New and Revised 209A Forms Effective January 1, 2012

Wednesday, December 14, 2011

Chief Justice for Administration & Management Robert A. Mulligan has promulgated new and revised forms for use in cases brought pursuant to G.L. c. 209A, the abuse prevention order statute. These forms will take effect on January 1, 2012. 

The revisions bring existing forms into compliance with statutory changes and clarify and streamline language. The new forms will assist courts in obtaining the information needed to handle certain aspects of these cases. An updated guide to completing these forms will be provided to all courts and to other interested parties. Some of the forms are being printed and will be sent within three weeks to all divisions of the four Trial Court Departments with jurisdiction over G.L. c. 209A cases. Other forms will have to be downloaded from the Trial Court website and printed for use. 

A list of revised, new and unchanged forms is provided below. The revisions to existing forms and descriptions of the new forms are detailed in the attached memorandum. A complete set of all forms used in G.L. c. 209A cases, including the revised and new forms, is available at:

The major revisions to the Guidelines and Forms required for abuse prevention proceedings were compiled and implemented with significant assistance from the Boston Municipal Court, District Court, Probate and Family Court, and Superior Court Departments. Chief Justice Mulligan thanks the following individuals who were instrumental in this process: Judge Mary Hogan Sullivan and the District Court Professional Development Group on Domestic Abuse Proceedings, and representatives of Trial Court Administrative Offices: Ellen Shapiro, Deborah Propp, Cheryl Sibley, Lisa Yee, Kim Wright, Ilene Mitchell, Maria Pena, Jamie Sabino, and Ann Archer.

List of Revised and New Forms: 

Revised forms
Complaint page 1 FA-1
Complaint page 2 FA-1A 
Order page 1 FA-2 
Order page 2 FA-2A 
JRS envelope FA-3  
Plaintiff Information form FA/HA-6  

New forms 
Plaintiff's Affidavit in Support of Request for a Child Support Order FA-11 
Defendant's Affidavit in Connection with Request for a Child Support Order FA-12 
Plaintiff's Motion to Modify or Terminate Abuse Prevention Order FA-13 
Defendant's Motion to Modify or Terminate Abuse Prevention Order FA-14 
Translation of Affidavit FA/HA-15 

Forms that have not changed 
Defendant Information Form FA/HA-5 
Request for Plaintiff Confidential Information FA/HA-7 
Motion Impoundment FA/HA-8 
Affidavit for out-of-state order FA/HA-9