Indiana Judicial Center
30 S. Meridian Street, Ste. 900
Indianapolis, IN 46204
View Map and Driving Directions
Pho: 317-232-1313
Fax: 317-233-3367
Jane A. Seigel
Executive Director
jane.seigel@courts.in.gov
Indiana's Updated Civil Protection Order, No Contact Order, and Workplace Violence Restraining Order Forms are effective July 1, 2012. The following forms are updated and valid for use in court.
All forms below contain dates of approval and revision in the bottom right corner of each page, which you can check against the dates listed in the table below. If the form you are using has been updated since you downloaded, you should download again now. Most forms below are available in both Microsoft Word and Adobe PDF formats.
The cover sheet is a fillable PDF document capable of being filled out electronically through the Adobe Acrobat Reader.
| Form # | Form Title | Created | Revised | ||
| n/a | Cover Sheet for Protection, No Contact, and Workplace Violence Restraining Orders | 07.01.02 | 07.01.10 | n/a |
| Form # | Form Title | Created | Revised | ||
| PNW-0100 | Instructions to Clerk | 07.01.03 | - - | Word | |
| PNW-0101 | Return Of Service Information For Protective Orders, No Contact Orders And Workplace Violence Restraining Orders | 07.01.03 | - - | Word |
| Form # | Form Title | Created | Revised | ||
| PO-0100 | Petition for an Order for Protection and Request for a Hearing (Filed by Person Seeking Protection) | 07.01.02 | 07.01.12 | Word | |
| PO-0101 | Petition for an Order for Protection and Request for a Hearing (Filed on Behalf of a Child) | 07.01.02 | 07.01.12 | Word | |
| PO-0102 | Instructions for Petition for an Order for Protection (Filed by Person Seeking Protection) | 07.01.02 | 07.01.12 | Word | |
| PO-0103 | Instructions for Petition for an Order for Protection (Filed on Behalf of a Child) | 07.01.02 | 07.01.12 | Word | |
| PO-0104 | Confidential Form (to accompany Petition for Order and Request) | 07.01.02 | 07.01.12 | Word | |
| PO-0105 | Ex Parte Order for Protection and Findings | 07.01.02 | 07.01.09 | Word | |
| PO-0106 | Notice to Appear | 07.01.02 | 07.01.08 | Word | |
| PO-0107 | Respondent's Verified Request for a Hearing | 07.01.02 | 07.01.08 | Word | |
| PO-0108 | Petitioner's Verified Request for Dismissal | 07.01.02 | 07.01.08 | Word | |
| PO-0109 | Order Dismissing Petition for an Order for Protection | 07.30.02 | 07.01.11 | Word | |
| PO-0110 | Order Denying Petition for an Order for Protection | 07.30.02 | 07.01.08 | Word | |
| PO-0111 | Verified Motion to Reinstate Petition for an Order for Protection | 07.01.02 | - - | Word | |
| PO-0112 | Order for Protection Issued After a Hearing | 07.01.02 | 07.01.09 | Word | |
| PO-0113 | Order for Protection Issued After a Hearing (long form with visitation options & child support language) | 07.01.02 | 07.01.09 | Word | |
| PO-0115 | Petition to Modify an Order for Protection | 07.01.02 | 07.01.08 | Word | |
| PO-0117 | Notice of Extension or Modification | 07.01.02 | 07.01.10 | Word | |
| PO-0118 | Notice of Termination | 07.01.02 | 07.01.10 | Word | |
| PO-0119 | Registration of Foreign Protection Order | 07.01.02 | 07.01.08 | Word | |
| PO-0120 | Confidential Data Entry Form for Foreign Protection Orders | 07.01.02 | 07.01.10 | Word | |
| PO-0121 | Order Modifying an Order for Protection Adding Brady Law Prohibition | 07.23.04 | 07.01.08 | Word | |
| PO-0122 | Order of Transfer To Court Having Jurisdiction | 07.01.06 | 07.01.12 | Word | |
| PO-0123 | Order of Protection (Short Form) | 07.01.07 | 07.01.09 | Word | |
| PO-0124 | Supplement to Cover Sheet | 07.01.07 | - - | Word | |
| PO-0125 | Supplement to Confidential Form for Protected Parties | 07.01.07 | - - | Word | |
| PO-0126 | Petition for Contempt | 07.01.09 | - - | Word | |
| PO-0127 | Address Verification Form | 07.01.09 | 07.01.12 | Word | |
| PO-0128 | Order to Appear | 07.01.09 | - - | Word | |
| PO-0129 | Order Finding Violation of Order of Protection and Requiring Respondent to Wear a GPS Device | 07.01.09 | - - | Word | |
| PO-0130 | Order Finding Respondent in Civil Contempt for Failure to Obey Order of Protection | 07.01.09 | - - | Word |
| Form # | Form Title | Created | Revised | MS Word | Adobe PDF |
| NC-0100 | No Contact Order - Pretrial Release | 07.01.02 | 07.01.10 | Word | |
| NC-0101 | No Contact Order - Diversion | 07.01.02 | 07.01.10 | Word | |
| NC-0102 | No Contact Order - Probation or Executed Sentence | 07.01.02 | 07.01.10 | Word | |
| NC-0103 | No Contact Order - CHINS | 07.01.02 | 07.01.08 | Word | |
| NC-0104 | No Contact Order - Delinquency | 07.01.02 | 07.01.08 | Word | |
| NC-0105 | No Contact Order - Supplement to Cover Sheet, Protected Persons | 07.01.05 | - - | Word | |
| NC-0106 | No Contact Order - Supplement to Confidential Form for Multiple Protected Parties | 07.01.05 | - - | Word | |
| NC-0107 | No Contact Order - Order Vacating or Modifying No Contact Order | 07.01.09 | 07.01.12 | Word | |
| NC-0108 | No Contact Order - Pretrial Release No Hearing | 07.01.10 | - - | Word |
| Form # | Form Title | Created | Revised | MS Word | Adobe PDF |
| WV-0100 | Instructions for Petitions to Prohibit Workplace Violence | 07.01.02 | 07.01.11 | Word | |
| WV-0101 | Petition of Employer for Injunction Prohibiting Violence or Threats of Violence Against Employee / Application for Temporary Restraining Order | 07.01.02 | 07.01.03 | Word | |
| WV-0102 | Order to Show Cause (Workplace Violence) & Temporary Restraining Order | 07.01.02 | 07.01.09 | Word | |
| WV-0103 | Proof of Personal Service (Workplace Violence) | 07.01.02 | 07.01.03 | Word | |
| WV-0104 | Response to Petition of Employer for Injunction Prohibiting Violence or Threats of Violence Against Employee | 07.01.02 | 07.01.03 | Word | |
| WV-0105 | Proof of Service of Completed Response (Workplace Violence) | 07.01.02 | 07.01.03 | Word | |
| WV-0106 | Order After Hearing on Petition of Employer for Injunction Prohibiting Violence or Threats of Violence Against Employee | 07.01.02 | 07.01.09 | Word | |
| WV-0107 | Petition to Modify a Workplace Violence Restraining Order | 07.01.10 | - - | Word |
| Form # | Form Title | Created | Revised | MS Word | Adobe PDF |
| CHPO-0100 | Department of Child Services Temporary Protection Order | 07.01.07 | 07.01.08 | Word | |
| CHPO-0101 | Department of Child Services Child Protection Order | 07.01.07 | 07.01.08 | Word |
| Document | Size | Pages | |
| Protection Order Deskbook | 1 mb | 134 | |
| House Enrolled Act No. 1232 | 301 kb | 54 | |
| Summary of HEA 1232 | 174 kb | 7 | |
| Senate Enrolled Act No. 479 | n/a | n/a | n/a |
| Hearings Required Under Act | 55 kb | 1 |
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