TO THE OFFICE OF THE HONOROBLE JUDGE OF FAMILY COURT ON DUTY

Plaintiff : (name and surname of plaintiff will be included)

Address : (the plaintiff’s Open address will be included)

Defendant: (if you know the name and surname of the violator, T.C. Identification number will be included)

Address: (address of the perpetrator of violence will be included)

Subject: describe the violence you have been subjected to by the defendant– for example, because of the physical violence I have seen – it consists in submitting my request to your court to take appropriate measures in accordance with the Law No. 6284 on the protection of the family and the Prevention of violence against women.

Explanations: please include in detail what kind of violence the defendant perpetrated. If he used a violent weapon or a weapon-like device, also indicate that the defendant has a weapon in private or business. Indicate how long the violence has been going on, what is the personal relationship between you, what is the unilateral decency if you have no personal relationship, if you have a child and have been subjected to violence. Indicate if the violent person has any alcohol or drug addiction.

Result and demand: for the reasons described above

* Preventing violent threats and insults,

* Immediate removal from joint housing and places where the plaintiff is located (may be places such as workplaces, schools, addresses will be located) and ensuring that he does not approach,

* Cancellation or limitation of personal relationship with respect to the Joint Child,

* Do not disturb with communication tools if the defendant is uncomfortable with communication tools, etc.

* Confiscation of the weapon if the defendant has a gun

*I request that one or more of the measures that will be appropriate to the situation described and all the necessary measures be given by Your Court for a period of six months.

Kindest regards,

(The name, surname and signature of the plaintiff will be included.)