FL All Family 150 Restraining Order - 2023 - 07

Superior Court of Washington, County of
In re:
No.
Petitioner/s (person/s who started this case):
Restraining Order
[ ] Temporary (TMRO)
And Respondent/s (other party/parties):
[ ] Final (RSTO)
Clerk’s action required: 6, 7
Surrender Weapons Ordered: [ ] yes [ ] no
Restraining Order
This order replaces all earlier Restraining Orders with the same Restrained Person, issued
under this case number.
Restrained Party’s Identifiers
1. This Order restrains (name):
Sex Race Hair
Restrained Party’s distinguishing features: Height Weight Eyes
Caution: Access to weapons: [ ] yes [ ] no [ ] unknown

2. This Order protects (name/s):
and the following children, who are under 18 (if any)
Child’s name Age Child’s name Age

1. 2.
3. 4.
3. To the Restrained Person listed in 1:
This Order starts immediately, and ends in 12 months or on (date):
Warning! You must obey this order. Violation of this order with actual notice of its
terms is a criminal offense under Chapter 7.105 RCW and will subject the violator to
arrest (RCW 7.105.450). This order is enforceable in all 50 U.S. states, the District of
Columbia, and U.S. territories and tribal lands (18 U.S.C. § 2265).
RCW 26.09.060, .110, .120, .194, .300 Restraining Order

Mandatory Form (07/2023) p. 1 of 4
FL All Family 150
4. Findings
Authority: The court has jurisdiction over the parties, the children listed in 2, and the
subject matter.
Notice: The Restrained Person had reasonable notice and an opportunity to be heard.
They were notified of the hearing by [ ] personal service [ ] service by mail
allowed by the court [ ] service by publication allowed by the court.
The Restrained Person [ ] was [ ] was not present at the hearing.
[ ] The Restrained Person had actual notice of the hearing.
[ ] other (specify):
.
[ ] Credible Threat: The Restrained Person represents a credible threat to the physical
safety of the Protected Person.
[ ] Intimate Partner: The Restrained Person and the Protected Person are/were intimate
partners because they are (check all that apply):
[ ] current or former spouses or domestic partners.
[ ] parents of a child-in-common (unless a child was conceived through sexual
assault).
[ ] current or former dating relationship (age 13 or older) and
[ ] never lived together. [ ] live or have lived together.
[ ] Military: The (check one): [ ] Petitioner [ ] Respondent lives in the state of
Washington, but was not able to go to the hearing because they are an active-duty
member of the National Guard or Reserves (or a dependent of one). A failure to act
despite the absence of the service member will result in a manifest injustice to the
other party.
5. Court Orders to the Restrained Person listed in 1:
Warning! You must obey this order until it ends. If you know about this order but do not
obey, you may be arrested and charged with a crime.
[ ] Do not disturb
Do not disturb the peace of the Protected Person or of any child listed in 2.
[ ] Stay away
Do not go onto the grounds of or enter the Protected Person’s home, workplace,
vehicle, or school, or the daycare or school of any child listed in 2.
[ ] Do not knowingly go or stay within _____ feet of the Protected Person’s home,
vehicle, workplace, school, or the daycare or school of any child listed in 2.
[ ] Do not hurt or threaten
Warning! If the court checks this box, the court must consider if weapons restrictions are required by
state law; federal law may also prohibit the Restrained Person from possessing firearms or
ammunition.

FL All Family 150
Do not:
 Assault, harass, stalk, or molest the Protected Person or any child listed in 2;
or
 Use, try to use, or threaten to use physical force against the Protected Person
or children that would reasonably be expected to cause bodily injury.
[ ] Prohibit weapons and order surrender (separate order required)
The Restrained Person must:
 Immediately surrender to law enforcement all firearms, dangerous weapons,
and concealed pistol licenses in the party’s custody, control, or possession;
 Not access, possess, have in their custody or control, purchase, receive, or
attempt to purchase or receive firearms, other dangerous weapons, or
concealed pistol licenses; and
 Comply with the Order to Surrender and Prohibit Weapons (form WS 001)
filed separately.
Findings – The court (check all that apply):
[ ] must issue the orders referred to above because:
[ ] the court ordered the do not hurt or threaten restraints above and the court
finds that the restrained person had actual notice and an opportunity to
participate. AND:
 the Restrained Person represents a credible threat to the physical
safety of a protected person, OR
 This order explicitly prohibits the use, attempted use, or threatened
use of physical force against any protected person.
Therefore, the weapons restrictions are required by state law. RCW
9.41.800(2).
[ ] the court finds by a preponderance of the evidence that the Restrained
Person:
[ ] has used, displayed, or threatened to use a firearm or other dangerous
weapon in a felony; or
[ ] is ineligible to possess a firearm under RCW 9.41.040.
[ ] may issue the orders referred to above because the court finds by a
preponderance of the evidence that the Restrained Person presents a serious
and imminent threat to public health or safety, or the health or safety of any
individual by possessing a firearm or other dangerous weapon.
[ ] Other restraining orders:
6. Washington Crime Information Center (WACIC) and Other Data Entry

Clerk’s Action. The court clerk shall forward a copy of this order immediately to the
following law enforcement agency (county or city)
(check only one): [ ] Sheriff’s Office or [ ] Police Department (List the same agency
that entered the temporary order, if any)

FL All Family 150
This agency shall enter this order into WACIC and National Crime Info. Center (NCIC).
7. Service
[ ] Required. The Restrained Person must be served with a copy of this order.
Important! The Protected Person has a right to have law enforcement serve this order free of charge if
the “Do not disturb,” “Stay away,” “Do not hurt or threaten,” or “Prohibit weapons and order surrender”
boxes are checked above.
[ ] The law enforcement agency where the Restrained Person lives or can be
served shall serve the Restrained Person with a copy of this order and shall
promptly complete and return proof of service to this court.
Law enforcement agency: (county or city)
(check only one): [ ] Sheriff’s Office or [ ] Police Department
[ ] The Protected Person shall make private arrangements for service.
(This is only an option if surrender of weapons is not ordered)
After serving, the server fills out a Proof of Personal Service (form FL All
Family 101) and gives it to you. File the original Proof of Personal Service
with the court clerk, and give a copy to the law enforcement agency listed in
section 6 above.
Clerk’s Action. The court clerk shall forward a copy of this order on or before the
next judicial day to the agency and/or person checked above. The court clerk shall
also provide a copy to the Protected Person.
[ ] Not required. The Restrained Person does not have to be served because the
Restrained Person or their lawyer signed this order, or was at the hearing when this
order was made and the court finds sufficient notice.
Ordered.
Date Time Judge or Commissioner
Petitioner and Respondent or their lawyers fill out below.

This order (check any that apply): This order (check any that apply):
[ ] is an agreement of the parties [ ] is an agreement of the parties
[ ] is presented by me [ ] is presented by me
[ ] may be signed by the court without notice to me [ ] may be signed by the court without notice to me
Petitioner signs here or lawyer signs here + WSBA # Respondent signs here or lawyer signs here + WSBA #
Print Name Date Print Name Date

Important! Protected Person: you must fill out a Law Enforcement and Confidential Information
form, PO 003, and give it to the court clerk.

FL All Family 150

FL All Family 150 Restraining Order - 2023 - 07

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Superior Court of Washington, County of

Restrained Party’s distinguishing features: Height Weight Eyes

Caution: Access to weapons: [ ] yes [ ] no [ ] unknown

Child’s name Age Child’s name Age

RCW 26.09.060, .110, .120, .194, .300 Restraining Order

RCW 26.09.060, .110, .120, .194, .300 Restraining Order

6. Washington Crime Information Center (WACIC) and Other Data Entry

RCW 26.09.060, .110, .120, .194, .300 Restraining Order

Date Time Judge or Commissioner

Petitioner and Respondent or their lawyers fill out below.

Print Name Date Print Name Date

RCW 26.09.060, .110, .120, .194, .300 Restraining Order

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