho cov me nyuam uas koj thiab tus neeg raug foob neb muaj ua ke (cov yug los yog cov saws),
Tsis Muaj
cov tsis tau teev ntawm nqe 5.
Name (first, middle, last)
Date of Birth
Who has the child now?
Hnub Yug
Npe
Leej twg tau tus me nyuam tam sim no?
(npe, npe nruab nrab, xeem)
Me
Respondent
Other
Kuv
Neeg Raug Foob
Lwm Tus
Me
Respondent
Other
Kuv
Neeg Raug Foob
Lwm Tus
Me
Respondent
Other
Kuv
Neeg Raug Foob
Lwm Tus
Me
Respondent
Other
Kuv
Neeg Raug Foob
Lwm Tus
Me
Respondent
Other
Kuv
Neeg Raug Foob
Lwm Tus
7. List all minor children living with you, not listed at #5 or #6.
None
Sau tag nrho cov me nyuam me nyob nrog koj, cov tsis tau teev muaj ntawm nqe 5 los yog nqe 6,
Tsis Muaj
Date of Birth
Name (first, middle, last)
How is this child related to
How is this child related to
Hnub Yug
Npe
you?
Respondent?
(npe, npe nruab nrab, xeem)
Tus me nyuam no txheeb ze
Tus me nyuam no txheeb ze li
li cas rau koj?
cas rau tus neeg raug foob?
8. What is your relationship to Respondent? (Check all that apply)
Koj txheeb ze li cas rau Tus Neeg Raug Foob? (Kos txhua yam muaj feem xyuam)
OFP102
State
Hmong
Rev 12/15
www.mncourts.gov/forms
Page 5 of 21
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