Form DC19:19 "Request for Modification to Domestic Abuse Protection Order" - Nebraska

What Is Form DC19:19?

This is a legal form that was released by the United States District Court for the District of Nebraska - a government authority operating within Nebraska. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2017;
  • The latest edition provided by the United States District Court for the District of Nebraska;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DC19:19 by clicking the link below or browse more documents and templates provided by the United States District Court for the District of Nebraska.

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Download Form DC19:19 "Request for Modification to Domestic Abuse Protection Order" - Nebraska

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Nebraska State Court Form
REQUEST FOR
REQUIRED
MODIFICATION TO
DOMESTIC ABUSE
DC 19:19 Rev. 11/17
PROTECTION ORDER
Neb. Rev. Stat. § 42-924
IN THE DISTRICT COURT OF
COUNTY, NEBRASKA
Petitioner,
Case No.
Additional Petitioner/Minor Child(ren),
REQUEST FOR MODIFICATION TO
Additional Petitioner/Minor Child(ren),
DOMESTIC ABUSE PROTECTION ORDER
.
vs
Respondent.
I, __________________________________________ , am the petitioner in this case. I am requesting a modification
to the existing domestic abuse protection order issued on _____________________________ pursuant to Neb. Rev.
Stat. § 42-924.
This request will apply to the following protected party(ies):
1.__________________________age:______
4.__________________________age:______
2.__________________________age:______
5.__________________________age:______
3.__________________________age:______
6.__________________________age:______
1. The modification(s) requested is/are detailed below:
2.
Reason(s) for modification are stated below:
Page 1 of 2
Request for Modification to Domestic Abuse Protection Order
DC 19:19 Rev 11/17
Nebraska State Court Form
REQUEST FOR
REQUIRED
MODIFICATION TO
DOMESTIC ABUSE
DC 19:19 Rev. 11/17
PROTECTION ORDER
Neb. Rev. Stat. § 42-924
IN THE DISTRICT COURT OF
COUNTY, NEBRASKA
Petitioner,
Case No.
Additional Petitioner/Minor Child(ren),
REQUEST FOR MODIFICATION TO
Additional Petitioner/Minor Child(ren),
DOMESTIC ABUSE PROTECTION ORDER
.
vs
Respondent.
I, __________________________________________ , am the petitioner in this case. I am requesting a modification
to the existing domestic abuse protection order issued on _____________________________ pursuant to Neb. Rev.
Stat. § 42-924.
This request will apply to the following protected party(ies):
1.__________________________age:______
4.__________________________age:______
2.__________________________age:______
5.__________________________age:______
3.__________________________age:______
6.__________________________age:______
1. The modification(s) requested is/are detailed below:
2.
Reason(s) for modification are stated below:
Page 1 of 2
Request for Modification to Domestic Abuse Protection Order
DC 19:19 Rev 11/17
NOTE: DO NOT SIGN UNTIL THE CLERK OF THE DISTRICT COURT OR A NOTARY IS PRESENT AND
WITNESSES YOU SIGNING
I hereby swear, or affirm, under penalty of perjury, the forgoing is true.
*If you are concealing your address or phone, do not provide them. Make separate arrangements with the clerk.
Date
Signature of Petitioner
Name
* Street Address/P.O. Box
Bar Number and Firm Name (attorneys only)
City/State/ZIP Code
Phone
E-mail Address
Subscribed and sworn before me on
, 20
Clerk of the Court/Notary Public
(Seal)
My Commission Expires: ____________________
Page 2 of 2
Request for Modification to Domestic Abuse Protection Order
DC 19:19 Rev 11/17
Page of 2