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Reviewed July 2023

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Produced by Massachusetts Law Reform Institute
Reviewed April 2021

Asking for a 209A restraining order

mass access forms icon Fill out a 209A application on your phone or computer. Answer questions and get all the forms you need that you can email to yourself, an advocate, save as part of your safety plan, send to the court.

Or get the paper forms

209A Restraining Order Application (5 forms)

  1. Complaint for Protection from Abuse (G.L. c. 209A) Page 1
  2. Complaint for Protection from Abuse (G.L. c. 209A) Page 2 (only required if you have minor children)
  3. Affidavit
  4. Plaintiff Confidential Information Form
  5. Defendant Information Form
  • Page 1 is the Instructions to the Plaintiff. You are the "plaintiff." This form tells you how to fill out the other form.
  • Page 2 is the Complaint. It has checkboxes and spaces for you to fill in with names and basic information about you, your relationship to the defendant, and what you are asking the court to order.
  • Page 3 is the 2nd page of the Complaint. Use this form if you have children under age 18. You use this form to ask for orders about custody, contact with your children, visitation, or child support.
  • Page 4 is the Affidavit. When you sign the Affidavit, you swear that what you said in the affidavit and the Complaint is true to the best of your knowledge. See Writing your 209A Affidavit
  1. Tell the judge what happened and why you need a 209A order.
  2. Write down exactly what happened. Do the best you can. Write down the things the abusive person said or did like, "They told me they would get their gun and shoot me."
  3. Start with the most recent incident.
  4. Include information about injuries, if children were present or hurt, police involvement, medical treatment, other help you got, or destruction of property
  • Page 5 is the Plaintiff Confidential Information Form. Write your name, home address, home telephone number, workplace name, address, telephone number, and school. This information is confidential. The defendant, the defendant’s attorney, and the public are not allowed to see it. Only certain authorized persons who ask for this information can see it. But first they must file a Request for Access to Confidential Information form.
  • Page 6 is Defendant Information Form. The court gives this information to the police so they can find the defendant to deliver the order. Include any information that will help the police find the defendant
  • Affidavit Disclosing Care or Custody Proceeding Involving a Child This form asks about other family court cases that involve your child. The form tells the court if there are already any court orders about your child. It also tells the court if you are asking the judge to make decisions about your child in the 209A order judge. See sample Affidavit Disclosing Care or Custody Proceedings.

See a Sample 209A Abuse Prevention Order. If the order is granted, the court will type up your order on this form. It is signed by a judge.

Other forms you may also need in a 209A restraining order case

pdf icon Plaintiff’s Affidavit in Support of Request for Child Support Order

You can ask the court to order the defendant to pay child support. This form allows you to fill out basic information about both parents' expenses and income to ask for child support. See a sample Plaintiff's Affidavit in Support of Request for a Child Support Order.

PDF icon 209A Affidavit Seeking Child Support

PDF icon Defendant's Affidavit in Connection with Request for a Child Support Order: This form is for the defendant to fill out basic information about their work, income and expenses, if the plaintiff asks for child support. See a sample Defendant's Affidavit in Connection with Request for a Child Support Order.

pdf icon Motion for Impoundment
Use this form to ask the court to keep any information in your application a secret from the defendant, the defendant's lawyer, prosecutor, and court staff. You must explain on the form why it is important to keep this information confidential. Your reasons to keep this information confidential must be more than simply to protect your privacy. The reasons must show that you need the court to keep the information confidential so nobody can use it to harm you.

PDF icon Request for Access to Plaintiff Confidential Information Form: Only certain kinds of people like a prosecutor or a domestic violence counselor can use this form to ask to see the plaintiff's confidential information. See a sample Request for Access to Plaintiff's Confidential Information.

pdf icon Translation of Affidavit Use this form if you file an affidavit that is not written in English. The person who translates your affidavit writes the English translation on this form. The translator also signs and prints their name at the bottom of the page, where it says, in English “I have provided a written translation into English, complete and accurate to the best of my ability.”

pdf icon Petition Filed Pursuant to G.L. c. 209A, § 11 Relative To Domesticated Animal(s) Use this form if your pets need protection from abuse.

PDF icon Plaintiff's Motion to Modify or Terminate Abuse Prevention Order Fill out this form to change or end an abuse prevention order. Also see How do I change or end my 209A Restraining Order?

PDF icon Defendant's Motion to Modify or Terminate Abuse Prevention Order Fill out this form if you are a defendant and you need to change or end an abuse prevention order. 

PDF icon Affidavit for Filing Out-of-State Protective Order Use this form to get your protective order from outside Massachusetts enforced in Massachusetts. Also see Protective Orders from Another State.

PDF icon Sample 209A Complaint form seeking protection at school

PDF icon Sample 209A Order providing protection at school

Reviewed July 2023

Child Support

PDF icon Child Support Guidelines

PDF icon Child Support Guidelines Worksheet

PDF icon Child Support Guidelines Chart

PDF icon Joint Petition/Motion to Change a Judgment/Temporary Order
 

Samples

PDF icon Complaint for Modification - Child Support - sample This is a copy of the Probate and Family Court Complaint for Modification Form. It has been filled out for an increase in child support case.

PDF icon Complaint for Contempt - Child Support - sample This is a copy of the Probate and Family Court Complaint for Contempt Form. It has been filled out for a non-payment of child support case.

PDF icon Motion for Temporary Support and Proposed Order - sample This sample shows how you might fill in the Probate and Family Court's Motion Form and a Proposed Order Form. This one asks the court to order a parent to pay temporary child support, provide health care coverage, and pay 50% of their children's uninsured medical and dental expenses.

Department of Revenue Child Support Enforcement

Department of Revenue Child Support Enforcement Application for Services
You can apply for DOR/CSE services online, or get a paper application from their website.

PDF icon Offer in Settlement Application Use this form to ask DOR/CSE to accept less child support than you owe.

PDF icon Request for Equitable Adjustment Application Use this form to ask DOR/CSE to adjust the amount of past due child support they say you owe.

Samples

PDF icon Failure to Pay Child Support May Result in License Suspension Notice An example of the warning notice you might get from Child Support Enforcement if you do not pay the child support you owe.

PDF icon Notice to Suspend An example of the notice DOR/CSE sends to a licensing agency if you do not pay your child support. The notice tells the agency you have not paid child support and the agency must take away your license.

PDF icon Final Determination of Delinquency An example of the notice Child Support Enforcement sends you after they have told the licensing agency to take away your license.

Reviewed July 2023

Court Fees

Affidavit of Indigency Affidavit of Indigency If you cannot afford court fees and costs, ask the court to have the state pay them.

Affidavit of Indigency Supplement to Affidavit of Indigency

Affidavit of Indigency Sample Affidavit of Indigency to see how you might fill out an Affidavit of Indigency if you need to complete the Supplement.

Reviewed July 2023

Divorce, Separation & Annulment

PDF icon Certification Vital Statistics Divorce or Annulment Statistical Form to be filed with all Complaints for Divorce or Annulment.

Annulment

PDF icon Complaint for Annulment

Divorce

PDF icon Complaint for Divorce

PDF icon Joint Petition for Divorce under G.L. c.208, Section 1A Use when both spouses want a divorce claiming irretrievable breakdown of the marriage.

PDF icon Complaint for Divorce under G.L. c.208, Section 1B Use when one spouse wants a divorce claiming irretrievable breakdown of the marriage.

PDF icon Court Order for Attorney Fee

PDF icon Defendant's Motion for Attorney Fee

PDF icon Plaintiff's Motion for Attorney Fee

Divorce Samples

Word icon Divorce answer - sample

PDF icon Complaint for Divorce - sample This form of complaint is used for "fault" divorces where the parties do not file a joint petition.

PDF icon Complaint for 1B Divorce (Irretrievable Breakdown) - Sample This form of complaint is used for for "no fault" divorces ("1B" divorces) where the parties do not file a joint petition.

PDF icon Joint Petition for Divorce - sample This court form is used when both spouses participate in seeking a joint "no fault" divorce, called a "1A" divorce. They also file a notarized separation agreement and a sworn affidavit that the marriage has irretrievably broken down.

Separation

PDF icon Complaint for Separate Support if you want to stay married and you need a custody order, and support or health insurance for your child, and/or support or health insurance for yourself.

PDF icon Complaint for Support of Spouse or Child

PDF icon Complaint for Support - Custody - Parenting Time where the parents are not married to each other.

Support

Support Samples

PDF icon Complaint for Support - sample If you are married you can use this form of complaint to seek a suitable amount of support for yourself and the children, as well as health insurance benefits.

PDF icon Complaint for Separate Support - sample This form of complaint has provisions for establishing that you are living apart from your spouse for justifiable cause and for custody and support.

PDF icon Complaint for Support - Custody - Parenting Time - Sample where the parents are not married to each other

Reviewed July 2023

Financial Statements

See How to Fill Out a Financial Statement

PDF icon Financial Statement short form

PDF icon Financial Statement Schedule A

PDF icon Financial Statement Schedule B

PDF icon Request for Financial Statement

Samples

PDF icon  Financial Statement sample This is the Probate and Family Court's Financial Statement Form. It is filled out for a parent with custody of two children. The other parent would have to fill out a form, too.

PDF icon Request Financial Statement sample

This is a Request for a Financial Statement Form, with an accompanying letter. You can type up your own identical form with your own Certificate of Service, and mail it to the other parent with a blank Financial Statement Form. 

Both parties in Probate and Family Court cases that deals with financial issues are required to give their financial statement to other party within 45 days of service of the summons. If a hearing is scheduled before the 45 days passes, the parties must exchange financial forms two days before the hearing. File a copy of the financial statement with the court. 

PDF icon Motion to Compel Financial Statement and Proposed Order - sample  This is an example of a Motion you can file to ask the Court to make the other party file a financial statement if you are having difficulty getting them to do so. You must also file a Proposed Order; an example is included.

Reviewed July 2023

Guardianship

Financial

PDF icon Fiduciary Bond

Medical and Educational Decisions

PDF icon Caregiver education and health care authorization affidavit also called Caregiver Authorization Affidavit

Word icon Temporary Agent Appointment also called Temporary Agent Affidavit

Parents' Right to a Lawyer

PDF icon Application for Appointment OF Counsel For Parent of Minor Child Guardianship of Minor For parents to ask for a court-appointed lawyer in guardianship cases.

Removing a Guardian

PDF icon Petition for Removal of Guardian of Minor

PDF icon Sample Petition for Removal of Guardian of Minor Look at this form to see how Susan Smith asks the court to end the guardianship of her daughter, Sarah. On the form she asks the court to return Sarah to her and she shows on her petition that her case has "merit."

Changing a Guardianship

PDF icon General Probate Petition

PDF icon Sample General Probate Petition Look at this form to see how Goodluck Fisherman asks the court to change the guardianship of his daughter, Martha. On the form he asks the court to allow Martha to spend weekends with him and he shows on his petition that his case has "merit."

See more Guardian of a Minor court forms on the Trial Court's website.

Reviewed July 2023

Probate and Family Court

Complaint, Petition, and Motion Forms

You can find most Probate and Family Court forms on the Probate and Family Court website.

You can find

  • forms,
  • instructions for how to complete each form, and
  • instructions for filing the forms.

PDF icon blank Motion form. You can use this form when you need to file a motion.

Word.doc icon blank Affidavit form. Use this form to state the facts the judge needs to know about what happened and when. In an affidavit you swear that everything you say is true.

PDF icon blank Proposed Order form.  Use this form to tell the court exactly what you want it to order.

PDF icon sample Proposed Order. See how you might use a blank Proposed Order form.

PDF icon Complaint for Contempt

PDF icon Complaint for Modification

PDF icon Sample Contempt Summons

PDF icon Sample Domestic Relations Summons

PDF icon Sample Divorce / Separate Support Summons

Motion for an Investigation performed by: Probation Officer, GAL Investigator, or a GAL Evaluator

PDF icon Motion for an Investigation performed by: Probation Officer, GAL Investigator, or a GAL Evaluator

Opposition to a Request for Investigation

PDF iconOpposition of a Request for Investigation

Service of Process by Publication and Mailing

PDF icon Motion for Alternate Service and Affidavit in Support in one file fillable - neither on court website (2020-08-31)

Sample Service of Process forms

PDF icon cjd400 Motion for Alternate Service + Affidavit - samples (2020-08-26)

PDF icon Motion for Alternate Service fillable - not on court website (2020-08-26)

PDF icon cjd 400 Motion for Alternate Service - sample (2020-08-26)

PDF icon Affidavit in Support of cjd400 Motion for Alternate Service not on court website (2020-08-27)

PDF icon Affidavit in Support of Motion for Alternate Service - sample (2020-08-26)

PDF icon cjd31 Motion for Alternate Service and Affidavit of Diligent Search - sample (2020-08-27)

PDF icon Sample Order for Service by Publication and Mailing

PDF icon Sample Summons by Publication and Mailing - divorce

PDF icon Sample Summons by Publication and Mailing - separate support

PDF icon Sample Track Assignment Notice

Reviewed July 2023

Subpoenas

See Subpoenas

A subpoena is a letter that tells a person they must:

  • come to court and testify or
  • deliver written evidence to a court or other legal proceeding.

A subpoena must be notarized.

PDF iconSubpoena for witness to testify and bring records. Fill out and bring it to a notary to sign. It will be an official subpoena once it is notarized. The affidavit of service is a certification that tells the court the subpoena has been properly served.

PDF iconSubpoena to bring records to court. Fill out and bring it to a notary to sign. It will be an official subpoena once it is notarized. The affidavit of service is a certification that tells the court the subpoena has been properly served.

PDF icon Sample Subpoena to Testify and Bring Written Evidence to Court - Family/Friend. In this sample the subpoena is for a family member or a friend to attend a court hearing to testify.

PDF iconSample Subpoena to Testify and Bring Written Evidence to Court - Social Worker. In this sample the subpoena is for a social worker to attend a court hearing to testify.

PDF icon Sample Subpoena to Bring Records to Court - Government Agency. In this sample the subpoena is for official records from a government agency.

PDF icon Sample Subpoena to Bring Records to Court - Business. In this sample the subpoena is for payroll records from a business.

 

Visitation

PDF icon Complaint for Modification and Answer - Visitation - sample  These are samples of a Probate and Family Court Complaint for Modification form and an Answer to a Complaint for Modification.

PDF icon Complaint for Contempt - Visitation - samples  These are samples of a Probate and Family Court Complaint for Contempt form and an Answer to a Complaint for Contempt.

PDF icon Motion for Visitation - sample forms Here are several samples of forms that are used in motions for visitation: A Motion for Specific Visitation Schedule and a Proposed Order (filled out for a case in which a parent wants the court to issue a very specific visitation with a third party to pick up and drop off). A Supplemental Order - Visitation Issues (an example of a Probate and Family Court form which can be used to propose a specific visitation order for the judge to approve. It give an idea of the options the judge has in ordering visitation. The form may look different from court to court). Agreement of Parties and Temporary Order (an example of a Probate and Family Court form that can be used for writing up an agreement on visitation and other issues. The agreement becomes a temporary order of the court. This form may look different from court to court.).

PDF icon A Motion for Specific Visitation Schedule and a Proposed Order filled out for a case in which a parent wants the court to issue a very specific visitation with a third party to pick up and drop off.

PDF icon A Supplemental Order - Visitation Issues- sample is an example of a Probate and Family Court form which can be used to propose a specific visitation order for the judge to approve. It gives an idea of the options the judge has in ordering visitation. The form may look different from court to court).

PDF icon Agreement of Parties and Temporary Order - sample forms is an example of a Probate and Family Court forms that can be used for writing up an agreement on visitation and other issues. The agreement becomes a temporary order of the court. This form may look different from court to court.

PDF icon Motion to Suspend Visitation - sample This is an example of a motion you would file if you needed to stop visitation. You must also file a Proposed Order, and a sample is included.

Supervised Visitation

Word icon Motion for Visitation at a Supervised Visitation Center

Word icon Motion for Visitation Supervised by an Individual

Word icon Proposed Order for Visitation Supervised by an Individual

Word icon Affidavit in Support of Motion for Supervised Visitation

Reviewed July 2023

Motion to Impound

If you need the court to keep information private so you can be safe, you can ask the judge to “impound” it. See Protecting your information in Probate and Family Court

Note: Courts use a special form for impounding information in 209A Restraining Order and 258E Harassment Protection Order cases. See Protecting my Information in 209A and 258E cases

Motion to keep addresses private from the other side in your case

Blank Fillable Motion to Impound Address from Other Party in Probate and Family Court, Proposed Order, and Affidavit

Sample Motion to Impound Contact Information In this sample the wife has moved to a new address that her husband does not know. She files a Motion to Impound her address in her divorce case.

Motion to keep sensitive information from the public

Blank Fillable Motion to Impound Documents and Information from Public and Court Staff

Sample Motion to Impound Sensitive Information. In this sample, a parent files a Motion to Impound because they wants to keep documents about their health history out of the public file.

Sample Motion to Impound Sensitive Information Entire File. In this sample the case involves the sexual abuse of a minor child. One parent filed a Motion to Impound the Entire File because it would be harmful to the child if any of the documents were available to the public.

Produced by Massachusetts Law Reform Institute
Reviewed August 2010

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