(b) The sworn petition shall be in substantially the following form:
PETITION FOR INJUNCTIONFOR PROTECTION AGAINST STALKING
Before me, the undersigned authority, personally appeared Petitioner (Name) , who has been sworn and says that the following statements are true:
1. Petitioner resides at:
(address)
(Petitioner may furnish the address to the court in a separate confidential filing if, for safety reasons, the petitioner requires the location of the current residence to be confidential.)
2. Respondent resides at:
(last known address)
3. Respondent's last known place of employment:
(name of business and address)
4. Physical description of respondent:
12. Distinguishing marks or scars:
13. Aliases of respondent:
(d) The petition must provide space for the petitioner to specifically allege that he or she is a victim of stalking because respondent has:
(Mark all sections that apply and describe in the spaces below the incidents of stalking specifying when and where they occurred, including, but not limited to, locations such as a home, school, or place of employment.)
Committed stalking.
Previously threatened, harassed, stalked, cyberstalked, or physically abused the petitioner.
Threatened to harm the petitioner or family members or individuals closely associated with the petitioner.
Intentionally injured or killed a family pet.
Used, or threatened to use, against the petitioner any weapons such as guns or knives.
A criminal history involving violence or the threat of violence, if known.
Another order of protection issued against him or her previously or from another jurisdiction, if known.
Destroyed personal property, including, but not limited to, telephones or other communication equipment, clothing, or other items belonging to the petitioner.
(e) The petitioner seeks an injunction:
(Mark appropriate section or sections.)
Immediately restraining the respondent from committing any acts of stalking.
Restraining the respondent from committing any acts of stalking.
Providing any terms the court deems necessary for the protection of a victim of stalking, including any injunctions or directives to law enforcement agencies.