CONFIDENTIAL
Law Enforcement Service Information Sheet for PROTECTION ORDERS

This information will not be shared with the Respondent. 

Law Enforcement needs information about the other person in order to serve the Protection Order. Service will depend on the amount and accuracy of information you can provide about the other person. Without service the protection order cannot be enforced. YOU MUST FILL IN EACH SECTION MARKED WITH AN “*”.  If you do not, law enforcement may not be able to serve the other person and the form will be returned to the court clerk.

Information About You (Petitioner):
Last Name*:	First*:	Middle Initial*:	
Date of Birth*:	Race*:	Male* [   ]  Female* [   ] 	Social Security No.	
Present Address*:	City*:	State*:	Zip*:	
Contact No.:	Another Phone No. Where Messages Can Be Left:	
Where Do You Work:	Work Phone No.	
Explain your relationship with the other person:

Information About the Other Person (Respondent): 
Last Name*:		First*:	Middle Initial*:	
Date of Birth:	Race*:	Male* [   ]  Female* [   ] 	Social Security No.	
Present Address:	City*:	State*:	Zip*:	
Contact No.:	Another Phone No. Where Messages Can Be Left:	
Employer/Company Name:	Work No.	Work Days/Hours:	
Business Address: 	City:	State:	Zip:	
Name of Relative or Friend: 	Their Phone No.	
Make & Model of Car:	License Plate No & State:	Color & Year:	

What Does This Person Look Like:
Height:	Weight:	Hair Color:	Eye Color:	
Describe any scars, tattoos or distinguishing characteristics:	

Additional Important Information:
Has This Person Been Convicted of a Crime? YES[  ] NO[  ] 
                                                               Unknown [  ]	If YES, for What?	
Do You Consider This Person Dangerous? YES [  ] NO [  ]	Does This Person Have Any Weapons? YES[  ] NO[  ] Unknown [  ]
What type?	
Places/Addresses Where This Person Can Be Found (i.e. friends, relatives, frequent places):

Directions must be drawn if a street number is not available.  A route or box number is not enough.  Without sufficient address information, service of the order may be delayed or may not be possible. If Respondent cannot be served within 10 days, law enforcement shall notify the petitioner. The Petitioner may provide additional information for service (I.C. § 39-6310(4))