| (o)__Have you ever been adjudicated as having | committed a juvenile offense described in division | (j)? |
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| (p)__Are you currently subject to an order of a | Maine court or an order of a court of the United | States or another state, territory, commonwealth | or tribe that restrains you from harassing, | stalking or threatening your intimate partner, as | defined in 18 United States Code, Section 921(a), | or a child of your intimate partner, or from | engaging in other conduct that would place your | intimate partner in reasonable fear of bodily | injury to that intimate partner or the child? |
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| (q)__Are you a fugitive from justice? |
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| (r)__Are you a drug abuser, drug addict or drug | dependent person? |
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| (s)__Do you have a mental disorder that causes you | to be potentially dangerous to yourself or others? |
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| (t)__Have you been adjudicated to be an | incapacitated person pursuant to Title 18-A, | Article 5, Parts 3 and 4 and not had that | designation removed by an order under Title 18-A, | section 5-307, subsection (b)? |
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| (u)__Have you been dishonorably discharged from | the military forces within the past 5 years? |
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| (v)__Are you an illegal alien? |
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| (w)__Have you been convicted in a Maine court of a | violation of Title 17-A, section 1057 within the | past 5 years? |
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| (x)__Have you been adjudicated in a Maine court | within the past 5 years as having committed a | juvenile offense involving conduct that, if | committed by an adult, would be a violation of | Title 17-A, section 1057? |
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| (y)__To your knowledge, have you been the subject | of an investigation by any law enforcement agency | within the past 5 years regarding the alleged | abuse by you of family or household members? |
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