• JUSTICE / MUNICIPAL CIVIL COURT COVER SHEET

  • I. Party Information (provide both home and mailing addresses if different)

  • Plaintiff(s) name/address/phone
    Name:   
             
    Address:      
    Phone:      
    E-mail Address:      

    Plaintiff(s) Attorney name/address/phone
    Name:      
    Address:      
    Phone:      
    Law Firm/Bar #:      
    E-mail Address:      

  • Defendant(s) name/address/phone:
    Name:
                
    Address:      
    Phone:      
    E-mail Address:      

    Defendant(s) Attorney name/address/phone:
    Name:      
    Address:      
    Phone:      
    Law Firm/Bar #:      
    E-mail Address:      

  • II. Nature of Controversy (please select the one most applicable filing type below)

    Civil Case Filing Types

  • Date:   Pick a Date   
    Signature of initiating party or representative:      

  • Civil Case Filing Types - Definitions:

  • Landlord/Tenant (Summary Eviction): A case for exclusion of a tenant for default of rent or other deficiency following as in NRS 40.253 and 40.254. These are eviction cases where a landlord cannot get a money judgment.
  • Unlawful Detainer Complaint (Writs of Restitution): A case involving a formal complaint alleging the occupant's right to possess a property has been terminated after the foreclosure or sale of a property. This category includes evictions of commercial tenants on any basis other than nonpayment of rent.
  • Other Real Property: A case involving disputes of real property that does not fit within the definitions of Landlord/Tenant or Unlawful Detainer Complaint.
  • Credit Card Collection: A debt collection case where the petitioner is a credit card company.
  • Payday Loan Collection: A debt collection case where the petitioner is a payday loan company.
  • Debt Collection Agency: A debt collection case where the petitioner is a debt collection agency.
  • Other Debt Collection: A debt collection case that does not fit within the definitions of any other debt collection case category. This category includes tax collection cases.
  • Contract Buyer Plaintiff: A contract case (expressed or implied) involving a buyer of goods or services alleging that a seller of goods or services has failed to either deliver said goods or services or honor a warranty.
  • Other Contract Case: A contract case (expressed or implied) that does not fit within the definitions of a Contract Buyer Plaintiff case.
  • Auto: A negligence case resulting from personal injury, property damage, or wrongful death arising out of a party's alleged negligent operation of a motor vehicle.
  • Premises Liability: A negligence case involving liability resulting from alleged negligence on property that results in damages or injuries to persons or property occupying said property.
  • Other Negligence: A negligence case that does not fit within the definitions of Auto negligence or Premises Liability.
  • Intentional Misconduct: A case involving issues of an alleged intentional misconduct. Examples include assault, battery, fraud, punitive damages, defamation, libel, and slander.
  • Other Torts: A case that does not fit within the definitions of any other negligence case type or Intentional Misconduct.
  • Contested Liens Case: A case that contests the validity of liens, or requests the enforcement of liens. Examples include the enforcement of mechanics' liens (NRS 108.239) and liens of owners of storage facilities, or to contest the validity of liens on mobile and manufactured homes.
  • District Court Order to Seal Records: An order from the District Court to the Justice or Municipal Court which directs the Justice or Municipal Court to seal their records. Original Petitions to Seal Records should be counted as "Other Civil Matters."
  • Petition to Seal Records: A case that involves a request to seal records of a previous court case or other matters under the courts jurisdiction. Orders by the district courts to seal records should selec the District Court Order to Seal Records case type instead.
  • Other Civil Matters: A case that involves a matter that does not fit within the definitions of any other civil case category. This includes "Confessions of Judgment" and Petitions to Seal Records.
  • Request for Domestic Violence Protective Order: A protection order application for a temporary order for protection from a person who has committed or may commit an act of domestic violence (including battery). (Refer to NRS 33.020, 33.030, 33.080, 33.100, and 200.481.)
  • Request for Protection Order (Non-Domestic Violence): A protection order application for a temporary order for protection from a person who has or may commit an act of harassment, stalking, or threat to life not related to domestic violence or sexual assault.
  • Sexual Assault Protection Orders: A protection order application for an order for protection against a person who has or may commit an act related to sexual assault. (Refer to NRS 193.166 and 200.378).
  • Requests for Extended Domestic Violence Protective Orders: A protection order case involving a request for an extended order for protection against domestic violence (including battery). (Refer to NRS 33.020, 33.030, 33.080, 33.100, and 200.481.)
  • Requests for Extended Protective Orders (Non- Domestic Violence): A protection order case involving a request for an extended order for protection against harassment, stalking, or threat to life not related to domestic violence.

  • Nevada AOC - Research and Statistics

    Pursuant to JCRCP 3

    Ver. 3.1

  • APPLICATION FOR PROTECTION

  • IN THE JUSTICE COURT OF THE SPARKS TOWNSHIP
    COUNTY OF WASHOE, STATE OF NEVADA

  • Employer (print the name of the workplace or employer),

                         

  • vs.

  • Adverse Party (print the name of the person you want protection from).

                                       

  • 1. Your information ( you are the "Applicant").

    Your name:   
                       

  • 3. Who do you want to be protected from (this person is the "Adverse Party"):

    Name:   
                            

    Address (if known):
             

  • 4. Are there any other court cases that involve you and the Adverse Party?

       
      List the case type, county, state, and case number if you know:
        

  • ©2020 Nevada Supreme Court

    Application for Temporary Order for Protection Against
    Harassment in the Workplace

    Page 1 of 6

  • 5. Most Recent Threat/Harassment.

    Think about the most recent threat or harassment. These questions ask about the most recent incident only. 

  • Approximate date it happened:   Pick a Date   

    City/State/Location where it happened:
       

  • Did the other person use or threaten to use a weapon? (a weapon can be a gun, a knife, or any object, that is used to cause or threaten physical harm)?


       (describe what kind of weapon was used or threatened)
       

  • Did the police come?
        

    Was anyone arrested?
          
     (who?)

    Is the adverse party in jail?
                      

  • ©2020 Nevada Supreme Court

    Application for Temporary Order for Protection Against
    Harassment in the Workplace

    Page 2 of 6

  • 6. Past Threats/Harassment.

    Think about any other times the person you want protection from threatened or harassed you and/or other employees. The following questions ask about any past incidents that may have happened. 

  • Have there been threats of violence in the past?
    (skip to the next page)
     (complete the sections on this page)  

  • Attach more pages if you need more room (3a, 3b, 3c).

    ©2020 Nevada Supreme Court

    Application for Temporary Order for Protection Against
    Harassment in the Workplace

    Page 3 of 6

  • 7. Locations that need protecting.

     The workplace where protection is needed is primarily located at the following address.

    Employer/Location Name:      
    Address:      
    City, State, Zip Code:      
    County:      

     List the specific locations that employees might need protection, such as other branches of the workplace or places where employees perform their duties:
         
    Location Name:      
    Address:      
    City, Sate, Zip Code:    
    County:       

    Location Name:      
    Address:      
    City, State, Zip Code:      
    County:      

  •  The Adverse Party should stay away from the following places.
     
    Location Name:      
    Why?      
    Address:      
    City, State, Zip Code:     
    County:         

    Location:      
    Why?      
    Address:      
    City, State, Zip Code:      
    County:      

  • 8. Have you given the adverse party notice that you are filing this? (check one and answer the questions that follow).

     On the following date,Pick a Date, I gave notice (check one or more): 
         
       
       
       
      
             

     In order for the judge to grant this without notice, you have to show that giving notice might cause irreparable, loss, or damage to the employer or employees. Explain why you should be allowed to skip the notice step.     
       

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  • ©2020 Nevada Supreme Court

    Application for Temporary Order for Protection Against
    Harassment in the Workplace

    Page 4 of 6

  • 9. Firearms/Guns. Does the adverse party own a gun or have a gun in his/her possession or control?

                

  • 10. Other Information: Is there anything else you want the judge to know? Any other conditions you are asking for?

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  • 11. Exhibits: You may attach documents, pictures, or anything else that you would like the judge to look at and consider when reviewing your application. Note: the adverse party will be able to see all the exhibits you attach. What exhibits are you attaching?
       

  • 12. Protections Requested. I request that an Order for Protection Against Harassment in the Workplace be issued against the Adverse Party so that the Adverse Party will be prohibited from contacting, intimidating, threatening, or otherwise interfering with the employer’s business and/or its employees and/or any person present at the workplace, and that the Adverse Party will be ordered to stay away from the employer’s workplace. I also request that the Court prohibit the Adverse Party from violating this Order via e-mail, correspondence, telephone, or by an agent.

  • ©2020 Nevada Supreme Court

    Application for Temporary Order for Protection Against
    Harassment in the Workplace

    Page 5 of 6

  • 13. Length of Protection Order.

    This is a 15-day order, do you need an extended order?
       
       If yes, you need to apply before the end of the 15th day.

  • This document does not contain the personal information of any person as defined by NRS 603A.040.

  • I declare under penalty of perjury under the law of the State of Nevada that the foregoing is true and correct.

    Date:   Pick a Date   
    Submitted by:         
    Print Name:      

  • VERIFICATION

    I declare that I am the applicant in the above-entitled action; that I have read the foregoing application and know the contents thereof; that the pleading is true of my own knowledge, except for those matters therein contained stated upon information and belief, and that as to those matters, I believe them to be true.

    I declare under penalty of perjury under the law of the State of Nevada that the foregoing is true and correct. 

  • Submitted by:      
    Print Name:      

    Attorney/Authorized Agent Information:
    Name:     
    Address:      
    City, State, Zip Code:      
    County:      
    Telephone Number:      
    Email Address:      

  • ©2020 Nevada Supreme Court

    Application for Temporary Order for Protection Against
    Harassment in the Workplace

    Page 6 of 6

  • WASHOE COUNTY SHERIFF'S OFFICE

    CIVIL SECTION

    INSTRUCTIONS FOR SERVICE

    PLEASE FILL OUT COMPLETELY

  • Name of Person Being Served

    Name:    
                      

  •       

  • Last Known Address

    Street:      
    City:      
    State:      
    Zip:      

    Phone(s) w/Area Code
          

    Need Interpreter?         
    Language:      

    Employer Name
       

    Employer Address
    Street:      
    City:      
    State:      
    Zip:      

    Work
    Hours:      
    Phone:               

    Vehicle License Number:      
    Vehicle Make and Model:      
    Vehicle Color:      
    Vehicle Year:      
    Driver's License Number:      
    State:      

  • Does the restrained person have a disability, brain injury, or impairment requiring special assistance when law enforcement serves the order?
       
    If yes, describe:         

  • Location of Weapons:
       

       
    Describe in detail:         

  • Plaintiff/Applicant Information

    Name:   
                      

  •       

  • If your information is not confidential, you must enter your address and phone number(s)

    Current Address
    Street:      
    City:      
    State:      
    Zip:      

    Phone(s) w/Area Code
          

    Need Interpreter?        
    Language:      

    If your information is confidential, you must provide the name, address, and phone number of someone willing to be your "contact".

    Contact Name:   

    Contact Address
    Street:      
    City:      
    State:      
    Zip:      

    Contact Phone:
          

  • CONFIDENTIAL PROTECTION ORDER INFORMATION

    Law Enforcement: Do not serve this sheet with documents to be delivered.

    Applicant: Print clearly all the information you know. This helps law enforcement locate and serve the Adverse Party. 

  • YOUR INFORMATION

  • Your Name (OBO Minor Child):

    Name:  
                      

  •             

  • Birthdate
    //   

    Social Security Number

    --   

    Race:      

    Address:                  

    Mailing Address (if different):      

    Home Phone:      
    Cell Phone:      
    Work Phone:      

    Email Address:      
    I prefer to be notified of future Court dates by         

  • ADVERSE PARTY INFORMATION

  • Adverse Party Name

    Name:  
                     

  •             

  • Birthdate:
    //         

    Social Security Number
    --         

  • Home Address:   

    Is this address difficult to find?
              Explain:        

    Mailing Address (if different):      

    Other Likely Address:      

    Home Phone:   
    Cell Phone:      
    Work Phone:      

    Employer:      
    Position:      
    Work Days:      
    Work Hours:      
    Work Address:      

    Scars/Marks/Tattoos (description and location):      

    Vehicle Make:      
    Model:      
    Year:      
    License Plate Number/State:      

  • Do you live with the Adverse Party now?
          

    Have you ever lived with Adverse Party?
             

    Does the Adverse Party speak English?
          What language does he/she speak?      

    Do you work for the same employer?
          

    Is the Adverse Party likely to act violently when served?
          

    Is the Adverse Party likely to avoid service?
          

    Does the Adverse Party have a CCW Permit?
          

    Does the Adverse Party have access to weapons?
          If yes, please describe type and location of weapon(s):
       

    Does the Adverse Party have a history of violent behavior or crimes?
          If yes, explain:      

  •  
  • Should be Empty: