Stalking/Domestic Violence/Sexual Assault OP Intake Form

The following information will help prepare your application for a STALKING or DOMESTIC VIOLENCE OR SEXUAL ASSAULT order of protection:

Note : Before completing the Intake form, you must call our agency to speak to a Domestic Violence Advocate to discuss your case. The phone number to call is (901)-222-3950. If you meet the criteria to file an Order of Protection, you will be required to attend an in-person meeting to get sworn in to complete the process.

 

INFORMATION ABOUT THE PERSON YOU ARE FILING AGAINST

NOTE: the complete work or home address of the person you are filing against is needed, so that law enforcement can physically serve them with the necessary paperwork (notice for the Order of Protection Hearing).

DESCRIPTION OF PERSON YOU ARE FILING AGAINST

VEHICLE DESCRIPTION

INFORMATION ABOUT YOU (THE COMPLAINANT) AND WHAT HAPPENED (THE COMPLAINT)

DETAILS ABOUT WHAT HAPPENED

(If YOU DO NOT KNOW EXACT DATE, THE MONTH AND YEAR IS FINE)