The affidavit form asks you to report on the “most recent incident” of abuse. Describe what your abuser did most recently to make you afraid. Include exact dates and times if you can. If you can’t remember exact dates and times, it’s okay to guess or estimate. For example, it’s okay to say “at about 3 p.m.,” or “about two weeks ago.” If you are guessing or estimating, write that it’s your best guess or estimate.
Describe what your abuser did to you or your children. Be sure to say where it happened and who else was there to see it. The judge will be most interested in information that you heard or saw and what was done to you.
Physical Harm
Describe any pain or injury that your abuser caused you or your children. Do you have bruises, scrapes or other injuries? Describe the injuries here. Also describe any soreness, strain or discomfort that you have. Have you gone to the doctor or hospital for an injury your abuser caused? Write that here. Briefly describe how you felt about what your abuser did. It is okay if you never received medical treatment.
Threats
Describe anything your abuser said or did that scared you. For example, did your abuser threaten to hurt you? Write that down. Did your abuser make threatening gestures (for example, shaking a fist at you)? Did your abuser block you from leaving a room? Include a description of what your abuser did and what the date and time was. What if you don’t know the exact date and time? It’s okay to give your best guess. If you are guessing or estimating, say so.
Weapons
Was there a weapon involved in the violence or threats? Include that in your description.
Damaging Property and Hurting Pets
Describe anything else your abuser did to make you afraid. Did your abuser hurt pets, break objects, damage property or threaten to damage property? Describe this. Include a description with a date and time. What if you don’t know the exact date and time? It’s okay to give your best guess. If you are guessing or estimating, say so.
Police
Were the police involved? Describe what the police did. Did they arrest your abuser? Include this information. Are there criminal charges against your abuser right now? Include what the charges are. It is okay if you don’t know what the charges are.
Alcohol and Drugs
Has your abuser used alcohol or drugs before making you scared? It’s okay for you to say so.
Stalking
Has your abuser stalked or followed you? Is your abuser trying to find out where you are and what you are doing? Include this. It is important to include any of these things in your affidavit if they happened.
Children
Have your children ever been in the same room when you were being abused? Were your children at home when your abuser abused you? Did your abuser abuse your children in any way? Include all of these in your affidavit if they happened.
Describe how the children reacted to the abuse. Describe how the abuse changed the children. Focus on what you saw about the children’s behavior. For example, “my children have difficulty sleeping,” ”my child looked scared,” or “my child started wetting his bed.”