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Reviewed June 2020
Fill out a 209A application on your phone or computer. Answer questions and get all the forms you need that you can email to yourself, an advocate, save as part of your safety plan, send to the court.
Or get the paper forms
- Complaint for Protection from Abuse (G.L. c. 209A) Page 1
- Complaint for Protection from Abuse (G.L. c. 209A) Page 2 (required if you have minor children)
- Plaintiff Confidential Information Form
- Defendant Information Form
- Page 1 is the Instructions to the Plaintiff. You are the "plaintiff." This form tells you how to fill out the other form.
- Page 2 is the Complaint. It has checkboxes and spaces for you to fill in with names and basic information about you, your relationship to the defendant, and what you are asking the court to order.
- Page 3 is the 2nd page of the Complaint. Use this form if you have children under age 18. You use this form to ask for orders about custody, contact with your children, visitation, or child support.
- Page 4 is the Affidavit. When you sign the Affidavit, you swear that what you said in the affidavit and the Complaint is true to the best of your knowledge. See Writing your 209A 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 the abusive person said or did like, "They told me they would get their 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
- Page 5 is the Plaintiff Confidential Information Form. Write your name, home address, home telephone number, workplace name, address, telephone number, and school. This information is confidential. The defendant, the defendant’s attorney, and the public are not allowed to see it. Only certain authorized persons who ask for this information can see it. But first they must file a Request for Access to Confidential Information form.
- Page 6 is Defendant Information Form. The court gives this information to the police so they can find the defendant to deliver the order. Include any information that will help the police find the defendant
- Affidavit Disclosing Care or Custody Proceeding Involving a Child This form asks about other family court cases that involve your child. The form tells the court if there are already any court orders about your child. It also tells the court if you are asking the judge to make decisions about your child in the 209A order judge. See sample Affidavit Disclosing Care or Custody Proceedings.
You can ask the court to order the defendant to pay child support. This form allows you to fill out basic information about both parents' expenses and income to ask for child support. See a sample Plaintiff's Affidavit in Support of Request for a Child Support Order.
Defendant's Affidavit in Connection with Request for a Child Support Order: This form is for the defendant to fill out basic information about their work, income and expenses, if the plaintiff asks for child support. See a sample Defendant's Affidavit in Connection with Request for a Child Support Order.
Motion for Impoundment
Use this form to ask the court to keep any information in your application a secret from the defendant, the defendant's lawyer, prosecutor, and court staff. You must explain on the form why it is important to keep this information confidential. Your reasons to keep this information confidential must be more than simply to protect your privacy. The reasons must show that you need the court to keep the information confidential so nobody can use it to harm you.
- if there is anything in your 209A papers that you need to keep from people who are allowed to see it. You might need to keep people who can look at your Plaintiff Confidential Information Form from seeing it.
- Or if you need to keep other information in your court papers confidential.
Request for Access to Plaintiff Confidential Information Form: Only certain kinds of people like a prosecutor or a domestic violence counselor can use this form to ask to see the plaintiff's confidential information. See a sample Request for Access to Plaintiff's Confidential Information.
Translation of Affidavit Use this form if you file an affidavit that is not written in English. The person who translates your affidavit writes the English translation on this form. The translator also signs and prints their name at the bottom of the page, where it says, in English “I have provided a written translation into English, complete and accurate to the best of my ability.”
Petition Filed Pursuant to G.L. c. 209A, § 11 Relative To Domesticated Animal(s) Use this form if your pets need protection from abuse.
Plaintiff's Motion to Modify or Terminate Abuse Prevention Order Fill out this form to change or end an abuse prevention order. Also see How do I change or end my 209A Restraining Order?
Defendant's Motion to Modify or Terminate Abuse Prevention Order Fill out this form if you are a defendant and you need to change or end an abuse prevention order.
Affidavit for Filing Out-of-State Protective Order Use this form to get your protective order from outside Massachusetts enforced in Massachusetts. Also see Protective Orders from Another State.
Complaint for Modification - Child Support - sample This is a copy of the Probate and Family Court Complaint for Modification Form. It has been filled out for an increase in child support case.
Complaint for Contempt - Child Support - sample This is a copy of the Probate and Family Court Complaint for Contempt Form. It has been filled out for a non-payment of child support case.
Motion for Temporary Support and Proposed Order - sample This sample shows how you might fill in the Probate and Family Court's Motion Form and a Proposed Order Form. This one asks the court to order a parent to pay temporary child support, provide health care coverage, and pay 50% of their children's uninsured medical and dental expenses.
Department of Revenue Child Support Enforcement
Department of Revenue Child Support Enforcement Application for Services
You can apply for DOR/CSE services online, or get a paper application from their website.
Offer in Settlement Application Use this form to ask DOR/CSE to accept less child support than you owe.
Request for Equitable Adjustment Application Use this form to ask DOR/CSE to adjust the amount of past due child support they say you owe.
Failure to Pay Child Support May Result in License Suspension Notice An example of the warning notice you might get from Child Support Enforcement if you do not pay the child support you owe.
Notice to Suspend An example of the notice DOR/CSE sends to a licensing agency if you do not pay your child support. The notice tells the agency you have not paid child support and the agency must take away your license.
Final Determination of Delinquency An example of the notice Child Support Enforcement sends you after they have told the licensing agency to take away your license.
Affidavit of Indigency If you cannot afford court fees and costs, ask the court to have the state pay them.
- Affidavit of Indigency Instructions - for you
- Affidavit of Indigency - Summary of Instructions to court staff, so you know your rights when you file an Affidavit of Indigency with a clerk at court.
Sample Affidavit of Indigency to see how you might fill out an Affidavit of Indigency if you need to complete the Supplement.
Divorce Separation Annulment
Certification Vital Statistics Divorce or Annulment Statistical Form to be filed with all Complaints for Divorce or Annulment.
Joint Petition for Divorce under G.L. c.208, Section 1A Use when both spouses want a divorce claiming irretrievable breakdown of the marriage.
Complaint for Divorce under G.L. c.208, Section 1B Use when one spouse wants a divorce claiming irretrievable breakdown of the marriage.
Complaint for Divorce - sample This form of complaint is used for "fault" divorces where the parties do not file a joint petition.
Complaint for 1B Divorce (Irretrievable Breakdown) - Sample This form of complaint is used for for "no fault" divorces ("1B" divorces) where the parties do not file a joint petition.
Joint Petition for Divorce - sample This court form is used when both spouses participate in seeking a joint "no fault" divorce, called a "1A" divorce. They also file a notarized separation agreement and a sworn affidavit that the marriage has irretrievably broken down.
Complaint for Separate Support if you want to stay married and you need a custody order, and support or health insurance for your child, and/or support or health insurance for yourself.
Complaint for Support - Custody - Visitation where the parents are not married to each other.
Complaint for Support - sample If you are married you can use this form of complaint to seek a suitable amount of support for yourself and the children, as well as health insurance benefits.
Complaint for Separate Support - sample This form of complaint has provisions for establishing that you are living apart from your spouse for justifiable cause and for custody and support.
Complaint for Support Custody Visitation - Sample where the parents are not married to each other
Financial Statement sample This is the Probate and Family Court's Financial Statement Form. It is filled out for a mother of two children, who has custody. The father would have to fill out a form, too.
Request Financial Statement sample This is a Request for a Financial Statement Form, with an accompanying letter. You can type up your own identical form with your own Certificate of Service, and mail it to the father of the children with a Financial Statement Form. Then you will find out how much he is making. You should know that if you Request a Financial Statement in this way, under a court rule (Supplemental Rule 401), you cannot request another financial statement until after ninety days have passed, unless the court orders it. And, under this same rule, in cases involving financial issues in Probate Court, unless the court orders otherwise, both parties are required to file a financial statement with the court and with each other within 45 days of service of the summons, or, if something is scheduled in court before the 45 days passes, two days before the hearing.
Motion to Compel Financial Statement and Proposed Order - sample This is an example of a Motion you can file to ask the Court to make the other party file a financial statement if you are having difficulty getting him to do so. You must also file a Proposed Order; an example is included.
Medical and Educational Decisions
Caregiver education and health care authorization affidavit also called Caregiver Authorization Affidavit
Temporary Agent Appointment also called Temporary Agent Affidavit
Parents' Right to a Lawyer
APPLICATION FOR APPOINTMENT OF COUNSEL For Parent of Minor Child Guardianship of Minor The Probate and Family Court form parents use to ask for a court-appointed lawyer in guardianship cases.
Removing a Guardian
Sample Petition for Removal of Guardian of Minor Look at this form to see how Susan Smith asks the court to end the guardianship of her daughter, Sarah. On the form she asks the court to return Sarah to her and she shows on her petition that her case has "merit."
Changing a Guardianship
Sample General Probate Petition Look at this form to see how Goodluck Fisherman asks the court to change the guardianship of his daughter, Martha. On the form he asks the court to allow Martha to spend weekends with him and he shows on his petition that his case has "merit."
See more Guardian of a Minor court forms on the Trial Court's website.
Voluntary Acknowledgement of Parentage Registry of Vital Records form
Subpoena form for witness to testify in Court
Subpoena letter sample to request employer's records
Subpoena - blank form, sample, and affidavit of service A subpoena is a written, notarized demand which makes a person come into court to testify on a case. The example is filled out to subpoena the father's wage records. You can take the blank form, fill it out with your own information, and bring it to a notary. It will be an official subpoena once it is notarized. The affidavit of service is a certification that tells the court the subpoena has been properly served.
Complaint for Modification and Answer - Visitation - sample These are samples of a Probate and Family Court Complaint for Modification form and an Answer to a Complaint for Modification.
Complaint for Contempt - Visitation - samples These are samples of a Probate and Family Court Complaint for Contempt form and an Answer to a Complaint for Contempt.
Motion for Visitation - sample forms Here are several samples of forms that are used in motions for visitation: A Motion for Specific Visitation Schedule and a Proposed Order (filled out for a case in which a parent wants the court to issue a very specific visitation with a third party to pick up and drop off). A Supplemental Order - Visitation Issues (an example of a Probate and Family Court form which can be used to propose a specific visitation order for the judge to approve. It give an idea of the options the judge has in ordering visitation. The form may look different from court to court). Agreement of Parties and Temporary Order (an example of a Probate and Family Court form that can be used for writing up an agreement on visitation and other issues. The agreement becomes a temporary order of the court. This form may look different from court to court.).
A Motion for Specific Visitation Schedule and a Proposed Order filled out for a case in which a parent wants the court to issue a very specific visitation with a third party to pick up and drop off.
A Supplemental Order - Visitation Issues- sample is an example of a Probate and Family Court form which can be used to propose a specific visitation order for the judge to approve. It gives an idea of the options the judge has in ordering visitation. The form may look different from court to court).
Agreement of Parties and Temporary Order - sample forms is an example of a Probate and Family Court forms that can be used for writing up an agreement on visitation and other issues. The agreement becomes a temporary order of the court. This form may look different from court to court.
Motion to Suspend Visitation - sample This is an example of a motion you would file if you needed to stop visitation. You must also file a Proposed Order, and a sample is included.
Proposed Order for Visitation Supervised by an Individual
Reviewed August 2010
Keeping your address unknown/hidden
Motion to Impound Plaintiff's Address, supporting affidavit, proposed order - sample This is an example of a Probate and Family Court Motion to Impound (remove) your address from all court papers so that your abuser cannot find out from court papers where you are living. The second page shows an example of a supporting affidavit. The supporting affidavit can be handwritten.
Confidential Information Form for Abuse Prevention Cases (209A) and Harassment Prevention Cases (258E)
DTA Welfare forms
TAFDC Denial Notice With Appeal Form (2 Pages) Sample This is an example of the kind of notice the Department of Transitional Assistance will send to you if they are going to deny your application. On the back of the notice, you will see an example of a filled out appeal request.
DTA Tracking Worksheet Use this chart to help your application for TAFDC, EAEDC, SNAP/Food Stamps, or Emergency Assistance go smoothly. Keep it in a folder with copies of all of your papers. Every time you talk to someone at DTA write down the date, who you talked to and what was said.
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