Writing Your 209A Affidavit

Produced by Attorney Jeff Wolf for MassLegalHelp
Created November 2016

Page 3 of the 209A Complaint is the AFFIDAVIT. Use the affidavit to explain the checkboxes you checked on page 1 of the Complaint.

On the AFFIDAVIT:

Tell the judge what happened and why you need a 209A order.

Write down exactly what happened. Do the best you can. Write down the things he said or did like, "He told me he would get his gun and shoot me."

Start with the most recent incident.

Include information about injuries, if children were present or hurt, police involvement, medical treatment, other help you got, or destruction of property.

Read these sections to help you write your affidavit:

Explaining the boxes you checked in part I on page 1 of the complaint

Writing about incidents when the defendant abused you

Writing about incidents when the defendant abused your child

Writing about incidents when your child witnessed the defendant abusing you

Writing about incidents of domestic violence that affected your child

Writing about incidents when the defendant did something that made you afraid that you were about to be seriously physically harmed

If the police were involved, should I write about it?

Explaining the boxes you checked in part I on page 1 of the complaint

Physical harm includes hitting, biting, grabbing, shaking, using a weapon, shoving, pushing, punching, slapping, kicking, pulling your hair, choking, strangling, throwing things at you, burning you with hot food or cigarettes, stabbing, shooting, or locking you in a room.

Explaining “caused me to engage in sexual relations by force, threat or duress” includes threatening, pressuring or forcing you to have sex.

Writing about incidents when the defendant abused you

When you write about the defendant abusing you include:

  • your injuries,
  • when, where, and how the defendant abused you,
  • the kind of medical help you got,and
  • If there was a reason you could not get medical treatment.

Example

Last night, November 15, 2006, Jack and I were in our kitchen talking about our child. Jack got angry and pushed me against the wall. He put his hands around my throat. I could not breathe. He loosened his grip for just a second, and I ducked under his arms and ran out of the house to a neighbor’s and called 911. The police came and talked to Jack. They told him to go take a walk, but I was too afraid to go back home.

That was not the first time Jack abused me. About a month ago, we were in the bedroom late at night. He punched me in the face. I told him he had to leave. He did. The next morning, my face was all swollen. I could not see out of one eye. I called a friend who took me to the doctor. I needed stitches.

Writing about incidents when the defendant abused your child

When you write about when the defendant abused your child include:

  • your child’s injuries,
  • when, where, and how your child got injured,
  • the kind of medical help you got for your child, and
  • if there was a reason you could not get medical treatment for your child.

Example

Last Thursday night, November 15, 2006, Arnold and I were arguing about our child’s grades. Harry is our 8 year old child.

Arnold screamed that I had better do exactly what he said or I would be sorry.

Harry ran into the room and got in between Arnold and me.

Arnold pushed Harry to the floor, kicked him out of the way, and got even closer to me.

Arnold was standing inches away from me and I was backed into the wall of the kitchen. I could feel his spit on my face as he screamed.

I was afraid because the last time, about a month ago, when he said I better do something or I would be sorry, I did not do what he wanted. Then he grabbed me and shook me really hard.

So this time I was really afraid he would do it again. I ducked under his arms, grabbed Harry, and ran out of the house.

Writing about incidents when your child witnessed the defendant abusing you

When you write about your child witnessing the defendant injuring you, include:

  • a description of the incident your child witnessed, and
  • when and where you and your child were when your child witnessed the defendant injuring you.

Writing about incidents of domestic violence that affected your child

When you write about incidents that affected your child, include:

  • details about the incident - when, where, and how you were injured, and
  • how the incident affected your child.

Writing about incidents when the defendant did something that made you afraid that you were about to be seriously physically harmed

When you write about incidents like this, include:

  • details that show specifically what the defendant did,
  • why his or her actions made you afraid that you were about to be physically harmed, and
  • why the harm would be serious.

Example

Last Thursday night, November 15, 2006, Jack and I were in our kitchen talking about our child.

Jack screamed that I had better do exactly what he said or I would be sorry.

He stood inches away from me and backed me into the kitchen wall. I could feel his spit on my face as he screamed.

I was afraid because the last time, about a month ago, when he had said I had better do something or I would be sorry, I did not do what he wanted. Then he grabbed me and shook me really hard. My head hit the wall. I had a terrible headache for days afterwards.

So this time I was really afraid he would do it again. When he loosened his grip I got away and ran out of the house.

If the police were involved should I write about it?

You may want to write about the police if they were involved in the incident.

It may help to explain what happened if the judge understands how the police were involved. But you do not have to talk about the police if you do not want to.

It may give the judge a clearer picture if you needed the police but you did not call them because you

  • were afraid, or
  • could not call them.

You might want write down why the police were not involved.

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