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Instructions/sample icon Sample Interim Apprehended Pe​rsonal Violence Order ​- text only version

This is a text only version of a Sample Interim Apprehended Personal​ Violence Order. It is not legal advice.

To see what a completed Interim Apprehended Personal Violence Order could look like, see the pdf version of Sample Interim Apprehended Personal Violence Order PDF icon(31 kb).

If you need more help, you should get legal advice.


INTERIM ORDER
APPREHENDED PERSONAL VIOLENCE ORDER 
Crimes (Domestic and Personal Violence) Act 2007

Mark Howard, you must follow the orders below. It is a criminal offence not to follow these orders. You could be arrested by police and charged. If you are convicted, you could go to prison for up to 2 years and be fined up to $5,500.

You could also be charged with other criminal offences. If you are convicted of these offences, you could receive a much higher penalty. 

You must follow these orders until it is revoked or a further order made by the Court becomes effective.

The Orders have been made to protect Didier Hasan and Saabeah Hasan. 

You must follow these orders even if Didier Hasan and Saabeah Hasan don’t want you to or tell you that you don’t need to. If you attempt to do any of the things below, it will still be a criminal offence called a breach. 

You must attend Fairfield Local Court on 10 February 20XX at 9:30 AM.

If you fail to attend the court may make orders against you or issue a warrant for your arrest to bring you before the court.

Orders about behaviour

1. You must not do any of the following to Didier Hasan and Saabeah Hasan, or anyone they have a domestic relationship with:
A) assault or threaten them,
B) stalk, harass or intimidate them, and
C) Intentionally or recklessly destroy or damage any property or harm an animal that belongs to or is in the possession of Didier Hasan and Saabeah Hasan.

For example:
  • You must not do any of these things in person, through another person, or through electronic communication and devices (for example, by phone, text messages, emails, Facebook or other social media, or GPS tracking). 
  • You must not do or say anything that may make Didier Hasan and Saabeah Hasan feel frightened, or feel that you may harm them or damage their belongings in any way, including any pets and jointly owned property.
Orders about where you cannot go

8. You must not go into:
A) any place where Didier Hasan and Saabeah Hasan live, or
B) any place where they work, or 
C) any place listed here 321 Pith Street Merrylands NSW 2160.

For example:
  • You are not allowed to go within 100 metres of the boundary of those places.

If you breach this order:
  • You could go to prison for up to 2 years and be fined up to $5,500.
  • You could be charged with other criminal offences (for example, assault or intimidation), as well as the breach of this order. If convicted of these offences, you could receive a higher penalty, such as more time in prison.
Immediately take all firearms and prohibited weapons, along with related licences and permits you have to the police. If you keep any of these, you could be in breach of this order and could also be charged with other criminal offences.

If you have any questions about the order, you can contact:
  • a solicitor
  • Legal Aid NSW on (02) 9219 5000
  • Local Police Station 
  • LawAccess NSW on 1300 888 529 or www.lawaccess.nsw.gov.au 
  • Interpreting Services on 131 450 or www.tisnational.gov.au.  

Defendant: Mark Howard, 29 November 1955, CNI 1234567
To protect: Didier Hasan, 10 March 1981, CNI 2345678
Applicant and Police Application Number: Senior Constable Owen Brown, Central Rose Bay LAC, Paddington Police Station, 666777
Date and Duration of Order: 10 February 20XX, 6 months
Case number and Court: 20XX/00001224, Fairfield Local Court