SCHEDULE - I FORM No. IV INFORMATION TO THE AGGRIEVED PERSON ON HER RIGHTS UNDER THE ACT If you are a aggrieved person of domestic violence and you believe that you require the assistance of the protection officer or a police officer, you will have the right to request that the officer assists you in providing for your safety, including asking for an appropriate protection order in view of the risk of the violence to you and your children. You may also request the officer assist you in obtaining your essential personal effects and locating and taking you to a including any registered service provider under the Act but not limited to it or to a family member's or a friend's residence, or a similar place of safety. If you are in need of medical treatment for yourself or your children, you have the right to request that the officer assist you in getting medical treatment. You may request a copy of any report or application to the court filed in your case, free of cost. You can ask the protection officer to assist you in registering an FIR in the police station. You also have the right to ask the protection officer to assist you in reporting the matter yourself directly to the concerned court or filing any application yourself directly in the concerned court and not through the Protection Officer. You can seek the following relief's from the concerned court - (a) An order enjoining your abuser from threatening to commit or committing further acts of domestic violence or violence to any person in whom you may be interested; (b) An order prohibiting your abuser from harassing, annoying, telephoning, contacting or otherwise communicating with you, directly or indirectly. (c) An order removing your abuser from residence; (d) An order directing your abuser to stay away from your residence, school, place of employment, or any other specified place frequented by you and another family or household member; (e) An order prohibiting you abuser from using or possessing any firearm or any other weapon or dangerous substance as specified by the court. (f) An order granting you possession of your personal effects and other necessary articles in the shared household and an order to put you again in the possession of the shared household; (g) An order granting you custody of your child or children; (h) An order denying your abuser visitation; (i) An order specifying arrangements for visitation, including requiring supervise visitation; (j) An order for interim monetary relief, including but not limited to payment of rent for the premises of the shared household, maintenance for you and your children, medical expenses and compensation for any other mental or physical injury caused to you by the abuser; The forms you need to make any application seeking the abovementioned reliefs from the court are available with the protection officer and the following service providers. The following assistance can be availed from the following service providers. (Details to be entered in accordance with the lists available with the Protection Officer) Name of the service provider service | 