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Civil Protection Orders
Washington State Courts - Court Forms - RCW 7.105 Protection Order Forms (Effective July 1, 2022)
Note: Additional documents may be required by local county superior court rules.
Important: To obtain legal advice you should hire a lawyer (for "full service" representation or for "limited" representation). If you cannot afford one, contact a low cost or free legal service program.
Different Types of Civil Protection Orders
- See PO Brochure_2023_01 (pdf) to for more information about protection orders and how they can help you.
Domestic Violence Protection Order
A petition for a domestic violence protection order must allege the existence of domestic violence committed against the petitioner(s) by an intimate partner or a family household member.
The petitioner (must be age 15 or older) may request relief on behalf of:
- Himself or herself
- Family or household members who are minors or vulnerable adults
The petition must specify that the petitioner and respondent are intimate partners or family or household members
A petitioner who has been sexually assaulted or stalked by an intimate partner or a family or household member should, but is not required to, seek a domestic violence protection order, rather than a sexual assault protection order or a stalking protection order.
Sexual Assault Protection Order
A petition for a sexual assault protection order must allege the existence of nonconsensual sexual conduct or nonconsensual sexual penetration that was committed against the petitioner by the respondent.
A single incident is sufficient grounds.
The petitioner (must be age 15 or older) may request relief on behalf of:
- Himself or herself
- A minor child, where the petitioner is the parent, legal guardian, or custodian
- A vulnerable adult where the petitioner demonstrates as an interested person in the adult's wellbeing and the adult cannot file the petition because of age, disability, health, or inaccessibility
Stalking Protection Order
A petition for a stalking protection order must allege the existence of stalking committed against the petitioner(s) by the respondent.
The petitioner (must be age 15 or older) may request relief on behalf of:
- Himself or herself
- A minor child, where the petitioner is the parent, legal guardian, or custodian
- A vulnerable adult where the petitioner demonstrates as an interested person in the adult's wellbeing and the adult cannot file the petition because of age, disability, health, or inaccessibility
Vulnerable Adult Protection Order
A petition for a vulnerable adult protection order must allege the person is a vulnerable adult and has been abandoned, abused, financially exploited, neglected, or is threatened with abandonment, abuse, financial exploitation, or neglect by the respondent.
If the petition is brought by an interested person, the affidavit or declaration must also include a statement of why the petitioner qualifies as an interested person (see Petition for Protection Order).
Extreme Risk Protection Order
A petition for an extreme risk protection order must allege that the respondent poses a significant danger of causing personal injury to self or others by having in the respondent's custody or control, purchasing, possessing, accessing, receiving, or attempting to purchase or receive, a firearm.
The petition must also identify the number, types, and locations of any firearms the petitioner believes to be in the respondent's current ownership, possession, custody, access, or control.
A petition for an extreme risk protection order may be filed by:
- An intimate partner or a family or household member of the respondent; or
- A law enforcement agency.
Antiharassment Protection Order
A petition for an anti-harassment protection order must allege the existence of unlawful harassment committed against the petitioner by the respondent.
The petitioner (must be age 15 or older) may request relief on behalf of:
- Himself or herself
- A minor child, where the petitioner is the parent, legal guardian, or custodian
- A vulnerable adult, where the petitioner is an interested person
- Any other adult for whom the petitioner demonstrates interest in the adult's well-being, and the adult cannot file the petition because of age, disability, health, or inaccessibility.
Forms & Instructions
Forms and instructions are provided in person at the Island County Clerk's office and on the Island County Clerk's webpage (see below) for Civil Protection Orders. Do not use the state website for forms and instructions - Island County has specific information on its forms that are required by the court.
Cost
- Domestic Violence: No cost to the petitioner
- Anti-Harassment: $53 in Superior Court (fees may be waived), additional costs can include copy and service fees
How to file in the County Clerk's Office for Superior Court
File in person at the Island County Clerk's Office Monday through Friday (except Federal holidays) between the hours of 8 am. and 4:30 pm at the Island County Law and Justice Center, 101 NE 6th Street, 1st Floor, Coupeville, WA 98239
You may also file via email at any time and your documents will be processed by the Clerk's office on the next business day. You will receive a confirmation email after processing that will inform you of when the Judge will review your case. Email the Island County Clerk's Office at islandcountyprotectionorders@islandcountywa.gov (Only for Civil Protection Order filings)
NOTICE: Please be aware that the contents of emails sent to and from an Island County email address are subject to public disclosure upon request per GR 31 or RCW CH. 42.56.
Required Documents to Start a Civil Protection Order Action in Island County Superior Court
The documents below are required when filing for a domestic violence, anti-harassment, stalking, vulnerable adult, or sexual assault civil protection order.
- PO 001 Petition for Protection Order 2023_01 (pdf)
- Section 1: If the 4th box is checked for Vulnerable Adult: Attachment B: Notice to Vulnerable Adult must be attached.
- Section 4: If any of the children show as "child" in the "How related to Restrained Person" box: Attachment C: Child Addendum must be attached.
- Section 4: If the 2nd box for minor children and 2nd or 3rd box are checked: Attachment D: Non-Parents Protection Children (ICWA) must be filled out.
- Section 15: If box is checked "Yes": Temporary Order to Surrender Weapons must be attached; this form is provided separately by the Clerk's office.
- (see POi 001 Instructions Petition for Protection Order_2023_01 (pdf) for directions for a Petition for a Civil Protection Order).
- PO 010 Statement_2022_07 (pdf)
- Attach this form to your Petition to add additional details or clarify content.
- PO 003 Law Enforcement and Confidential Info_2023_01 (pdf)
- PO 030 Temporary Protection Order and Hearing Notice_2023_01 (pdf)
- (see POi 030 Temp PO Order Instructions_2023_01 (pdf) for directions for a Temporary Civil Protection Order and Hearing Notice).
- NOTE: Please complete page 1 of the temporary protection order and the address portion of section C on page 4 of the temporary protection order.
- PO 018 Declaration_2022_07 (pdf)
- PO 004 Proof of Service_2023_01 (pdf)
- (see POi 004 Instructions Proof of Service_2023_01 (pdf) for directions on serving the other party).
- PO 040 Protection Order 2023_01 (pdf)
- See POi 040 PO Order Instructions_2023_01 (pdf) for directions for a Civil Protection Order.
- NOTE: Please complete page 1 of the protection order and the address portion of section C on page 6 of the protection order.
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Debra Van Pelt
Island County Clerk
-
County Clerk
Physical Address
1 NE 7th Street
Coupeville, WA 98239
Mailing Address
1 NE 7th Street
Coupeville, WA 98239
Phone 360-679-7359
Phone Numbers
- Whidbey: 360-679-7361
- Camano: 360-629-4522, ext. 7361
- South Whidbey: 360-321-5111, ext. 7361
Hours
Monday through Friday
8 am to 4:30 pm