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ORI THE SUPERIOR COURT FOR THE COUNTY OF COLUMBIA STATE OF GEORGIA ] ] Petitioner, ] Civil Action File v. ] ] ] ] Respondent. ] ORDER TO MODIFY PRIOR PROTECTIVE ORDER IT IS HEREBY ORDERED, ADJUDGED and DECREED that the prior Family Violence Protective Order issued is modified as follows: the remaining parts of the Protective Order issued remains unmodified and in full effect. This day of JUDGE, SUPERIOR COURT County Print or stamp Judge’s name TRANSMITTED TO GEORGIA PROTECTIVE ORDER REGISTRY DATE CLERK Rev’d 1/10/03 For your convenience, this form has been designed to be completed online. The information typed on the first page will automatically update to the other pages. Please be sure all pertinent information is completed before printing. Once the form is completed, select 'Print' to print the form. Selecting 'Reset' will clear the entire form. Reset Print ---PAGE BREAK--- * REMOVE THIS PAGE FROM ORDER * Pursuant to O.C.G.A. Section 19-13-3, Petitioner assisted by: Name: Address: Telephone: