This is not a Court Order—Do not place in court file.
CLETS Information
Person to Be Protected (Name):
Eye Color: Date of Birth:
Hair Color:
Age:
Confidential CLETS Information
Judicial Council of California, www.courts.ca.gov
New January 1, 2012, Mandatory Form
Cal. Rules of Court, rule 1.51
F
Sex:
Height:
Weight:
Race:
M
Person to Be Restrained (Name):
Describe any marks, scars, or tattoos:
Other names used by the restrained person:
Describe any guns or firearms that you believe the person in owns or has access to
(Number, types, and locations):
1
CLETS-001, Page 1 of 1
Eye Color: Date of Birth: Hair Color:
Age:
F
Sex:
Height:
Weight:
Race:
M
4
Other People to Be Protected
Sex
Name Date of Birth
CONFIDENTIAL
CLETS-001
Additional persons to be protected are listed on Attachment 4.
Guns or Firearms
3
2
California Law Enforcement Telecommunications System (CLETS)
Information Form
Important: This form MUST NOT become part of the public court file. It is confidential and private.
Case Number (if you know it):
This form is submitted with the initial filing (date):
This is an amended form (date):
Fill out as much of this form as you can and give it to the court clerk. If the court issues a restraining order, this form
will provide law enforcement with information that will help them enforce it. If any of this information changes, fill out
a new (amended) form.
1
Race
Driver’s License Number and State:
Social Security Number:
Vehicle (Type, Model, Year):
(License Number and State):
Vehicle (Type, Model, Year):
(License Number and State):
Mailing Address (listed on restraining order):
Zip:State:
City:
Telephone (optional):
Employer:
Occupation/Title:
Work Hours:
Residence Address:
Zip:State:City:
Telephone:
Business Address:
Zip:State:City:
Telephone:
Relation to
Person in
2
To keep other people from seeing what you
entered on your form, please press the Clear This
Form button at the end of the form when finished.
For your protection and privacy, please press the Clear This Form
button after you have printed the form.
