THIS IS NOT A COURT ORDER
The current child you are requesting orders for:   {{ currentChildName }}
  • If you are in danger now, call 911 and come back later.
  • What is this wizard for? Use this wizard to ask a judge for a domestic violence, stalking, or sexual assault civil protective order in Alaska. You may use paper forms if you prefer not to use the wizard.
  • How does this work?

    Step 1: The wizard will ask you a series of questions and prepare the right forms for you.

    Step 2: You must print the forms and then file them at the courthouse.

    You should print your forms in a safe location such as a domestic violence shelter. You may also email a copy to yourself and print it later when you are at a safe place.

    Click here for more information about tech safety.

    Step 3: After the court has your forms, the court clerk will contact you.
Yes
No 
Do you need an interpreter? (Court forms are not translated but we need to know if you will need an interpreter at your hearing.)
Select a language
Who do you want protection from?

First name
Last name
Middle name
Suffix
Nicknames or aliases
{{respondentNameBlank ? 'Respondent' : def.respondentFirstName}}'s gender (the gender respondent identifies as)
Male
Female
Who do you want protection for?

Yes
No 
Are you seeking protection for yourself?

Yes
No 
Are you seeking protection for a child?


Please answer the questions above before clicking next
You may be using the wrong tool to make your request. Please see the court clerk.

Are you related to {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} in any of these ways? (Check all that apply.)

Married to each other now or in the past
Child together
Dated or had a sexual relationship but did not live together
Lived together but did not date or have a sexual relationship
Lived together and dated or had a sexual relationship
Related by marriage (such as in-laws)
Other relationship, {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} is my
child or step child
parent or step parent
grandchild (or great or great great granchild)
grandparent (or great or great great grandparent)
brother or sister
first cousin
uncle or aunt (or great uncle or great aunt)
niece or nephew (or grand niece or grand nephew)
I am a child of a person in a relationship described above
None of the above
Is {{child.name}} related to {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} in any of these ways? (Check all that apply.)
Married to each other now or in the past
Child together
Dated or had a sexual relationship but did not live together
Lived together but did not date or have a sexual relationship
Lived together and dated or had a sexual relationship
Related by marriage (such as in-laws)
Other relationship, {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} is {{child.name}}'s
child or step child
parent or step parent
grandchild (or great or great great granchild)
grandparent (or great or great great grandparent)
brother or sister
first cousin
uncle or aunt (or great uncle or great aunt)
niece or nephew (or grand niece or grand nephew)
{{child.name}} is a child of a person in a relationship described above
None of the above
Next we will ask you some questions about {{currentChildName}}.
What type of protective order do you want for {{currentChildName}}?
20 Day Order
If granted, a 20 day (short term) order can start immediately without first telling {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}}.
1 Year Order
If granted, a one year (long term) order can start after notice to {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} and a court hearing. ({{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} is entitled by law to 10 days' notice before the hearing can take place. Long term orders may be extended. Each extension lasts for one additional year, and you may request an extension each year for as many years as needed.)
Both
If you want an order for more than 20 days, you can ask for both a 20 day order and a one year order.
Please select the type of order.

What type of protective order do you want for {{currentChildName}}?
20 Day Order
If granted, a 20 day (short term) order can start immediately without first telling {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}}.
1 Year Order
If granted, a one year (long term) order can start after notice to {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} and a court hearing. ({{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} is entitled by law to 10 days' notice before the hearing can take place. Long term orders may be extended. Each extension lasts for one additional year, and you may request an extension each year for as many years as needed.)
Both
If you want an order for more than 20 days, you can ask for both a 20 day order and a one year order.
Please select the type of order.

Do you think {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} knows you are asking for a protective order?
Yes
No 
You are not required to tell {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} that you are asking for a protective order. If you did tell {{himorher}}, describe your efforts.
Yes
No 
Did {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} sexually assault you{{currentChildName}}?
Yes
No 
Are you afraid that {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} may sexually assault you{{currentChildName}} again?
Yes
No 
Has {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} stalked you{{currentChildName}}?
Yes
No 
Did {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}}'s actions make you{{currentChildName}} afraid that you{{currentChildName}} would be killed or physically injured?
Yes
No 
Did {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}}'s actions make you{{currentChildName}} afraid that a family member would be killed or physically injured?
Family member name How is this family member related to {{ petitionType == 'Child' ? currentChildName : 'you' }}?
You may be using the wrong tool to make your request. Please see the court clerk.

Please answer the question to move on.

Describe the {{(def.petitionerInfo.petitioners[currentPetitionerIndex].contactWithoutConsent == 'Y') ? 'sexual assault' : (def.petitionerInfo.petitioners[currentPetitionerIndex].hasStalked == 'Y') ? 'stalking' : '' }} in this box. Include dates and places.
Describe the domestic violence, starting with the most recent incident.
Be sure to say what, when, and where it happened. If there were more incidents before that, click the "add another incident" button and describe them too.
Yes
No 
Were kids around when the domestic violence happened?
Yes
No 
Were there other witnesses?
Yes
No 
Was anyone hurt?
Yes
No 
Was {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} under the influence of alcohol or drugs during the most recent domestic violence?
Did {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} have a weapon with {{himorher}} during the violence?
Yes
No 
Don't Know
What kind of weapon?
Gun  
Knife
Other
Has {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} been involved in other DV incidents with anybody else?
Yes
No 
Don't Know

Next we will ask you some questions about what you want the judge to order.
Next we will ask you some questions about what you want the judge to order to protect {{currentChildName}}.
Orders to limit contact
The judge can order that {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} not contact you {{currentChildName}} in any way directly or indirectly. Or the judge can order some limited contact if you think it would be safe.

Pick one of these options...

I want the judge to order {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} not to contact {{currentChildName}} me at all.
I want the judge to order that {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} can contact {{currentChildName}} me in a limited way.
Even if you say no contact, the judge may order limited contact if it can be safe. Think about things that might come up where some contact may be needed (school, kids, work, church, bills, etc.) and answer the next questions. We will ask about contact by e-mail and other ways on the next page.
Yes
No 
Would contact be safe by phone?

Yes
No 
Would contact be safe by text?

More orders to limit contact
Yes
No 
Would contact be safe by email?

Yes
No 
Would contact be safe through another person?
Orders to stay away
Yes
No 
Do you want the judge to order {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} to stay away from {{currentChildName}}'s your residence?
Check this box if you want to keep this address confidential.
Yes
No 
Does {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} live in the residence too?
Yes
No 
Does {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} know where {{currentChildName}} livesyou live?

Yes
No 
Do you want the judge to order {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} to stay away from {{currentChildName}}'s your job?
Yes
No 
Does {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} work there too?
Yes
No 
Does {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} know where {{currentChildName}} worksyou work?
More orders to stay away
Yes
No 
Do you want the judge to order {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} to stay away from {{currentChildName}}'s your school?
Yes
No 
Does {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} go to the same school?
Yes
No 
Does {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} know where {{currentChildName}} goes you go to school?
Yes
No 
Do you want the judge to order {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} to stay away from some other place that {{currentChildName}} goes you go to often?
Yes
No 
Is there anything else you need the judge to order?
Yes
No 

Don't know
Is {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} involved in any civil or criminal cases in Alaska or anywhere else?
Yes
No 

Is {{currentChildName}}Are you involved in any open civil or criminal cases in Alaska or anywhere else?
Orders about children
Yes
No 
Do you have children under the age of 18? * Please answer before clicking next
Yes
No 
Are you concerned about their safety? * Please answer before clicking next
Yes
No 
Do you want the judge to give you temporary physical custody? * Please answer before clicking next
Fill out this table for each child and ward:
child's
first
name		 child's
middle
name		 child's
last
name		 Did {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}}
commit or
try to
commit DV
against child?		 child's date
of birth		 child's
gender		 how are
you
related to
child?		 how is
{{respondentNameBlank ? 'Respondent' : def.respondentFirstName}}
related to
child?
NO
YES 		Male
Female


First name is required.
Last name is required.
How you are related is required.
How {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} is related is required.
More orders about children
Yes
No 
Do you want the judge to let {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} visit with the children?
The judge will only let {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} visit with the children if your safety and the children's safety can be protected. If you think visits can be safe, describe a schedule that will work including:
(1) the day-to-day schedule (for each child if different);
(2) where the children should be picked up and dropped off, and by who; and
(3) whether visits should be supervised and if so, by who. (Please give at least 2 names.)
Have a prepared schedule in mind before going to court because there is a possibility the judge will order visits.
More orders about children
Yes
No 
Have the children lived in Alaska for the past 6 months? * Please answer before clicking next
Yes
No 
Are the children staying with you now? * Please answer before clicking next
Yes
No 
Are there any other custody orders involving the children, including any custody orders issued by the court or the Office of Children's Services? (Please bring a copy with you to court.)
List the custody orders below

child's first name what state or tribe
issued the order?		 what is the
case number,
if you know?		 who got custody in the
state or tribal order?
More orders about children
Yes
No 
Do you want the judge to make {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} pay temporary child support?
  How does {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}}
earn money?		 Who is {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}}'s
employer?		 How much is
{{respondentNameBlank ? 'Respondent' : def.respondentFirstName}}'s monthly
take-home pay?

Where do you want temporary child support money sent?
Important Note: If you are asking for child support, then you should bring proof of {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}}'s income and your income to the court hearing. Proof of income includes papers such as paystubs, tax returns, W2 forms, and 1099 forms.
Orders for other support
Yes
No 
Do you want the judge to order {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} to pay support for {{currentChildName}} you?
Orders about the house and the car
Yes
No 
Do you want the judge to give you temporary possession of the home {{currentChildName}} is you are living in while the order is in effect? (You can ask for this even if it is not in your name.)

Check this box if you want to keep this address confidential.
Check this box if you need the police to help {{currentChildName}} you get the house.
Check this box if you need the police to help get {{currentChildName}}'s your things from the house.
Check this box if you need the police to help remove {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} from the house.
Check this box if you need the police to go with {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} to the house once to pick up undisputed items.
Yes
No 
Do you want the judge to give {{currentChildName}} you temporary possession of the vehicle while the order is in effect?
Check this box if {{currentChildName}} needs you need the police to help {{currentChildName}} you get the car.
Orders about the pets
Yes
No 
Do you want the judge to give {{currentChildName}} you temporary possession of the family pets while the order is in effect?
Do you want the judge to give {{currentChildName}} you temporary possession of any of these other things while the order is in effect?

House keys
Cell phone
Mailbox keys
Personal computer
Garage door opener
My medicine
Children's things
Clothes and toiletries
Children's medicine
Food stamps
Driver's license, state ID, military ID
ANSCA ID/Tribal card/Indian Blood Certificate
Medicare/Medicaid coupons
Passport / Social Security cards
Immigration documents
Birth certificates
Other things
Orders for a long term order only and only after a hearing
Yes
No 
Do you want the judge to order {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} to get treatment for alcohol or drug abuse (at {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}}'s expense)?
Yes
No 
Do you want the judge to order {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} to go to a domestic violence intervention program (at {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}}'s expense)?
Yes
No 
Do you want the judge to order {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} not to use or have guns and other deadly weapons? (This can only be ordered if {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} used or possessed a gun during the DV.)
Yes
No 
Do you want the judge to order {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} to give up all the guns {{assailantproNoun}} has? (This can only be ordered if {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} used or possessed a gun during the DV.)
Yes
No 
Do you want the judge to order {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} to pay costs that happened because of the violence (such as medical bills or repair bills)?

Yes
No 
Do you want the judge to order {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} to stay away from drugs?
Yes
No 
Is there anything else you need the judge to order?
Yes
No 

Don't know
Is {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} involved in any open criminal DV cases in Alaska or anywhere else?
{{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} is the defendant in that case.
{{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} is the victim in that case.
Yes
No 

Don't know
Is {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} involved in any open civil cases in Alaska or anywhere else?
{{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} filed first in that case.
Other person filed first in that case.
Yes
No 

Is {{currentChildName}} Are you involved in any open criminal DV cases in Alaska or anywhere else?
{{currentChildName}} isI am the defendant in that case.
{{currentChildName}} isI am the victim in that case.

Yes
No 
Is {{currentChildName}} Are you involved in any open civil cases in Alaska or anywhere else?
{{currentChildName}}I filed first in that case.
Other person filed first in that case.

How can we contact you?
Please let us know how to contact you about any upcoming hearing. The court will keep your license and SSN information confidential.
Your first name First name is required
Your middle name
Your last name Last name is required
Your mailing address
Check here to keep your address and phone numbers confidential.
Your phone numbers
In case the court needs to leave you a message, what would be the safe number to use?
Message phone number
Please enter a home phone number Please enter a work phone number Please enter a cell phone number Please enter a phone number Please select a message phone option
Your date of birth
Date of birth is required
Your license/state ID
Last 4 of your SSN
Your gender (the gender you identify as)
Male
Female
Information about the children you are here on behalf of
Child's First Name Child's Middle Name Child's Last Name Child's Date of Birth Child's Gender How are you related to Child?
Male
Female
First name is required.
Last name is required.
Date of birth is required.
How you are related is required.
How can we contact {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}}?
Fill in the information below to the best of your ability. It will help the court and the police find {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} if they need to give {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} any orders or other documents in the case.
{{respondentNameBlank ? 'Respondent' : def.respondentFirstName}}'s mailing address
Physical address
(if different)
Is {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} in jail?
Yes
No 
Where is {{assailantproNoun}} likely to be?
{{respondentNameBlank ? 'Respondent' : def.respondentFirstName}}'s phone numbers
Name of {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}}'s employer
Employer's address
Check this box if {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} works the night shift.
{{respondentNameBlank ? 'Respondent' : def.respondentFirstName}}'s date of birth
I think {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} is under the age of 18.
{{capitalhisorhers}} license/state ID
Last 4 of {{hisorhers}} SSN
The police will need to know what {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} looks like.

What is {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}}'s race?
What color is {{hisorhers}} hair?
What color are {{hisorhers}} eyes?
What does {{assailantproNoun}} weigh?  lbs. How tall is {{assailantproNoun}}?  ft.  in.
Describe scars, tattoos, or other marks on {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}}
The police will need to know what vehicle {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} drives.
The police will need to know if {{respondentNameBlank ? 'Respondent' : def.respondentFirstName}} carries a weapon.
This is a PREVIEW of the information that will be added to your forms. Review it carefully. Once you click the NEXT button below, you cannot go back and change the information. You will be able to print the forms on the next page.
click underlined text to make changes before submitting
Preview Screen for:

NEXT STEPS:

1. Open your forms by clicking Open Forms:

2. Print your forms from the new window or tab that opens.
Click File, then click Print. Select your printer and click the print button.

3. File the printed forms at your nearest courthouse. You must print your forms and file them at the courthouse. Your request is not official until the court clerk receives your printed forms. Print your forms in a safe place such as a domestic violence shelter. You may also email a copy to yourself and print it later at a safe location. Click here for more information about tech safety.

4. For an email copy, type your safe email address and click send:

It will take the wizard a few minutes to email your forms to you.
{{ alertContactEmailMessage }}

5. For more information or assistance, contact the nearest court location.

6. You may now close the window.