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Non-Domestic Sexual Assault PPO

You are filing for a Non-domestic Sexual Assault PPO. In order to file for a non-domestic Sexual Assault PPO, you will need to complete four documents and you will need to write a statement about why you need a PPO.  You can either use our statement packet or you may write or type a statement out on blank sheets of paper.  Do not write on the back of any pages.  For tips on what to include in your statement, click here.


Complete the following four documents

1.) Non-domestic Sexual Assault PPO Petition: You are only completing and turning in Page 3 of this document. You are filling out all of Page 3 starting with names at the top. 

A. You are the Petitioner.  You must provide your first and last name and a mailing address.  This must be an address where you can receive mail.  It does not have to be the address where you are living, so if the person you are filing against does not know where you are living and if you can get mail at a different address they do know (for example work, P.O. Box) you can write in that mailing address and not your home address.  If the person does not know your phone number, you do not have to list it even though it asks for it.


The person you are filing against is the Respondent.All you need to know about someone in order to file for a PPO against them is their 1) first and last name; 2) Race; 3) Sex; and 4) Date of Birth or accurate age.So if you don’t have their address or phone number, you can still complete the paperwork.


B.2. If the respondent has to carry a firearm for their job, check box B. If they do not have to carry a firearm for their job, leave box B blank.  If you are unsure, check ‘Unknown’.

C.3. If you have other court cases with the Respondent, list them here. If they are open, list them in section C.3.a. If they are closed, list them in section C.3.b. Examples might include civil cases (for example, small claims actions) or even criminal cases where one party is the defendant and the other party is the victim. 


D.4. Here you must check the box that is true for your situation so the Judge knows why you are filing for a sexual assault PPO.  You write/type your statement separately.


E.5. You will tell the Judge what you don’t want the Respondent to be allowed to do by checking boxes in E.5. 


F.6. When you check box F, you are asking the Judge to make a quick decision without a court hearing. This means the Judge will decide whether or not to grant you a PPO within one business day of you turning in your paperwork and will make the decision without a court hearing and without any advance notice being given to the Respondent. 


G.7. You will not check box G.7.


H. Date and sign at the bottom.  If you cannot print this paperwork and sign it and scan it in again, then type your name using the following format for your signature: /s/ First name Last name (for example: /s/ Jan Jones)



2.) Non-domestic Sexual Assault Order: You need to submit pages 1 & 2 of this document but you are ONLY completing A and B on page 1. (Leave the rest of page 1, and all of page 2 blank.)


A. is your information again (it is the same as section A in the petition).  It must include your first and last name and a mailing address. 

B. is the bolded sections and it is Respondent’s information, not yours.  Put the Respondent’s first and last name (and contact information if you have it) on the top right bolded section. Below, you are asked to list information asking about the Respondent’s height, weight, race, sex, date of birth or (accurate) age, hair color, eye color, and other identifying information, such as tattoos and scars.  You must list the Respondent’s race, sex, date of birth if, you have it, and age if you don’t.  If you know the other things, list them. If you don’t, leave them blank.


3.) Case Inventory Addendum This is a mandatory form where the Court wants you to list any family division cases you and the other person have together (including other PPO cases).  Even if you do not have any family division cases together, you will still complete and submit this form:

Fill in the parties names at the top.  In this form, you are the Plaintiff. The person you are filing for the PPO against is the Defendant.

Next, read the instructions to see if you need to list any court cases in the middle section of this form.  Remember, these are family division cases that the two of you have together.  If you don’t have any, leave that section blank.

If you have cases you need to list:

Check the proper box to state whether the case is in this court (the 30th Circuit Court where you are filing for this PPO) or a different one.

Write the case name: this is typically the names of the parties: the person who opened the case vs. the other person.

The case number if you have it (usually found in the upper right-hand corner of court documents). If you do not have that information and cannot obtain it with an online search (many family law cases are in online court databases, but some cases, such as PPOs, are not found online), write what you know.  If you can remember the year it was filed and the type of case it was, that can be helpful.  (For example, 18-3456-PH might be the case number, but if you don’t have it and can at least write down that it was a 2018 PPO, do that.)


Assigned Judge is the Judge assigned to that case (and if it was a case in the 30th Circuit Court, you will probably have that same Judge assigned to your PPO case).

You will check the box ‘Pending’ if the case is still open or ‘Resolved’ if the Judge has already made his/her order(s) and the case is closed or if the case was dismissed. 

Date and sign at the bottom.  If you cannot print the form and sign it and scan it back in, type your name using the following format for your signature: /s/ First name Last name (for example: /s/ Jan Jones)


4.) Questions for Petitioner: NOTE: This form is not fillable online, so if you cannot print it, complete it and scan it back to the computer, then please answer those questions on a blank Word document for example, and submit that instead.

Put parties’ names at the top.  (Petitioner v Respondent- names)


Answer the four questions at the top half of the page. Leave the bottom half blank. 


Next, you will need to write your statement so the Judge knows what’s been happening to cause you to need a Personal Protection Order.

Click here if you want to use our statement packet.

Click here for tips on writing your statement.

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