Protection from Harassment Act, 2010 (Act No. 17 of 2010)RegulationsRegulations in terms of the Protection from Harassment Act 2011Annexure : Form 19 [Regulation 20(1)] |
FINAL PROTECTION ORDER
SECTION 9(1), AND (4) AND (6) OF THE PROTECTION FROM HARASSMENT ACT, 2011 (ACT NO. 17 OF 2011)
(*Delete whichever is not applicable)
Take note: In terms of section 10(4) of the Protection from Harassment Act, 2011, the physical, home and work address of the complainant or related person must be omitted from the protection order (including any reference to such an address in documents annexed to the protection order), unless the nature of the terms of the order necessitates the inclusion of the address.
IN THE MAGISTRATE'S COURT FOR THE DISTRICT OF ................................................................................................................................................
HELD AT .......................................................................................................................................................... APPLICATION NO............./..............
In the matter between:
....................................................................................................................................................................................................... (Complainant)
AND .........................................................................................................................................................................................................(Respondent) |
1. PARTICULARS OF RESPONDENT |
Name and surname: ...................................................................................................................................................................................................
Address: ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Contact number (telephone number/cellular phone number/facsimile number/e-mail address (whichever is available)): ..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
2. PARTICULARS OF APPLICATION |
The complainant applied for a protection order against the respondent in terms of the Protection from Harassment Act, 2011 (Act No. 17 of 2011). This court, after considering the application, issued an interim protection order against the respondent on ...................... (date).
3. PARTICULARS OF FINAL PROTECTION ORDER |
In terms of the protection order:
3.1 The respondent is prohibited by this court from -
(a) engaging in or attempting to engage in the harassment of -
*(i) | the complainant; |
*(ii) | the following related person/s: |
➢ | ............................................................................................................................................................................................................................... |
➢ | ............................................................................................................................................................................................................................... |
➢ | ............................................................................................................................................................................................................................... |
➢ | ............................................................................................................................................................................................................................... |
➢ | ............................................................................................................................................................................................................................... |
*(b) enlisting the help of another person to engage in the harassment of the complainant and/or above related person/s; and/or
*(c) committing any of the following act/s:
(i) | ................................................................................................................................................................................................................................. |
(ii) | .................................................................................................................................................................................................................................. |
(iii) | ................................................................................................................................................................................................................................... |
*3.2 The court imposes the following additional conditions that are necessary to protect and to provide for the safety and well-being of the complainant or related person/s:
(a) .........................................................................................................................................................................................................................
(b) .........................................................................................................................................................................................................................
(c) .........................................................................................................................................................................................................................
*3.3 The court orders:
*(a) |
That a member of the South African Police Service is to seize the following weapon(s) .............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................. |
*(b) |
That a member of the South African Police Service is to accompany the complainant or related person to the following residence: ............................................................................................................................................................................................................................................................................................................................................................................................................., to supervise the collection of the complainant's or related person's personal property set out in paragraph 8 of the application for a protection order, and such member is authorised to take all reasonable steps to effect the collection of the said property. |
4. In terms of sections 9(6) and 15(a) of the Protection from Harassment Act, 2011,.................................................................... (name and surname), who is a *clerk of the court/*sheriff/ *peace officer, is hereby directed to serve—
(a) the original of this protection order on the respondent; and
(b) a certified copy of this order and the original warrant of arrest on the complainant,
in accordance with regulation 28 of the Protection from Harassment Regulations, 2013.
5. This protection order expires on .................................................................... (date).
______________________________________________ |
____________________________________ |
MAGISTRATE |
DATE |
Office stamp |
TAKE NOTE: (a) A warrant of arrest has been authorised for the arrest of the respondent, the execution of which is suspended subject to the respondent's compliance with any specified prohibition, condition, obligation or order contained in this protection order. (b) A respondent who contravenes any specified prohibition, condition, obligation or order contained in the protection order is in terms of section 18(1)(a) of the Protection from Harassment Act, 2011, guilty of an offence and liable on conviction to a fine or imprisonment for a period not exceeding five years. |
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