Final Disposition Report (R-84)

R-84f (9-22-2017)
OMB 1110-0051

1) Please provide if the subject has an active protection order(s) within your agency.
2) Please verify if the protection order is temporary, ex parte, or permanent.
3) Did the subject receive actual notice and how was the subject notified?
4) What is the relationship of the victim?
5) Please provide the hearing date.
6) If the hearing has been held, was the subject present?
7) Does the order contain a finding that the subject represents a credible threat to the physical
safety of the victim or does the order prohibit the use, attempted use, or threatened use of
physical force?
8) Does the order restrain from any future conduct (harassing, stalking, threatening, etc.)?
9) Is the subject prohibited from purchasing or possessing a firearm?
10) If applicable, please provide the protection order termination date?
11) Please provide all applicable documentation (protection order/petition).