TEMPORARY PROTECTION 
FROM ABUSE ORDER 
  Amended Order    Continued Order 

IN THE COURT OF COMMON PLEAS OF 
____________________ COUNTY, PENNSYLVANIA 
NO. 

PLAINTIFF 

DEFENDANT 

First 

Middle 

Last 

Plaintiff’s DOB 

Name(s) of all protected persons, including minor child/ren and DOB:  ___________________________________________________ 
___________________________________________________ 
    ___________________________________________________ 

 

V. 

First 

Middle 

Last 

Suffix 

Defendant’s Address: 
________________________________________________ 

________________________________________________ 

DEFENDANT IDENTIFIERS 
HEIGHT 
WEIGHT 
EYES 

DOB 
SEX 
RACE 
HAIR 
SSN 
DRIVERS 
LICENSE # 
EXP DATE 

STATE 

CAUTION: 

  Weapon Involved 
  Weapon Present on the Property 
  Weapon Ordered Relinquished 

The Court Hereby Finds:   
That it has jurisdiction over the parties and subject matter, and Defendant will be provided with reasonable notice and opportunity to 
be heard. 

The Court Hereby Orders: 
   Defendant shall not abuse, harass, stalk, threaten, or attempt or threaten to use physical force against any of the above persons 
in any place where they might be found. 

   Except for such contact with the minor child/ren as may be permitted under Paragraph 5 of this order, Defendant shall not 

   contact Plaintiff, or any other person protected under this order, by telephone or by any other means, including through third 
   persons. 

   Additional findings of this order are set forth below. 

Order Effective Date________________________________     

Order Expiration Date________________________  

___________________________________________________________________________________________________________ 

NOTICE TO DEFENDANT 

Defendant is hereby notified that failure to obey this order may result in arrest as set forth in 23 Pa.C.S. § 6113 and that violation of the order may result in a charge of 
indirect criminal contempt, as set forth in 23 Pa.C.S. §6114.  Consent of Plaintiff to Defendant’s return to the residence shall not invalidate this order, which can only be 
changed or modified through the filing of appropriate court papers for that purpose.  23 Pa.C.S. §6108(g).  If Defendant is required to relinquish any firearms, other 
weapons, ammunition, or any firearm license, those items must be relinquished to the sheriff or the appropriate law enforcement agency within 24 hours of the service 
of this order.  As an alternative, Defendant may relinquish any firearm, other weapon, or ammunition listed herein to a third party provided Defendant and the third 
party first comply with all requirements to obtain a safekeeping permit.  If, due to their current location, firearms, other weapons, or ammunition cannot reasonably be 
retrieved within the time for relinquishment, Defendant shall provide an affidavit to the sheriff or the appropriate law enforcement agency listing the firearms, other 
weapons, or ammunition and their current location no later than 24 hours after the service of this order.  Defendant is further notified that violation of this order may 
subject him/her to state charges and penalties under the Pennsylvania Crimes Code under 18 Pa.C.S. § 6105 and to federal criminal charges and penalties under 18 
U.S.C. § 922(g)(8) and the Violence Against Women Act, 18 U.S.C. §§2261-2262. 

ENGLISH/HAITIAN PFA Temp. Order 
Pa R.C.P. 1905(c) Rev. 3-19 

Page 1 of 6 / Paj 1 sou 6 

AOPC Rev. 4-2019 

LÒD PWOTEKSYON 
TANPORÈ KONT MOVE TRETMAN 
  Lòd la Modifye    Lòd la Kontinye 

DEVAN TRIBINAL PREMYE ENSTANS NAN 
KONTE ____________________, PENNSILVANI 
NIMEWO 

PLEYAN 

AKIZE 

Prenon 

Prenon 

Dezyèm prenon 

Siyati 

Dat Nesans Pleyan an 

Non tout moun ki pwoteje, ansanm ak timoun minè yo ak Dat Nesans:  ___________________________________________________ 
___________________________________________________ 
___________________________________________________ 

kont 

 

Dezyèm prenon 

Siyati 

Adrès Akize a: 
__________________________________________________ 

__________________________________________________ 

IDANTITE AKIZE A 

DAT NESANS 
SÈKS 
RAS 
CHEVE 
NIMEWO 
SEKIRITE SOSYAL 
# LISANS 
CHOFÈ 
DAT 
EKSPIRASYON 

Sifiks 

WOTÈ 
PWA 
ZYE 

ETA 

PREKOSYON: 

  Gen zam nan ensidan an 
  Gen zam nan kay la 
  Akize a remèt zam yo mande a 

Ak dokiman sa a Tribinal la konkli:   
Li gen konpetans pou pati yo ak sijè a, epi y ap bay Akize a avi atan ak opòtinite pou yo tande li. 

Nan dokiman sa a Tribinal la Òdone: 
   Akize pa dwe maltrete ni pèsekite, suiv toupatou oswa menase okenn nan moun ki anwo yo kèlkanswa kote yo ta ye. 

   Eksepte pou kontak ak timoun minè yo jan sa kapab otorize dapre Paragraf 5 nan lòd sa a, Akize a pa dwe kontakte Pleyan an, 

ni okenn lòt moun ki pwoteje anba lòd sa a, nan telefòn oswa pa nenpòt lòt mwayen, menm pa lentèmedyè lòt moun. 

   W ap jwenn lòt desizyon tribinal la pran nan lòd sa a nan paj anba a. 

Dat Lòd la anvigè________________________________   

Dat ekspirasyon Lòd la _____________________________          

___________________________________________________________________________________________________________ 

AVI POU AKIZE A 

Nan dokiman sa a, tribinal la fè Akize a konnen ke si li  dezobeyi lòd tribinal la, yo  gendwa arete li dapre 23 Pa.C.S. §6114  epi vyolasyon lòd tribinal la gendwa 
lakòz yon akizasyon zak  kriminèl endirèk dapre 23 Pa.C.S. §6114. Oubyen, menm si Demandè a ta dakò pou Akize a tounen nan kay la, sa pa pral anile lòd sa a.  
Sèl  jan  pou  lòd la chanje oswa modifye, se si Demandè a depoze dokiman ki apwopriye yo nan tribinal la dapre 23 Pa.C.S. §6108(g).  Si tribinal la egzije Akize a 
pou li remèt zam pou tire, lòt kalite zam oswa minisyon, oswa nenpòt lisans zam pou tire, Akize a dwe remèt cherif la oswa ajans legal apwopriye a atik sa yo anvan 24 
èdtan ki vini apre lè Akize a te resevwa lòd sa a.  Kòm yon lòt posiblite, Akize a  gendwa remèt nenpòt zam pou tire, lòt kalite zam oswa minisyon ki ekri nan dokiman 
sa a bay yon tyès pèsòn depi Akize a ak tyès pèsòn nan respekte tout egzijans ki genyen pou jwenn yon pèmi pou yon kote ki an sekirite dabò.  Si Akize a pa kapab 
jwenn zam pou tire yo, lòt kalite zam oswa minisyon nan kantite tan yo ba li pou li remèt zam yo poutèt kote zam yo ye a, Akize a dwe bay cherif la oswa ajans legal 
apwopriye a yon deklarasyon sou sèman ansanm ak yon lis ki gen non tout zam pou tire, lòt kalite zam oswa minisyon yo ladan ansanm ak kote yo ye nan moman 
an  anvan  24  èdtan  ki vini apre lè Akize a te resevwa lòd sa a.  Tribinal la fè Akize konnen tou si li vyole lòd sa a, yo kapab pote akizasyon ak sanksyon kont li 
dapre Kòd Penal 18 Pa.C.S. § 6105   Pennsilvani  an  epi  akizasyon  ak  sanksyon  federal  dapre  18  U.S.C.  §  922(g)(8)  epi  Lwa  18  U.S.C.  §§2261-2262  sou  Vyolans 
kont  Fanm,  (Violence  Against  Women Act, 18 U.S.C. §§2261-2262).  

ENGLISH/HAITIAN PFA Temp. Order 
Pa R.C.P. 1905(c) Rev. 3-19 

Page 2 of 6 / Paj 2 sou 6 

AOPC Rev. 4-2019 

AND NOW, this ____________ day of ______________, 20___, 
upon consideration of the attached Petition for Protection from 
Abuse, the court hereby enters the following Temporary Order: 

EPI KOUNYE A, nan ___________ jou sa nan ______________, 
20___, apre egzamen Demann pou Pwoteksyon kont Move 
Tretman ki vini ansanm  ak dokiman sa a, Tribinal la pran Lòd 
Tanporè sa: 

  Plaintiff’s request for a Temporary Protection Order is 

  Demann Pleyan an pou yon Lòd Pwoteksyon Tanporè 

denied. 

granted. 

refize. 

akòde. 

  Plaintiff’s request for a Temporary Protection Order is 

  Demann Pleyan an pou yon Lòd Pwoteksyon Tanporè 

  1.  Defendant shall not abuse, harass, stalk, threaten, or 
attempt or threaten to use physical force against any of  
the above persons in any place where they might be found. 

  1.  Akize pa dwe maltrete, pèsekite, suiv toupatou , menase ni 
eseye oswa menase pou itilize fòs fizik kont okenn nan moun 
anwo yo kèlkanswa kote yo ta ye. 

  2.  Defendant is evicted and excluded from the residence at: 

  2.  Akize a dwe degèpi epi li pa dwe rete nan kay ki nan: 

___________________________________________________ 

_____________________________________________________ 

or any other permanent or temporary residence where 
Plaintiff or any other person protected under this order may 
live.  Plaintiff is granted exclusive possession of the 
residence.  Defendant shall have no right or privilege to enter 
or be present on the premises of Plaintiff or any other person 
protected under this order. 

oswa nan nenpòt lòt kay tanporè oswa pèmanan kote Pleyan 
an oubyen nenpòt lòt moun ki pwoteje anba Lòd sa a kapab 
abite.  Yo akòde Pleyan an dwa pou se limenm sèlman ki rete 
nan kay la.  Akize pa gen dwa ni privilèj pou antre ni pou li 
prezan sou pwopriyete Pleyan an oswa nenpòt lòt moun ki 
pwoteje anba Lòd sa a. 

  3.  Except for such contact with the minor child/ren as may be 
permitted under Paragraph 5 of this order, Defendant is 
prohibited from having ANY CONTACT with Plaintiff, or 
any other person protected under this order, either directly or 
indirectly, at any location, including but not limited to any 
contact at Plaintiff’s school, business, or place of 
employment.  Defendant is specifically ordered to stay away 
from the following locations for the duration of this order: 

  3.  Eksepte pou kontak ak timoun minè yo menm jan Tribinal 
la otorize nan paragraf 5 nan lòd  sa a, yo entèdi Akize a gen 
KÈLKANSWA KONTAK avèk Pleyan an, ni nenpòt lòt 
moun ki pwoteje anba lòd sa a, swa dirèkteman oubyen 
endirèkteman, nan nenpòt kote, tankou (men se pa sa yo 
sèlman) kontak nan lekòl Pleyan an, biznis li oswa kote l ap 
travay.  Akize a resevwa lòd espesyalman pou rete lwen kote 
sa yo pandan tout tan lòd sa a anvigè: 

       ________________________________________________ 
       ________________________________________________ 

       ________________________________________________ 
       ________________________________________________ 

  4.  Except for such contact with the minor child/ren as may be 
permitted under Paragraph 5 of this order, Defendant shall 
not contact Plaintiff, or any other person protected under this 
order, by telephone or by any other means, including through 
third persons. 

  4.  Eksepte pou kontak ak timoun minè yo menm jan Tribinal 
la otorize nan paragraf 5 nan lòd sa a, Akize a pa dwe 
kontakte Pleyan an, ni nenpòt lòt moun ki pwoteje anba lòd sa 
a, nan telefòn oswa pa nenpòt lòt mwayen, menm pa 
lentèmedyè lòt moun. 

  5.  CUSTODY 

  5.  SIPÈVIZYON TIMOUN 

  There is a current custody order as to the child/ren of the 

parties: __________________________________________ 
      _________________________________________________ 
       _________________________________________________ 

  Gen yon lòd kounye a pou sipèvizyon konsènan timoun toude 
pati yo: ___________________________________________ 
 _________________________________________________ 
        _________________________________________________ 

(county court and docket number)

   (Tribinal Konte ak nimewo rejis odyans) 

  THIS ORDER SHALL NOT SUPERSEDE THE CURRENT 

  LÒD SA A PA RANPLASE LÒD SIPÈVIZYON TIMOUN KI 

CUSTODY ORDER. 

GENYEN KOUNYE A. 

  THIS ORDER SUPERSEDES ANY PRIOR ORDER 

  LÒD SA A RANPLASE NENPÒT LÒD ANVAN 

RELATING TO CHILD CUSTODY. 

KONSÈNAN SIPÈVIZYON TIMOUN. 

ENGLISH/HAITIAN PFA Temp. Order 
Pa R.C.P. 1905(c) Rev. 3-19 

Page 3 of 6 / Paj 3 sou 6 

AOPC Rev. 4-2019 

  Until the final hearing, all contact between Defendant and the 
child/ren shall be limited to the following: ______________ 
       _________________________________________________ 
      _________________________________________________ 
       _________________________________________________ 
       _________________________________________________ 

  Jiskaske odyans final la fèt, tout kontak ant Akize a ak timoun 
nan(yo) ap limite nan sèlman sa ki annapre la a: __________ 
       _________________________________________________ 
       _________________________________________________ 
       _________________________________________________ 
       _________________________________________________ 

  Pending the outcome of the final hearing in this matter, 
Plaintiff is awarded temporary custody of the following 
minor child/ren: 
______________________________________________ 
       ______________________________________________ 

  Annatandan rezilta jijman final nan zafè sa a, yo akòde Pleyan 
an sipèvizyon tanporè timoun minè ki gen non yo anba la a: 

______________________________________________ 
       ______________________________________________ 

  ______________________________________________ 

       ______________________________________________ 

The local law enforcement agency in the jurisdiction where the 
child/ren are located shall ensure that the child/ren are placed in 
the care and control of the Plaintiff in accordance with the terms 
of this order. 

Biwo lokal aplikasyon lalwa nan jiridiksyon kote timoun nan/yo 
ye a dwe asire yo bay Pleyan an sipèvizyon ak kontwòl timoun 
nan/yo annakò avèk kondisyon lòd sa a. 

  6.  FIREARMS, OTHER WEAPONS, OR 
AMMUNITION RESTRICTIONS 

Check all that apply: 

MINISYON 

Tcheke tout sa ki aplike: 

  6.  RESTRIKSYON SOU ZAMAFE, LÒT ZAM, OSWA 

  Defendant is prohibited from possessing or 
       acquiring any firearms for the duration of this order. 

  Yo entèdi Akize a gen kontwòl oswa posede kèlkanswa zam 

pou tire pandan dire lòd sa a. 

  Defendant shall relinquish to the sheriff or the appropriate 
law enforcement agency the following firearm licenses 
owned or possessed by Defendant. ___________________ 

  Akize a dwe remèt ba cherif la oswa ajans legal apwopriye a 
lisans pou zam pou tire ki annapre  a ke Akize a posede 
oswa gen kontwòl sou yo. ___________________________

  Defendant is directed to relinquish to the sheriff or the 
appropriate law enforcement agency any firearm, other 
weapon, or ammunition listed in Attachment A to Temporary 
Order, which is incorporated herein by reference, under 
Defendant’s control or in Defendant’s possession 

  Yo egzije Akize a remèt ba cherif la oswa ajans legal 

apwopriye a kèlkanswa zam pou tire, lòt zam, oswa minisyon 
ki site nan Dokiman siplemantè A Lòd Tanporè a, ki nan 
anèks la a pou referans, anba kontwòl Akize a oswa nan zafè 
Akize a.  

Defendant may relinquish any firearms, other weapons, or 
ammunition to the sheriff or the appropriate law enforcement 
agency.  As an alternative, Defendant may relinquish firearms, 
other weapons, or ammunition to a third party provided 
Defendant and the third party first comply with all the 
requirements to obtain a safekeeping permit.  Defendant must 
relinquish any firearm, other weapon, ammunition, or firearm 
license ordered to be relinquished no later than 24 hours after 
service of this order.  If, due to their current location, firearms, 
other weapons, or ammunition cannot reasonably be retrieved 
within the time for relinquishment, Defendant shall provide to the 
sheriff or the appropriate law enforcement agency an affidavit 
listing the firearms, other weapons, or ammunition and their 
current location no later than 24 hours after the service of this 
order.  Failure to timely relinquish any firearm, other weapon, 
ammunition, or any firearm license shall result in a violation of 
this order and may result in criminal conviction under the 
Uniform Firearms Act, 18 Pa.C.S. §6105. 

Akize a kapab remèt nenpòt zam pou tire, lòt zam oswa minisyon 
li genyen ba cherif la oswa ajans legal apwopriye a.  Oubyen, 
Akize a kapab remèt zam pou tire yo, lòt zam, oswa minisyon yo 
ba yon lòt moun akondisyon Akize a ak lòt moun lan te respekte 
toudabò tout kondisyon pou jwenn yon pèmi pou kenbe yo.  Akize 
a dwe remèt kèlkanswa zam pou tire, lòt zam ak minisyon oswa 
lisans pou zam pou tire yo egzije pou li remèt yo pa pita pase 24 
èdtan apre li te resevwa Lòd sa a.  Si Akize a pa kapab jwenn zam 
pou tire yo, lòt kalite zam oswa minisyon nan kantite tan yo ba li 
pou li remèt zam yo poutèt kote zam yo ye a, Akize a dwe bay 
cherif la oswa ajans legal apwopriye a yon deklarasyon sou sèman 
ansanm ak yon lis ki gen non tout zam pou tire, lòt kalite zam 
oswa minisyon yo ladan ansanm ak kote yo ye nan moman an 
anvan 24 èdtan pase sou lè Akize a te resevwa lòd sa a.  Si li pa 
remèt alè kèlkanswa zam pou tire, lòt zam, minisyon, oswa nenpòt 
lisans pou zam pou tire, sa ap yon vyolasyon Lòd sa a epi li kapab 
lakòz yon kondanasyon kriminèl dapre Lwa sou Zamafe (Uniform 
Firearms Act, 18 Pa.C.S. §6105). 

ENGLISH/HAITIAN PFA Temp. Order 
Pa R.C.P. 1905(c) Rev. 3-19 

Page 4 of 6 / Paj 4 sou 6 

AOPC Rev. 4-2019 

 

  7.  The following additional relief is granted: 
    Defendant is prohibited from stalking, as defined in  
       18 Pa.C.S. §2709.1, or harassing, as defined in  
       18 Pa.C.S. §2709, the following family and household 

members of Plaintiff. 

  7.  Yo akòde lòt reparasyon sa a tou: 

 

  Yo entèdi Akize a suiv toupatou, jan sa defini nan 

18 Pa.C.S. §2709.1, oswa pèsekite, jan sa defini nan 
18 Pa.C.S. §2709, manm fanmi ak moun nan kay Pleyan 
an ki annapre la yo. 

Name / Non 

Address (optional) / Adrès (si w vle) 

Relationship to Plaintiff / 
Kisa yo ye pou Pleyan an 

 
 
 

 
 
 

  Other relief: ___________________________________ 
               _____________________________________________ 
               _____________________________________________ 
               _____________________________________________ 
              ______________________________________________ 
 
  8.  The Pennsylvania State Police, the municipal police, or 

the sheriff shall accompany Plaintiff to his or her residence to 
retrieve personal belongings or accompany Plaintiff while the 
petition or order is served on Defendant. 

    Lòt reparasyon : ________________________________ 
               _____________________________________________ 
               _____________________________________________ 
               _____________________________________________ 
               _____________________________________________ 
 
  8.  Polis Eta Pennsilvani, polis minisipal oswa cherif la dwe 
ale ak Plentif lan nan kay li pou pran zafè pèsonèl li yo oswa 
yo dwe ale ak Plentif pandan yap bay Akize a petisyon oswa 
lòd la. 

 

  9.  A certified copy of this order shall be provided to the 

  9.  Yo dwe remèt yon kopi sètifye lòd sa a ba cherif oubyen 

sheriff or police department where Plaintiff resides and any 
other agency specified hereafter: (insert name of agency) 
_________________________________________________ 
_________________________________________________ 

 
 
 
  10.  THIS ORDER SUPERSEDES ANY PRIOR 

depatman lapolis la kote Pleyan an abite ak ba nenpòt lòt biwo 
ki presize annapre la a: (mete non ajans lan) 
_________________________________________________ 
_________________________________________________ 

 
 
 
  10.  LÒD SA A RANPLASE NENPÒT PWOTEKSYON 

PROTECTION FROM ABUSE ORDER OBTAINED BY 
THE SAME PLAINTIFF AGAINST THE SAME 
DEFENDANT. 

MENM PLEYAN AN TE GENYEN KONT MENM AKIZE 
A ANVAN LÒD SA A. 

 
  11.  THIS ORDER APPLIES IMMEDIATELY TO 

 
  11.  LÒD SA A APLIKE IMEDYATMAN POU AKIZE A 

DEFENDANT AND SHALL REMAIN IN EFFECT UNTIL 
___________________________ OR UNTIL OTHERWISE 
MODIFIED OR TERMINATED BY THIS COURT AFTER 
NOTICE AND HEARING. 

EPI LI DWE RETE ANVIGÈ JISKA ___________________ 
OSWA JISKASKE TRIBINAL SA A CHANJE OUBYEN 
ANILE LI APRE AVI AK ODYANS. 

   

NOTICE TO DEFENDANT 

efendant is hereby notified that failure to obey this order may result in arrest as set forth in 23 Pa.C.S. § 6113 and that violation of 
the order may result in a charge of indirect criminal contempt as set forth in 23 Pa.C.S. §6114.  Consent of Plaintiff to Defendant’s 
return to the residence shall not invalidate this order, which can only be changed or modified through the filing of appropriate court 
papers for that purpose.  23 Pa.C.S. §6108(g). 
If  Defendant  is  required  to  relinquish  any  firearms,  other  weapons,  ammunition,  or  any  firearm  license,  those  items  must  be 
relinquished to the sheriff or the appropriate law enforcement agency within 24 hours of the service of this order.  As an alternative, 
Defendant may relinquish any firearm, other weapon, or ammunition listed herein to a third party provided Defendant and the third 
party first comply with all requirements to obtain a safekeeping permit.  If, due to their current location, firearms, other weapons, or 
ammunition cannot reasonably be retrieved within the time for relinquishment, Defendant shall provide an affidavit to the sheriff or 
the appropriate law enforcement agency listing the firearms, other weapons, or ammunition and their current location no later than 24 
hours after service of this order.  Defendant is further  notified that violation of this order may subject him/her to state charges and 
penalties under the Pennsylvania Crimes Code under 18 Pa.C.S. § 6105 and to federal criminal charges and penalties under 18 U.S.C. 
§ 922(g)(8) and the Violence Against Women Act, 18 U.S.C. §§2261-2262. 

 

 
 
 

   

 

  D

     

ENGLISH/HAITIAN PFA Temp. Order 
Pa R.C.P. 1905(c) Rev. 3-19 

Page 5 of 6 / Paj 5 sou 6 

AOPC Rev. 4-2019 

AVI POU AKIZE A 

an  dokiman  sa  a,  tribinal  la  fè  Akize  a  konnen  ke,  si  li  dezobeyi  lòd  tribinal  la,  yo  gendwa  arete  li  dapre  23  Pa.C.S.  §6114  epi 
vyolasyon lòd tribinal la gendwa lakòz yon akizasyon zak kriminèl endirèk dapre 23 Pa.C.S. §6114. .  Oubyen, menm si Demandè a ta 
dakò pou Akize a tounen nan kay la, sa pa pral anile lòd sa a.  Sèl jan pou lòd la chanje oswa modifye se si Demandè depoze dokiman 
apwopriye yo itilize nan tribinal pou rezon sa a dapre 23 Pa.C.S. §6108(g).  

i tribinal la egzije Akize a pou li remèt zam pou tire, lòt kalite zam oswa minisyon, oswa nenpòt lisans zam pou tire, Akize a dwe 
remèt cherif la oswa ajans legal apwopriye a atik sa yo anvan 24 èdtan pase sou lè Akize a te resevwa lòd sa a.  Akize a kapab remèt 
nenpòt zam pou tire, lòt kalite zam, oswa minisyon ki ekri nan dokiman sa a bay yon tyès pèsòn depi Akize a ak tyès pèsòn lan respekte 
tout egzijans ki genyen pou jwenn yon pèmi pou yon kote ki ansekirite dabò.  Si Akize a pa kapab jwenn zam pou tire yo, lòt kalite zam 
oswa  minisyon  nan  kantite  tan  yo  ba  li  pou  li  remèt  zam  yo  poutèt  kote  zam  yo  ye  a,  Akize  a  dwe  bay  cherif  la  oswa  ajans  legal 
apwopriye  a  yon  deklarasyon  sou  sèman  ansanm  ak  yon  lis  ki  gen  non  tout  zam  pou  tire,  lòt  kalite  zam  oswa  minisyon  yo  ladan 
ansanm ak kote yo ye nan moman an anvan 24 èdtan pase sou lè Akize a te resevwa lòd sa a.  Tribinal la fè Akize konnen tou si li 
vyole lòd sa a, yo kapab pote akizasyon ak sanksyon kont li dapre Kòd Penal 18 Pa.C.S. § 6105  Pennsilvani an epi akizasyon ak 
sanksyon federal dapre 18 U.S.C. § 922(g)(8) epi Lwa 18 U.S.C. §§2261-2262 Vyolans kont Fanm, (Violence Against Women Act, 18 
U.S.C. §§2261-2262). 

 
NOTICE TO SHERIFF, POLICE AND LAW ENFORCEMENT OFFICIALS 

his order shall be enforced by the police department or sheriff who has jurisdiction over Plaintiff’s residence OR any location where 
a  violation  of  this  order  occurs  OR  where  Defendant  may  be  located.    If  Defendant  violates  Paragraphs  1  through  6  of  this  order, 
Defendant shall be arrested on the charge of indirect criminal contempt.  An arrest for violation of this order may be made without 
warrant, based solely on probable cause, whether or not the violation is committed in the presence of a police officer or sheriff. 

ubsequent to an arrest, the law enforcement officer or sheriff shall seize all firearms, other weapons, or ammunition in Defendant’s 
possession which were used or threatened to be used during the violation of the protection order or during prior incidents of abuse and 
any other firearms in Defendant’s possession.  Any firearm, other weapon, ammunition, or any firearm license must be delivered to 
the  sheriff  or  the  appropriate  law  enforcement  agency,  which  sheriff  or  agency  shall  maintain  possession  of  the  firearms,  other 
weapons,  or  ammunition  until  further  order  of  this  court,  unless  the  weapon(s)  are  evidence  of  a  crime,  in  which  case,  they  shall 
remain with the law enforcement agency whose officer or sheriff made the arrest. 
 

AVI POU CHERIF, LAPOLIS AK OTORITE RESKONSAB APLIKASYON LALWA 

e depatman lapolis oswa cherif ki gen otorite sou kote demandè a rete a OSWA nenpòt kote yo vyole lòd sa a OSWA kote yo kapab 
jwenn  akize  a  ki  dwe  fè  respekte  lòd  sa  a.    Si  akize  a  vyole  kondisyon  Paragraf  1  jiska  6  nan  Lòd  sa  a,  yo dwe  arete  Akize  a  epi 
pouswiv li pou Dezobeyisans Kriminèl Endirèk.  Yo kapab poze yon arestasyon pou vyolasyon Lòd sa a san yon manda arestasyon, 
pou kòz pwobab sèlman, kit se nan prezans yon ajan lapolis oswa yon cherif vyolasyon an te fèt, kit se pa nan prezans yo. 

pre yon arestasyon, ajan ki fè respekte lalwa a oswa cherif la dwe sezi tout zam pou tire, lòt kalite zam ak minisyon Akize a posede si 
li  te  itilize  yo  oswa  si  li  te  menase  pou  itilize  yo  lè  li  t  ap  vyole  lòd  pwoteksyon  an  oswa  pandan  ensidan  move  tretman  ki  te  pase 
anvan, epi tout lòt zam pou tire Akize a posede.  Yo dwe pote nenpòt zam pou tire, lòt kalite zam, minisyon oswa lisans zam pou tire 
bay cherif la oswa ajans legal apwopriye a .   Cherif oswa ajans lan dwe kenbe zam pou tire yo, lòt kalite zam yo ak minisyon yo 
jiskaske yo resevwa nouvo lòd tribinal la sof si zam yo se prèv yon krim.  Nan ka sa a, zam yo dwe rete nan biwo ki fè respekte lalwa 
kote ajan lapolis oswa cherif ki te poze arestasyon an ye a. 

 

 
 

 
 

 

 
 

 
 

 

 
 

 
 

 

 
 

 
 

 

 
 

 
 

 

 
 

 
 

 

 
 

 
 

 

 
 

 
 

 

 
 

 
 

 

 
 

 
 

 

 
 

 
 

 

 
 

 
 

 

 
 

 
 

 

 
 

 
 

BY THE COURT / SIYATI TRIBINAL LA: 

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Judge / Jij 

 

 

 

 

 

 

 

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Date / Dat 

 

 

 

 

 

 

 

  N

  S

  T

  S

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  A

   

     

 

   

 

ENGLISH/HAITIAN PFA Temp. Order 
Pa R.C.P. 1905(c) Rev. 3-19 

Page 6 of 6 / Paj 6 sou 6 

AOPC Rev. 4-2019