2023 Rhode Island General Laws › Title 8 - Courts and Civil Procedure – Courts › Chapter 8-8.1 - Domestic Assault › Section 8-8.1-6. - Form of complaint.

§ 8-8.1-6. 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.
(1) My full name, present street address, city and telephone number are as follows: _________________________________________
_________________________________________
(2) My former residence, at which I resided with the defendant, is as follows (street address and city): _________________________________________
_________________________________________
(3) My former residence is a house
I own _________________________________________
Defendant owns _________________________________________
We jointly own _________________________________________
My former residence is an apartment
There is no lease _________________________________________
My name is on lease and defendant's is not _________________________________________
Defendant's name is on lease and mine is not _________________________________________
Both our names are on lease _________________________________________
(4) The full name, present street address, city and telephone number of the person causing me abuse (the defendant) are as follows: _________________________________________
_________________________________________
(5) 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
specifically, the defendant: _________________________________________
(6) 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.
_____ The court order the defendant to immediately leave the household which is located at _________________________________________
_________________________________________
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.
(7) 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. 20_____ .
______________
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: ___________ , 20__
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:
:
_________________________________________
:
Defendant
:
(TEMPORARY) ORDER PURSUANT TO CHAPTER
______ OF THE G.L. OF R.I.
Upon consideration of plaintiff’s complaint, (and having found that immediate and irreparable injury, loss or damage will result to the plaintiff before a notice can be served and a hearing had thereon) it is ORDERED:
_____ That the defendant is restrained and enjoined from contacting, assaulting, molesting, or otherwise interfering with plaintiff at home, on the street or elsewhere.
_____ That the defendant vacate forthwith the household located at
_________________________________________
_________________________________________
A hearing on the continuation of this ORDER will be held at the District Court, __________ County, __________ Division, at __ (A.M.) (P.M.) on __________ . If the defendant wishes to be heard, she/he will be heard at that time. If she/he does not appear at that time, this ORDER shall remain in effect.
This ORDER is effective forthwith, and will remain in effect until the time and date of the above-mentioned hearing.
A copy of this ORDER shall be transmitted to the appropriate local law enforcement agency forthwith, and shall be served in-hand on the defendant herein.
ENTERED as an Order of Court this ______ day of ________ A.D. 20____ .
ENTER: __________ PER ORDER: __________
Judge __________ Clerk __________
Presented by: _________________________________________
Attorney for Plaintiff
WHITE COPY
___ Court
YELLOW COPY
___ Plaintiff
PINK COPY
___ Defendant
GOLDENROD COPY
___ Police Department
History of Section.
P.L. 1985, ch. 492, § 2; P.L. 1988, ch. 539, § 4; P.L. 1989, ch. 78, § 2; P.L. 1995, ch. 145, § 1; P.L. 2021, ch. 77, § 4, effective June 23, 2021; P.L. 2021, ch. 78, § 4, effective June 23, 2021.