RI Gen L § 11-37.2-7 (2021)
2021 Rhode Island General Laws|Title 11 - Criminal Offenses|Chapter 11-37.2 - Sexual Assault Protective Orders|Section 11-37.2-7 - Form of complaint.

§ 11-37.2-7. Form of complaint.(a) A form in substantially the following language shall suffice for the purpose of filing a complaint under this chapter:STATE OF RHODE ISLAND DISTRICT COURT COUNTY OF __________ DIVISION  _____________________________________________________________________  Plaintiff: VS: NO:  _____________________________________________________________________ : Defendant: COMPLAINT FOR PROTECTION FROM ABUSE  Pursuant to chapter 8.1 of title 8, I request that the court enter an order protecting me from abuse.  (a)(1) My full name, present street address, city and telephone number are as follows:   _________   (b)(2) The full name, present street address, city and telephone number of the person causing me abuse (the defendant) are as follows:    _________   (c)(3) On or about __________, without cause or provocation, I suffered abuse when the defendant: [ ] Threatened or harmed with a weapon: __________ (type of weapon used) [ ] Attempted to cause me physical harm; [ ] Caused me physical harm; [ ] Placed me in fear of imminent physical harm; [ ] Caused me to engage involuntarily in sexual relations by force, threat of force or duress;  [ ] Attempted to cause me to engage involuntarily in sexual relations by force, threat of force or duress;  Specifically, the defendant: _________    _________   (d) I ask that: [ ] The court order that the defendant be restrained and enjoined from contacting, assaulting, molesting or otherwise interfering with the plaintiff at home, on the street or elsewhere.  [ ] I request that the above relief be ordered without notice because it clearly appears from specific facts shown by affidavit or by the verified complaint that I will suffer immediate and irreparable injury, loss or damage before notice can be served and a hearing had thereon. I understand that the court will schedule a hearing no later than twenty-one (21) days after such order is entered on the question of continuing such temporary order.  (e) I have not sought protection from abuse from any other judge of the district court arising out of the same facts or circumstances alleged in this complaint.    _________  (Signature) (Date) Subscribed and sworn to before me in __________ in the County of ______ in the State of Rhode Island, this ______ day of _______ A.D. _________  Notary Public  Note: If this complaint is filed by an attorney, the attorney's certificate should appear below:  ATTORNEY CERTIFICATE  Signed: _________  Attorney for Plaintiff  Address: _________    _________   Date: _____________________________________________________________________   WHITE COPY [ ] Court  YELLOW COPY [ ] Plaintiff  PINK COPY [ ] Defendant  GOLDENROD COPY [ ] Police Department  (b) A form in substantially the following language shall suffice for the purpose of requesting temporary orders under this chapter: STATE OF RHODE ISLAND DISTRICT COURT COUNTY OF __________ DIVISION  _________ : Plaintiff: VS: NO: History of Section.P.L. 2009, ch. 239, § 1; P.L. 2009, ch. 240, § 1; P.L. 2021, ch. 77, § 11, effective June 23, 2021; P.L. 2021, ch. 78, § 11, effective June 23, 2021.