7/28/2019 T. Kimberlin v. B. Kimberlin Petition for Protective Order 7.9.13 (OCR)

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aH4.q)- D a R l V S 1 1 l I f i 1 ' r ~ w r r ~ l H A N D F:\IAR\"L: 'D fOR MontgomeI)'County ~ ' J n ~ - - - " ' c , " ' " . " ' c - - - , , - - - - -

8552SECOND AVENUE

.r- . . J_ / \

2-5P 18'-l

LocaL..a at SlLVER SPRINct Ml)iUDftDi Case o. Vl-V

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) hiuing .. ilb objecl 0 stabbingetainin!!: a!!:2.ins will ~ -in!!. 0 biting- -- - -

PETITION FOR PROTECTION FROMDOMESTIC VIOLENCE CHILD ABUSE VULNERABLE ADULT ABUSE

I. I ' 3 :1 heffu ~ y s e l fm .. I e r a b l e 2 ~ m~ ey 8 Y < - ! ~H { ~ ~ e~e Respon ' m t mmirted me fol lowi g acts ofab: I5e ag'il:> I - v l g a . . . / ; ~1 1 . ( ; ~her " V1.

on or a :J- -3 - / 3 ( hee ' a.! mat a;Jply.) hoki g.suanglingoar;

o sl a pi g shooting rape or ether _exual offense (or 2rreo shoving th eats of violen e ~ n t a li ~ u; oi a hilG.tO ,er H 1 . ~abUSe...

Respoc. e

.-\ his "-ime the v: 'm can be found at _

I am State's A omey DSS 0 a rela 'v e an a I In,;n=: ime

me.1. e er3 0(5) I ant pro ec ed are (include }ollrsdfifYau are ,,'c im):

I-ames(s) J ' B' " ::J 'JI.,Wthev/lvt I- / -J-04

J K , ' ~ h 4 ! . Y I ( V l l [- . t4 -qq~ J I L , c \ - t b ~ / , ' l - ' \If - /6 - 8 0CC-D VI (Re 10 _0] I)

7/28/2019 T. Kimberlin v. B. Kimberlin Petition for Protective Order 7.9.13 (OCR)

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fi r he fnl lowing per iod ohime during, the pe n ( )1 \ 'ant, rOlec ell n w li ....es. or has Ii e ,'ith he R15 .1e

the past ~ e a r : _

There Dare 0 are not additional persons living in the home,

5. I k fme Col 0 \ ' jng court cases in -01 ing me, or the P r!On I \ " : t , t \ l I ' u , , , , - , - ~ ~ u . .3; the Res nden (Exan:plesin;:1 ~ : a ~ m i t y .c it support, divor e, 00

0', d.., .eslie ,-i Ie ceo ' ,min'll ases)

Coun 'ind of Case . ear F:led Result or S il,US (i f O!J kno \ )

6, I ave recei oed a mal protectj 'e 0 er ag-" ..s: i l i ~s::u::eabuse allege in is petition. and which" 'as 'ssued fi a ])ericd

Ore l5med _ -e e. ueil _

3

l . n where issue

r has access to e

f u ~ h e rahuse.}

E l l / o f f

~ O T10 go to The residencers) a t - L - - - - - - - - - = = = = 7 E = = = " "~ . & ! r e s s

9,

. 'OT m go O ' e schoo (s ) aI , . - - _ ~ - - - , - - - - ; - ; - ; - - -'= : " f " , l O d " " " ~

! 'OT ti l go t e hild are pro,,'der{s) .,.------",.".--.-:--: __ . . . , . . . , . - - - ; - ; - ; - : : : - - - - - - - - -

CC-DCiD . HRe , to '20 II )

7/28/2019 T. Kimberlin v. B. Kimberlin Petition for Protective Order 7.9.13 (OCR)

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