Preview
FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022
NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022
EXHIBIT 11
FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022
NYSCEF DOC. NO. 23 BRENDA D. FORMAN, BROWARD COUNTY CLERK OF COURTS RECEIVED NYSCEF: 12/16/2022
PROGRESS DOCKET
CASE No. DVCE-16-006739
Cheri A.Pierson § Location: Domestic Violence
Petitioner § JudicialOfficer:63 Moon, StefanieC.
vs. § Filedon: 09/06/2016
§ Case Number History:
Wendy Levitt § Uniform Case Number: 062016DR006739AXDVCE
Respondent
CASE IMORMA GON
Related Cases Case Type: Repeat Violence
DVCE-16-005984 (RelatedFamily Case)
StCase
09/20/2016 Disposed
Statistical
Closures
09/20/2016 Disposed by Judge 09/06/2016 Pending
DATE CASE ASSIGNMENI
Current Case Assignment
Case Number DVCE-16-006739
Court Domestic Violence
Date Assigned 09/06/2016
JudicialOfficer 63 Moon, StefanieC.
Previous Case Assignments
Case Number DVCE-16-006739
Court Domestic Violence
Date Assigned 09/06/2016
JudicialOfficer 59 Kaplan,Michael G.
Reason PreviouslyExistingCase
PARTY INFORMATION
Petitioner Pierson,Cheri A.
2255 NE 9th St Pro Se
# 1A 2255 NE 9th St
Pompano Beach, FL 33062 # 1A
Pompano Beach, FL
33062
Respondent Levitt,Wendy
2255 NE 9th ST
# 2A
Pompano Beach, FL 33062
DATE EVENTS & ORDERS OF l‰E COURT INDEX
DISPOSITIONS
09/20/2016 Vol./Book0,
Order Dismissing Ord SettingHrg forInjunction/DV/RV/SV/DA Page 0, 2 pages
Instrument#
113948872
EVENTS
09/20/2016 Clerk'sCertificate
ofCompliance
09/20/2016 Proceedings
Hearing
PAGE 1 OF 2 Printedon 10/05/2021 at 1:41 PM
FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022
NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022
BRENDA D. FORMAN, BROWARD COUrfrY CLERK OF COURTS
PROGRESS DOCKET
CASE No. DVCE-16-006739
09/15/2016 Proof ofService
Served On 06/13/16
Party:Respondent Levitt,Wendy
09/06/2016 Order Hearing/RV W/O Temp Injunction-Judge
Setting
HRG 9/20/16 @ 10AM RM 860
09/06/2016 PetitionerWaiver Repeat Violence
09/06/2016 DescriptionSheet
09/06/2016 Petition
09/06/2016 How To Proceed - DV
09/06/2016 CivilCover Sheet
09/06/2016 Affidavitof the Clerk
09/06/2016 Notice of RelatedCases
PAGE 2 OF 2 at 1:41 PM
Printed on 10/05/202l
FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022
**** FILED: PM.****
BROWARD COUNTY, FL Howard C. Forman, CLERK 9/6/2016 12:15:01
NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022
RESPONDENT DESCRIPTION INFORMATION
ATTENTION LAW ENFORCEMENT OFFICERS, PLEASE REMOVE THIS
SHEET PRIOR TO SERVICE. PLEASE DO NOT GIVE THIS SHEET TO THE
RESPONDENT.
THE FOLLOWING INFORMATION MUST BE AS COMPLETE AS POSSIBLE TO
ALLOW THE POLICE TO PUT THE INFORMATION INTO THEIR COMPUTERS
SECTION L RESPONDENTS NAME
Respondent's Full Name
Nickname/Ahas
SECTION H: PHYSICAL DESCRIPTION
ex· .- Female
Race / Male Date of Birth
I Color
Age Height (f Weight 22 ,SHair Color Eye
Other Marks/Scars/Tattoos
Relationship to Victim
SECTION III: RESPONDENT'S ADDRESS
Current Address NL- f 6
A/'
Name of omplex Bldg_____Apt# '). ú
City vo c Å, State
P /- Zip T506,1
Phone o 00 5 7ager/Cell Phone No.
Work Address
City State Zip
Last Known Address
City State Zip
Hangouts
SECTION IV: RESPONDENT'S CLOSE RELATIVES
Name r t Relationship
Address
City 3 O q n tate Zip
1
FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022
NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022
SECTION V: 12CENSE/VEHICLE INFORMATION
Does Respondent have a vahd Driver's License9
O Yes O No State
VEHICLE #1:
Make
Year Color
Cf
{< prd
Model
Tag No te
'/Q riÅ C
VEHICLE #2:
Make Model
Year Color Tag No State
SECTION VI: LETHALITY ASSESSMENT
Does Respondent have any weapons? Yes o ¤Unknown
Ifyes, type of weapon
Does Respondent have a drug problem9 es D No Q Unknown
Does Respondent have an alcohol problem? es D No D Unknown
Does Respondent
many9
have children m his/her care9
D Yes o Q Unknown
Ifyes, how
Is the Respondent wanted by
Police9
D Yes Unknown
If for what9
yes,
Does Respondent
what9
have a enmmal record9
¤ Yes G No nknown
If yes,for
Is the Respondent expectmg this Order9
G Yes o D Unknown
PLEASE ATTACH A PHOTOGRAPH OF RESPONDENT IF YOU HAVE ONE
2
FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022
NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022
J
ATTENTION LAW ENFORCEMENT OFFICIAL-PLEASE DO NOT GIVE
THIS INFORMATION TO RESPONDENT
Petitioner's Name c
Date of Birth -(,, P_ Race (2 )h Sex Male Female
Address nly ifN_QT Confiden
ff
1)
ate
r-),! N /[
City ()rpf4--rk Zip
Telephone Number where Petitioner be contacted 7 7 - ¶/
may () /f
Other ways Petitioner may be contacted
PERSONS'
OTHER PROTECTED NAMES & ADDRESSES (Ifdifferent from
Petstroner 's and N_O.T Confidentral)
Name
Date of Birth Race PE][Hff Sex ÈϽÑl2
Address
City State Zip
Name
Date of Birth Race TiFjEftê Sex 33
Address
City State Zip
. .
Name
Date of Birth Race is??57 Sex
Address
City State Zip
FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022
**** FILED: BROWARD FL Howard C. CLERK 9/6/2016 12:15:01 PM.****
NYSCEF DOC. NO. 23 COUNTY, Forman, RECEIVED NYSCEF: 12/16/2022
IN THE CIRCUIT C URT OF THE JUDICIAL CIRCUIT,
IN AND FOR pro A) C-- FLORIDA
COUNTY,
Case No 16-6 73 9 -
Division ...,mn.
Petitioner,
and .
Respondent
PETITION FOR INJUNCTION FOR PROTECTION
AGAINST REPEAT VIOLENCE
1, {full
legalname} being sworn, certifythat the
following statements are true.
SECTION l. PETITIONER
(Thissection is bout you Itmust be completed )
1 Petitione currently lives_atth following ss {addr , city, te,zipcode}
[Indicate ifapplicable]
Petitioner seeks an injunction for protection on behalf of a minor child. Pet toner s the
parent or legalguardian of legal
{full namel ,
a minor childwho is living
at home
2. Petitioner'sattorney's name, address, and telephone number is
(Ifyou do not have an attorney, wnte "none ")
SECTION II.RESPONDENT
(Thissect n i about the person you want to be protec d from It must be ompleted )
1 Respon nt currentlyli s at e folI ing a dress {oddr state,
, city, and zip code}
FamilySupreme Court Approved Law Form 12 980(f),Petition
forInjunctionforProtectionAgainstRepeat Violence
(03/15)
FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022
NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022
Respondent's License is·
Driver's number {tfknown}
2 Petitioner has known Respondent since {date}
3 Respondent's lastknown Iaceof employment p ()
Employment address.
Working hours
4 Physicaldescription of Respondent
Race C r ' Sex Male Female Date of Birth . ,
Height . Weight ÅsEydor Hair Color ) f f)7t/)t / / (p...
Distinguishingmarks and/or scars
Vehicle (make/model) Color f CA Tag Number
5 Other names Respondent goes by (aliasesor nicknames)
6. Respondent's attorney's name, address, and telephone number is:
(ifyou do "
not know whether Respondent has an attorney, wnte "unknown IfRespondent
does not have an attorney, wnte "none ")
SECTION Ill.CASE HISTORY AND REASON FOR SEEKING PETITION (Thissection must be completed )
1 Has Petitioner ever received or tried to get an injunction for protection against domestic
violence, repeat violence, dating violence, or sexualviolence against Respondent inthis or any
other court?
2. Has Respondent ever received or tred to get an mjunction for otect on aga nst domest c
violence, repeat violence, dating violence, or sexual violence against Petitioner m thisor any
other court?
Yes No If yes,what happened in thatcase? {tncludecase number, if known)
3. Descnbe any other court case that is eithergoing on now orthat happened in thepast between
Petit®
er and Respo dent (1 cludecps number, if known}.
4 espondent has directed at leasttwo incidentsof violence, aning assault,aggr ated assault,
aggravated battery, sexual assault, sexual battery, stalking, aggravated stalking,
battery,
Suprerne Court Approved Law Form 12 980(f), for
Petition InjunctionforProtectionAgainstRepeat V o ence
Farnily
(03/15)
FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022
NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022
kidnapping, or false impnsonment, or any criminal offense inphysical ordeath
resulting injury
against Petitioner or a member of Petitioner'simmediate One of these two incidentsof
family
violence has occurred within 6 months of the date of of thispetition The most recent
fibng
incident (includingdate and locatio ) is desenbed below
On {date} , at{locati r
j
Res ndent 40d / f
Please indicate here f you areatt ingadd t onalpages ont nue these fa s.
5. Other prior incidents(incu ingdates and locat on) are described below
On {date} te /L f
Respo ent
)...( C
Please indicate here if youare attachingbdditional pages to continue these facts
6 Petitionergenuine fear peat violenc pondent Ex ain (
FamilySupreme Court Approved Law Form 12 980(f),PetitionforInjunctionforProtectionAgainstRepeat Violence
(03/15)
FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022
NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022
CONTINUATION PAGE #
ALLEGATION(S)
_3rd crh is c (frob /o
CaÄ 0 A dam a&
SEE ATTACHED FOR ADDITIONAL INFORMATION
DO NOT WRITE ON BACK OF SHEET!!!
FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022
NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022
Aa a cAa d
C
d as
sa 22 06 he d6a c
fe / fov , T TM A b4
y T d b ad d a
DO NOT WRITE ON BACK OF SHEET!!!
FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022
NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022
CONTINUATION PAGE #
ALLEGATION(S)
E ATTACHED FOR ADDITIONAL INFORMATION
T DO NOT
to
WRITE ON BACK OF SHEET!!!
FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022
NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022
CONTINUATION PAGE #
ALLEGATION(S)
M pm O's
of0 /¤ 9 d
c rN &
DO NOT WRITE ON BACK OF SHEET!!!
|
FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022
NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022
CONTINUATION PAGE #
ALLEGATION(S)
[ ]SEE ATTACHED FOR ADDITIONAL INFORMATION
DO NOT WRITE ON BACK OF SHEET!!!
FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022
NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022
ALLE GA TION(S)
[ ]SEE ATTACHED FOR ADDITIONAL INFORMATION
DO NOT WRITE ON BACK OF SHEET!!!
FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022
NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022
7 Additional information
[Choose oilthat apply)
a _Respondent owns, has, and/or is known to have guns or other weapons
Descnbe weapon(s)
b s orpnor acts of to· or
epeat violence have been previously rep ed {p rson agency)
SECTION IV. N UNCTIÒN (T is sectionmust be completed )
1 toner asks the Court to enter a TEMPORARY INJUNCTION for protection against repeat
violence that willbe in placefrom now untilthe scheduled heanng in thismatter
2 Petitioner asks the Court to enter, aftera hearing has been held on this petition,a final
judgment of injunction prohibiting Respondent from committing any acts of violence against
Petitionerand
a prohibiting Respondent from going to orwithin 500 feet of any place Petitionerlives,
b. prohibitmg Respondent from going to or withm 500 feet of Petitioner'splace(s) of
employment or the school that Petitioner attends; the address of Petitioner's place(s) of
employment and/or school is
c. prohibitingRespondent from contacting Petitioner by telephone, mail, by e-mail, in wnting,
through another person, or in any other manner,
d ordenng Respondent not to use orpossess any guns or firearms,
[Indica e allthatapply]
e prohibiting Respondent from going to or within 500 feet of following place(s)
P tition e mily to oft
Supreme Court Approved Law Form 12 980(f),Petition
forInjunctionforProtectionAgainstRepeat Violence
Family
(03/15)
FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022
NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022
f prohibiting Respondent from knowingly and intentionally going to or within 100 feet of
Pe tioner'smotor vehicle, and any other terms the Court deems necessary for the safety of
Petitionerand Petitioner'simmediate family
I UNDERSTAND THAT BY FILING THIS PETITION, I AM ASKING THE COURT TO HOLD A HEARING ON THIS
PETITION, THAT BOTH THE RESPONDENT AND I WILL BE NOTIFIED OF THE HEARING, AND THAT I MUST
APPEAR AT THE HEARING. I UNDERSTAND THAT IF EITHER RESPONDENT OR 1 FAllTO APPEAR AT THE
FINAL HEARING, WE WILL BE BOUND BY THE TERMS OF ANY INJUNCTION OR ORDER ISSUED AT THAT
HEARING.
I UNDERSTAND THAT I AM SWEARING OR AFFlRMING UNDER OATH TO THE TRUTHFULNESS OF THE
CLAIMS MADE IN THIS PETITION AND THAT THE PUNISHMENT FOR KNOWINGLY MAKING A FALSE
STATEMENT INCLUDES FINES AND/OR IMPRISONMENT.
Dated:
Signature of Petitio
Printed Name
Address Ñ --
City,State,Zip vyr^ ²e CLA--
Telephone Number
-7
7 )
Fax Number
Designated E-Mail Address(es):
STATE OF FLORI
COUNTY OF
Sworn to or affirmed and signed be re me on y0 4. ) 9
Jf
A L r EPUTY C E
CO)d
{Prftópb]r stamp commissioned name of notary or
Supreme Court Approved Law Form 12 980(f), for
Petstion for
injunction ProtectionAgainstRepeat Violence
Family
(03/15)
FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022
NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022
clerk)
ersonally known
Produced identification
Type ofidentificationproduced
FamilySupreme Court Approved Law Form 12 980(f),
PetitionforInjunctionforProtectionAgainstRepeat Violence
(03/15)
FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022
INSTRDOC. # 113948872 Page 1 of Recorded 09/23/2016 at 08:43 AM
NYSCEF NO. 23 2, RECEIVED NYSCEF: 12/16/2022
Broward Commission, Deputy Clerk ERECORD
County
**** 9/20/2016 2:56:36 PM.****
FILED: BROWARD COUNTY, FL Howard C. Fonnan, CLERK
IN THE CIRCUIT COURT OF THE SEVENTEENTH JUDICIAL CIRCUIT,
IN AND FOR BROWARD COUNTY, FLORIDA
Case No : DVCE p
Division {Á
Petitioner,
and
/J on r / ondf .
espondent
ORDER OF DISMISSAL OF TEMPORARY INJUNCT ON FOR PROTECTION
AGAINST ( ) DOMESTIC VIOLENCE ( EPEAT VIOLENCE
( ) DATING VIOLENCE ( ) SEXUAL VIOLENCE ( ) STALKING
THIS CAUSE came before the Court on {date} ( , upon Petitioner's action for an
injunction for against·
protection domestic violence, repeat, dating, or sexual violence, or stalking.
Based upon the following circumstances, the Court dismisses the Petition
{Indicate allthat apply}
a Petitioner failedto appear at the hearing scheduled inthis cause
b. Petitioner appeared at the heanng but desires to voluntarily dismiss this action.
c The evidence presented is insufficientunder Florida law (sections 741 30, 784 046, or
784.0485, Florida Statutes) to allow the Court to issue an injunction forprotection
against domestic, repeat, dating, or sexual violence, or stalking
Accordingly, the case is dismissed without prejudice
DONE AND ORDERED in Ft Lauderdale, Browar ounty , FInda on c
IRC J
Flonda Supreme Court Approved Law Form 12 980(e), Order of Dismissalof Temporary injunctionfor
Family
Protection Against Domestic Violence,Repeat Violence, DatingViolence, Sexual Violence,or Stalking(03/15)
FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022
NYSCEF of 2 End of Document
INSTR DOC.# NO. 23
11394887 2 Page 2 , RECEIVED NYSCEF: 12/16/2022
COPIES TO
Shenff of Broward County
Petitioner
by U S. Mail
by hand delivery in open court
by e-mail to designated e-mail address(es)
Respondent.
I;pfU.S Mail
by hand delivery in open court
by e-mail to designated e-mail address(es)
State's Attorney's Ofhce
Other.
I CERTIFY the foregoing is a truecopy of the onginal Order of Dismissal of Temporary injunction as it
appears on filein the office of the Clerk of the Circuit Court of Broward County,
Florida,and that I have fumashed copies of thisorder as indicated above
CLERK OF THE CIRCUIT COURT
(SEAL)
By. AXJL JM
{Dep Clerk or Judi atAssistant}
Court Approved Law Form 12 980(e),Order of Dismissalof Temporary Injunction for
FloridaSupreme Family
Protection Against Domestic Viole-nce,Repeat Violence, Dating Violence,Sexual Violence, orStalking(03/15)
Preview
FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022 NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022 EXHIBIT 11 FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022 NYSCEF DOC. NO. 23 BRENDA D. FORMAN, BROWARD COUNTY CLERK OF COURTS RECEIVED NYSCEF: 12/16/2022 PROGRESS DOCKET CASE No. DVCE-16-006739 Cheri A.Pierson § Location: Domestic Violence Petitioner § JudicialOfficer:63 Moon, StefanieC. vs. § Filedon: 09/06/2016 § Case Number History: Wendy Levitt § Uniform Case Number: 062016DR006739AXDVCE Respondent CASE IMORMA GON Related Cases Case Type: Repeat Violence DVCE-16-005984 (RelatedFamily Case) StCase 09/20/2016 Disposed Statistical Closures 09/20/2016 Disposed by Judge 09/06/2016 Pending DATE CASE ASSIGNMENI Current Case Assignment Case Number DVCE-16-006739 Court Domestic Violence Date Assigned 09/06/2016 JudicialOfficer 63 Moon, StefanieC. Previous Case Assignments Case Number DVCE-16-006739 Court Domestic Violence Date Assigned 09/06/2016 JudicialOfficer 59 Kaplan,Michael G. Reason PreviouslyExistingCase PARTY INFORMATION Petitioner Pierson,Cheri A. 2255 NE 9th St Pro Se # 1A 2255 NE 9th St Pompano Beach, FL 33062 # 1A Pompano Beach, FL 33062 Respondent Levitt,Wendy 2255 NE 9th ST # 2A Pompano Beach, FL 33062 DATE EVENTS & ORDERS OF l‰E COURT INDEX DISPOSITIONS 09/20/2016 Vol./Book0, Order Dismissing Ord SettingHrg forInjunction/DV/RV/SV/DA Page 0, 2 pages Instrument# 113948872 EVENTS 09/20/2016 Clerk'sCertificate ofCompliance 09/20/2016 Proceedings Hearing PAGE 1 OF 2 Printedon 10/05/2021 at 1:41 PM FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022 NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022 BRENDA D. FORMAN, BROWARD COUrfrY CLERK OF COURTS PROGRESS DOCKET CASE No. DVCE-16-006739 09/15/2016 Proof ofService Served On 06/13/16 Party:Respondent Levitt,Wendy 09/06/2016 Order Hearing/RV W/O Temp Injunction-Judge Setting HRG 9/20/16 @ 10AM RM 860 09/06/2016 PetitionerWaiver Repeat Violence 09/06/2016 DescriptionSheet 09/06/2016 Petition 09/06/2016 How To Proceed - DV 09/06/2016 CivilCover Sheet 09/06/2016 Affidavitof the Clerk 09/06/2016 Notice of RelatedCases PAGE 2 OF 2 at 1:41 PM Printed on 10/05/202l FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022 **** FILED: PM.**** BROWARD COUNTY, FL Howard C. Forman, CLERK 9/6/2016 12:15:01 NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022 RESPONDENT DESCRIPTION INFORMATION ATTENTION LAW ENFORCEMENT OFFICERS, PLEASE REMOVE THIS SHEET PRIOR TO SERVICE. PLEASE DO NOT GIVE THIS SHEET TO THE RESPONDENT. THE FOLLOWING INFORMATION MUST BE AS COMPLETE AS POSSIBLE TO ALLOW THE POLICE TO PUT THE INFORMATION INTO THEIR COMPUTERS SECTION L RESPONDENTS NAME Respondent's Full Name Nickname/Ahas SECTION H: PHYSICAL DESCRIPTION ex· .- Female Race / Male Date of Birth I Color Age Height (f Weight 22 ,SHair Color Eye Other Marks/Scars/Tattoos Relationship to Victim SECTION III: RESPONDENT'S ADDRESS Current Address NL- f 6 A/' Name of omplex Bldg_____Apt# '). ú City vo c Å, State P /- Zip T506,1 Phone o 00 5 7ager/Cell Phone No. Work Address City State Zip Last Known Address City State Zip Hangouts SECTION IV: RESPONDENT'S CLOSE RELATIVES Name r t Relationship Address City 3 O q n tate Zip 1 FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022 NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022 SECTION V: 12CENSE/VEHICLE INFORMATION Does Respondent have a vahd Driver's License9 O Yes O No State VEHICLE #1: Make Year Color Cf {< prd Model Tag No te '/Q riÅ C VEHICLE #2: Make Model Year Color Tag No State SECTION VI: LETHALITY ASSESSMENT Does Respondent have any weapons? Yes o ¤Unknown Ifyes, type of weapon Does Respondent have a drug problem9 es D No Q Unknown Does Respondent have an alcohol problem? es D No D Unknown Does Respondent many9 have children m his/her care9 D Yes o Q Unknown Ifyes, how Is the Respondent wanted by Police9 D Yes Unknown If for what9 yes, Does Respondent what9 have a enmmal record9 ¤ Yes G No nknown If yes,for Is the Respondent expectmg this Order9 G Yes o D Unknown PLEASE ATTACH A PHOTOGRAPH OF RESPONDENT IF YOU HAVE ONE 2 FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022 NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022 J ATTENTION LAW ENFORCEMENT OFFICIAL-PLEASE DO NOT GIVE THIS INFORMATION TO RESPONDENT Petitioner's Name c Date of Birth -(,, P_ Race (2 )h Sex Male Female Address nly ifN_QT Confiden ff 1) ate r-),! N /[ City ()rpf4--rk Zip Telephone Number where Petitioner be contacted 7 7 - ¶/ may () /f Other ways Petitioner may be contacted PERSONS' OTHER PROTECTED NAMES & ADDRESSES (Ifdifferent from Petstroner 's and N_O.T Confidentral) Name Date of Birth Race PE][Hff Sex ÈϽÑl2 Address City State Zip Name Date of Birth Race TiFjEftê Sex 33 Address City State Zip . . Name Date of Birth Race is??57 Sex Address City State Zip FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022 **** FILED: BROWARD FL Howard C. CLERK 9/6/2016 12:15:01 PM.**** NYSCEF DOC. NO. 23 COUNTY, Forman, RECEIVED NYSCEF: 12/16/2022 IN THE CIRCUIT C URT OF THE JUDICIAL CIRCUIT, IN AND FOR pro A) C-- FLORIDA COUNTY, Case No 16-6 73 9 - Division ...,mn. Petitioner, and . Respondent PETITION FOR INJUNCTION FOR PROTECTION AGAINST REPEAT VIOLENCE 1, {full legalname} being sworn, certifythat the following statements are true. SECTION l. PETITIONER (Thissection is bout you Itmust be completed ) 1 Petitione currently lives_atth following ss {addr , city, te,zipcode} [Indicate ifapplicable] Petitioner seeks an injunction for protection on behalf of a minor child. Pet toner s the parent or legalguardian of legal {full namel , a minor childwho is living at home 2. Petitioner'sattorney's name, address, and telephone number is (Ifyou do not have an attorney, wnte "none ") SECTION II.RESPONDENT (Thissect n i about the person you want to be protec d from It must be ompleted ) 1 Respon nt currentlyli s at e folI ing a dress {oddr state, , city, and zip code} FamilySupreme Court Approved Law Form 12 980(f),Petition forInjunctionforProtectionAgainstRepeat Violence (03/15) FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022 NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022 Respondent's License is· Driver's number {tfknown} 2 Petitioner has known Respondent since {date} 3 Respondent's lastknown Iaceof employment p () Employment address. Working hours 4 Physicaldescription of Respondent Race C r ' Sex Male Female Date of Birth . , Height . Weight ÅsEydor Hair Color ) f f)7t/)t / / (p... Distinguishingmarks and/or scars Vehicle (make/model) Color f CA Tag Number 5 Other names Respondent goes by (aliasesor nicknames) 6. Respondent's attorney's name, address, and telephone number is: (ifyou do " not know whether Respondent has an attorney, wnte "unknown IfRespondent does not have an attorney, wnte "none ") SECTION Ill.CASE HISTORY AND REASON FOR SEEKING PETITION (Thissection must be completed ) 1 Has Petitioner ever received or tried to get an injunction for protection against domestic violence, repeat violence, dating violence, or sexualviolence against Respondent inthis or any other court? 2. Has Respondent ever received or tred to get an mjunction for otect on aga nst domest c violence, repeat violence, dating violence, or sexual violence against Petitioner m thisor any other court? Yes No If yes,what happened in thatcase? {tncludecase number, if known) 3. Descnbe any other court case that is eithergoing on now orthat happened in thepast between Petit® er and Respo dent (1 cludecps number, if known}. 4 espondent has directed at leasttwo incidentsof violence, aning assault,aggr ated assault, aggravated battery, sexual assault, sexual battery, stalking, aggravated stalking, battery, Suprerne Court Approved Law Form 12 980(f), for Petition InjunctionforProtectionAgainstRepeat V o ence Farnily (03/15) FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022 NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022 kidnapping, or false impnsonment, or any criminal offense inphysical ordeath resulting injury against Petitioner or a member of Petitioner'simmediate One of these two incidentsof family violence has occurred within 6 months of the date of of thispetition The most recent fibng incident (includingdate and locatio ) is desenbed below On {date} , at{locati r j Res ndent 40d / f Please indicate here f you areatt ingadd t onalpages ont nue these fa s. 5. Other prior incidents(incu ingdates and locat on) are described below On {date} te /L f Respo ent )...( C Please indicate here if youare attachingbdditional pages to continue these facts 6 Petitionergenuine fear peat violenc pondent Ex ain ( FamilySupreme Court Approved Law Form 12 980(f),PetitionforInjunctionforProtectionAgainstRepeat Violence (03/15) FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022 NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022 CONTINUATION PAGE # ALLEGATION(S) _3rd crh is c (frob /o CaÄ 0 A dam a& SEE ATTACHED FOR ADDITIONAL INFORMATION DO NOT WRITE ON BACK OF SHEET!!! FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022 NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022 Aa a cAa d C d as sa 22 06 he d6a c fe / fov , T TM A b4 y T d b ad d a DO NOT WRITE ON BACK OF SHEET!!! FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022 NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022 CONTINUATION PAGE # ALLEGATION(S) E ATTACHED FOR ADDITIONAL INFORMATION T DO NOT to WRITE ON BACK OF SHEET!!! FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022 NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022 CONTINUATION PAGE # ALLEGATION(S) M pm O's of0 /¤ 9 d c rN & DO NOT WRITE ON BACK OF SHEET!!! | FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022 NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022 CONTINUATION PAGE # ALLEGATION(S) [ ]SEE ATTACHED FOR ADDITIONAL INFORMATION DO NOT WRITE ON BACK OF SHEET!!! FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022 NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022 ALLE GA TION(S) [ ]SEE ATTACHED FOR ADDITIONAL INFORMATION DO NOT WRITE ON BACK OF SHEET!!! FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022 NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022 7 Additional information [Choose oilthat apply) a _Respondent owns, has, and/or is known to have guns or other weapons Descnbe weapon(s) b s orpnor acts of to· or epeat violence have been previously rep ed {p rson agency) SECTION IV. N UNCTIÒN (T is sectionmust be completed ) 1 toner asks the Court to enter a TEMPORARY INJUNCTION for protection against repeat violence that willbe in placefrom now untilthe scheduled heanng in thismatter 2 Petitioner asks the Court to enter, aftera hearing has been held on this petition,a final judgment of injunction prohibiting Respondent from committing any acts of violence against Petitionerand a prohibiting Respondent from going to orwithin 500 feet of any place Petitionerlives, b. prohibitmg Respondent from going to or withm 500 feet of Petitioner'splace(s) of employment or the school that Petitioner attends; the address of Petitioner's place(s) of employment and/or school is c. prohibitingRespondent from contacting Petitioner by telephone, mail, by e-mail, in wnting, through another person, or in any other manner, d ordenng Respondent not to use orpossess any guns or firearms, [Indica e allthatapply] e prohibiting Respondent from going to or within 500 feet of following place(s) P tition e mily to oft Supreme Court Approved Law Form 12 980(f),Petition forInjunctionforProtectionAgainstRepeat Violence Family (03/15) FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022 NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022 f prohibiting Respondent from knowingly and intentionally going to or within 100 feet of Pe tioner'smotor vehicle, and any other terms the Court deems necessary for the safety of Petitionerand Petitioner'simmediate family I UNDERSTAND THAT BY FILING THIS PETITION, I AM ASKING THE COURT TO HOLD A HEARING ON THIS PETITION, THAT BOTH THE RESPONDENT AND I WILL BE NOTIFIED OF THE HEARING, AND THAT I MUST APPEAR AT THE HEARING. I UNDERSTAND THAT IF EITHER RESPONDENT OR 1 FAllTO APPEAR AT THE FINAL HEARING, WE WILL BE BOUND BY THE TERMS OF ANY INJUNCTION OR ORDER ISSUED AT THAT HEARING. I UNDERSTAND THAT I AM SWEARING OR AFFlRMING UNDER OATH TO THE TRUTHFULNESS OF THE CLAIMS MADE IN THIS PETITION AND THAT THE PUNISHMENT FOR KNOWINGLY MAKING A FALSE STATEMENT INCLUDES FINES AND/OR IMPRISONMENT. Dated: Signature of Petitio Printed Name Address Ñ -- City,State,Zip vyr^ ²e CLA-- Telephone Number -7 7 ) Fax Number Designated E-Mail Address(es): STATE OF FLORI COUNTY OF Sworn to or affirmed and signed be re me on y0 4. ) 9 Jf A L r EPUTY C E CO)d {Prftópb]r stamp commissioned name of notary or Supreme Court Approved Law Form 12 980(f), for Petstion for injunction ProtectionAgainstRepeat Violence Family (03/15) FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022 NYSCEF DOC. NO. 23 RECEIVED NYSCEF: 12/16/2022 clerk) ersonally known Produced identification Type ofidentificationproduced FamilySupreme Court Approved Law Form 12 980(f), PetitionforInjunctionforProtectionAgainstRepeat Violence (03/15) FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022 INSTRDOC. # 113948872 Page 1 of Recorded 09/23/2016 at 08:43 AM NYSCEF NO. 23 2, RECEIVED NYSCEF: 12/16/2022 Broward Commission, Deputy Clerk ERECORD County **** 9/20/2016 2:56:36 PM.**** FILED: BROWARD COUNTY, FL Howard C. Fonnan, CLERK IN THE CIRCUIT COURT OF THE SEVENTEENTH JUDICIAL CIRCUIT, IN AND FOR BROWARD COUNTY, FLORIDA Case No : DVCE p Division {Á Petitioner, and /J on r / ondf . espondent ORDER OF DISMISSAL OF TEMPORARY INJUNCT ON FOR PROTECTION AGAINST ( ) DOMESTIC VIOLENCE ( EPEAT VIOLENCE ( ) DATING VIOLENCE ( ) SEXUAL VIOLENCE ( ) STALKING THIS CAUSE came before the Court on {date} ( , upon Petitioner's action for an injunction for against· protection domestic violence, repeat, dating, or sexual violence, or stalking. Based upon the following circumstances, the Court dismisses the Petition {Indicate allthat apply} a Petitioner failedto appear at the hearing scheduled inthis cause b. Petitioner appeared at the heanng but desires to voluntarily dismiss this action. c The evidence presented is insufficientunder Florida law (sections 741 30, 784 046, or 784.0485, Florida Statutes) to allow the Court to issue an injunction forprotection against domestic, repeat, dating, or sexual violence, or stalking Accordingly, the case is dismissed without prejudice DONE AND ORDERED in Ft Lauderdale, Browar ounty , FInda on c IRC J Flonda Supreme Court Approved Law Form 12 980(e), Order of Dismissalof Temporary injunctionfor Family Protection Against Domestic Violence,Repeat Violence, DatingViolence, Sexual Violence,or Stalking(03/15) FILED: NEW YORK COUNTY CLERK 12/16/2022 12:00 PM INDEX NO. 952002/2022 NYSCEF of 2 End of Document INSTR DOC.# NO. 23 11394887 2 Page 2 , RECEIVED NYSCEF: 12/16/2022 COPIES TO Shenff of Broward County Petitioner by U S. Mail by hand delivery in open court by e-mail to designated e-mail address(es) Respondent. I;pfU.S Mail by hand delivery in open court by e-mail to designated e-mail address(es) State's Attorney's Ofhce Other. I CERTIFY the foregoing is a truecopy of the onginal Order of Dismissal of Temporary injunction as it appears on filein the office of the Clerk of the Circuit Court of Broward County, Florida,and that I have fumashed copies of thisorder as indicated above CLERK OF THE CIRCUIT COURT (SEAL) By. AXJL JM {Dep Clerk or Judi atAssistant} Court Approved Law Form 12 980(e),Order of Dismissalof Temporary Injunction for FloridaSupreme Family Protection Against Domestic Viole-nce,Repeat Violence, Dating Violence,Sexual Violence, orStalking(03/15)