If you feel you need a Personal Protection Order against a significant other, former significant other, or individual you have lived with at some point, go the County Clerk’s Office and ask for a PPO Form.
When filling out Form CC 375 “Petition for Personal Protection Order (Domestic Relationship)” you will need to fill out items A through I.
Box A: Your name and information go in the box labeled “Petitioner.” If you do not want the other person knowing your address or telephone number, you may use the address and telephone number of a friend or relative. This information will be how the court contacts you.
The information of the person you want restrained goes in the box labeled “Respondent.”
Box B: Check the box which most accurately describes your relationship with the person you want restrained.
Box C: If the person you want restrained is required to carry a gun for work check the corresponding box. If you are unsure, check the box labeled “Unknown.” If you know that they are not required to carry a gun for work, you may leave this section blank.
Box D: Check with the court to see whether there is any pending action between you and the respondent. This includes pending: divorces, paternity, child support, other PPOs, etc. If you find that there are pending actions you must check the box labeled “are” and fill out in the “Case number,” “court, county, and state,” and “Name of judge” boxes.
Check with the court to see whether there are any court orders or judgments in place involving you and the respondent. These include: divorces, parenting time orders, custody orders, and other PPOs already in place. If you find that these exist check the box next to “are” and fill in the case number, name of court, etc.
Box E: This is the most important part of the PPO application. On a separate piece of paper, explain what instances have caused you to file for a Personal Protection Order. To get a PPO, you will have to demonstrate that there are multiple instances of harassment or stalking behaviors and that the instances are recent. Be as specific as possible in your descriptions and include as many details as possible, including dates and location where the incidents took place and whether you called the police after each incident.
When writing, ensure that each instance is broken into its own section or paragraph and these sections are ordered chronologically to make the writing clear and easy to follow for the judge. You can attach “Exhibits” to your PPO Petition, including photographs, text messages, police reports, and anything else you feel is relevant to your request.
Box F: Check all the boxes that you need. Box “b” may be checked if you wish to have the respondent barred from entering a place other than your home (e.g. your work or school) Box “e” may be checked only if there has been more than one instance of harassment. Box “l” is generally filled out to keep the respondent from having access to records that they would normally have access to like school records.
Box G: Check this box. Requesting an ex parte order allows the PPO to go into effect without first having a hearing.
Box H: Check this box if you are under 18 years old. If you are under 18 you must have an adult help you file and sign the form.
Box I: Sign the form and fill in the date then give the form to the clerk who will fill in the rest and give you copies. Then move on to Form CC 376.
When filling out Form CC 376 “Personal Protection Order (Domestic Relationship)” you will need to fill out items A through D.
Box A: Check the box next to “Ex Parte.” This indicates you would like the PPO granted without a hearing.
Box B: Put the Case Number from Form CC 375 in this box.
Box C: Your information (Name, contact address, and contact telephone number) goes in this box.
Box D: The information of the person against whom you are requesting the PPO goes in this box. Fill it out to the best of your ability and make sure the boxes with asterisks (*) are filled out.
Once you have successfully filled out both CC375 and CC376, bring both forms to the County Clerk’s Office. Once the judge has reviewed your petition, the Clerk will contact you to let you know whether the Petition was granted and to give you instructions on how to proceed.
If you need assistance filling out any part of your PPO Petition, an advocate at the Diane Peppler Resource Center will be glad to work with you.
If you need assistance filling out any part of your PPO Petition, an advocate at the Diane Peppler Resource Center will be glad to work with you.
You can also click here to be taken to a Michigan “Do it Yourself” Toolkit on filling out Personal Protection Orders.
Download a Petition for Personal Protection Order Form
PPO Related Forms and Instructions*
*Information retrieved from the Michigan State Courts Index of SCAO-Approved Forms for Use in Personal Protection Proceedings
*The link includes Forms used to obtain, modify, or terminate personal protection orders that you might receive from the court or the respondent after you file your PPO.
