Application to the Family Court Judge: Issuance of a protection order (Form 15458*05)

Ministry of Justice - Cerfa n° 15458*05

To obtain protection measures if you experience domestic violence (physical, psychological or sexual) from the person you are with live (or live) as a couple.

Go to the online administrative form

Verified 22 October 2020 - Directorate for Legal and Administrative Information (Prime Minister)

To whom shall I send this form ?

For details, please use the practical information sheets :

J'ai réalisé une démarche administrative

Je donne mon avis sur Services Publics +. L'administration concernée me répondra.

Je donne mon avis