Fillable Domestic Violence Booklet (The Superior Court of California - County of Orange)

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Domestic Violence Booklet (The Superior Court of California - County of Orange)

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Domestic Violence Booklet
National Domestic Violence Hotline: 800-799-SAFE (7233)
All documents must be typed or printed neatly. Please use black ink.
Domestic Violence papers are accepted at the Lamoreaux Justice
Center, 7
th
Floor, Family Law Clerk’s Office.
The Domestic Violence Assistance Program Office has staff available to provide
information and assist with the completion of Domestic Violence forms. The
office is located at the Lamoreaux Justice Center, 6
th
Floor.
Court Self-Help Centers are available at the Justice Centers listed below, to
provide procedural assistance and to review your documents for completeness.
Lamoreaux Justice Center
1
st
Floor
341 The City Drive
Orange, CA
Central Justice Center
1
st
Floor
700 Civic Center Drive
Santa Ana, CA
Harbor Justice Center -
Laguna Hills
2
nd
Floor, Room 202
23141 Moulton Pkwy
Laguna Hills, CA
North Justice Center
3
rd
Floor, Room 360
1275 N. Berkeley Ave.
Fullerton, CA
Revised 12/24/2012
What is a “domestic violence restraining
order”?
Can I get a domestic violence restraining
order?
You can ask for one if:
A person has abused you or threatened to abuse you and
You have one of the following relationships with that
person: married, divorced, separated, registered
domestic partnership, have a child together, dating or
used to date, live together or used to live together*;
Or you are related within the second degree of affinity or
consanguinity. This means: mother or mother-in-law,
father or father-in-law, child or stepchild or legally
adopted child, grandparent or grandparent-in-law,
grandchild or grandchild-in-law, sister or sister-in-law,
brother or brother-in-law, stepparent, daughter-in-law or
son-in-law. The in-law must be through a current
marriage. (See Family Code § 6211).
* You have to regularly reside in the household.
DV-500-INFO, Page 1 of 3
It is a court order that can help protect people who have
been abused or threatened with abuse.
Judicial Council of California, www.courts.ca.gov
Revised January 1, 2012
•
•
Can a Domestic Violence Restraining Order Help Me?
Can a Domestic Violence
Restraining Order Help Me?
(Domestic Violence Prevention)
Obey child custody and visitation orders
Pay child support
Pay spousal support
Obey orders about property
•
•
•
How will the restraining order help me?
The court can order the restrained person to:
Not contact or go near you, your children, other
relatives, or others who live with you
Not have any guns or ammunition
Move out of your house
•
•
•
The forms are available at any California courthouse or
county law library or at: www.courts.ca.gov/forms.
How do I ask for a domestic violence
restraining order?
You may get assistance in completing and filing your
request from the court’s self-help center or a legal aid
association.
After completing the forms, give them to the clerk of the
court. The clerk will write a hearing date on the Notice of
Court Hearing (Form DV-109). If your request for
temporary orders is granted, the clerk will also give you a
copy of the Temporary Restraining Order (DV-110)
signed by a judicial officer.
How soon can I get the order?
The judge will decide within one business day whether
or not to make any temporary orders. Sometimes the
judge decides sooner. Ask the clerk if you should wait or
come back later to get copies of the Notice of Court
Hearing (Form DV-109) and Temporary Restraining
Order (Form DV-110).
Ask the court clerk for the forms you need for these special
kinds of orders, or visit www.courts.ca.gov. You may also
want to talk to a lawyer.
What is abuse?
•
Abuse means to intentionally or recklessly cause or
attempt to cause bodily injury to you; or sexually assault
you; or to place you or another person in reasonable fear
of imminent serious bodily injury; or to molest, attack,
hit, stalk, threaten, batter, harass, telephone, or contact
you; or to disturb your peace; or destroy your personal
property. Abuse can be spoken, written, or physical. (See
Family Code §§ 6203, 6320).
See Form DV-505-INFO, How Do I Ask for a Temporary
Restraining Order? to know which forms you need and for
steps to follow after you complete the forms.
•
DV-500-INFO
What if I don’t have the relationship
necessary to qualify for a domestic violence
restraining order?
There are other kinds of orders you can ask for:
Civil harassment order (can be used for neighbors,
roommates, cousins, uncles, and aunts)
Dependent adult or elder abuse restraining order
Workplace violence order
•
•
•
Having a lawyer is always a good idea, especially if you
have children, but it is not required. You are not entitled to
a free court-appointed lawyer. Ask the court clerk about
free and low cost legal services and domestic violence
help centers in your county. You can also go to the
Family Law Facilitator for help with child support.
Do I need to bring a witness to the court
hearing?
Do I need a lawyer?
No. But it helps to have proof of the abuse. You can
bring:
A written statement from a witness, made under oath
Witnesses
Photos
Medical or police reports
Damaged property
Threatening letters, e-mails, or telephone messages
•
•
•
•
•
•
Can a Domestic Violence Restraining Order Help Me?
You can get a restraining order even if you are not a
U.S. citizen. If you are worried about deportation, talk
to an immigration lawyer.
What if I don’t have a green card?
How will the person to be restrained
know about the order?
Someone who is at least 18—not you or anyone
else to be protected by the order—must “serve” (give)
the person to be restrained a copy of the order in person.
The sheriff or marshal will do it for free, but you have to
ask. For help with service, ask the court clerk for form
DV-200-INFO, What Is “Proof of Personal Service”? or
visit www.courts.ca.gov.
Call the police. The restrained person can be arrested
and charged with a crime.
What if the restrained person doesn't obey
the order?
Yes. Go to court on the date the clerk gives you.
If you do not, your order will end.
Do I have to go to court?
Will I see the restrained person at the court
hearing?
If the restrained person comes to the hearing, yes. But
that person does not have the right to speak to you. If
you are afraid, tell the court officer. Read Get Ready for
the Court Hearing (Form DV-520-INFO).
Yes. You can bring someone to sit with you during the
court hearing. But that person cannot speak for you in
court. Only you or your lawyer (if you have one) can
speak for you.
Can I bring someone with me to court?
When you file your papers, ask the clerk if a court
interpreter is available. If the interpreter is not available
for your court date, bring someone to interpret for you.
Do not ask a child, or anyone to be protected by the
order, to interpret for you.
What if I don’t speak English?
How much does it cost?
Nothing.
DV-500-INFO
DV-500-INFO, Page 2 of 3
Can a Domestic Violence
Restraining Order Help Me?
(Domestic Violence Prevention)
Revised January 1, 2012
The judge may or may not let a witness speak at the
hearing.
So if possible, you should bring their written statement
under oath to the hearing. (You can use Form MC-030,
Declaration, for this purpose.)
If the judge makes a temporary order, it will last until the
hearing date. At that time, the judge will decide to
continue or cancel the order. The restraining order can last
up to 5 years. Child custody, visitation, child support, and
spousal support orders can last longer than 5 years and
they do not end when the restraining order ends.
How long does the order last?
Can I use the restraining order to get
divorced or terminate a registered
domestic partnership?
No. These forms will not end your marriage or
registered domestic partnership. You must file other
forms to end your marriage or registered domestic
partnership.
If you get a temporary restraining order that includes an
order for custody, the parent with custody may not
remove the child from California before notice to the
other parent and a court hearing on the request to
establish or modify custody. Read the order and Form
DV-140, Child Custody and Visitation Order, if issued,
for any other limits. There are some exceptions. Ask a
lawyer.
The restraining order is valid anywhere in the United
States. If you move out of California, contact the local
police so they will know about your orders.
Ask the court clerk about free or low-cost legal help.
For a referral to a local domestic violence or legal
assistance program, call the National Domestic
Violence Hotline:
1-800-799-7233
TDD: 1-800-787-3224
It’s free and private.
They can help you in more than 100 languages.
Can the order stop the other parent from
taking our children away?
What if I want to leave the county or state?
Need more information?
DV-500-INFO
Can a Domestic Violence Restraining Order Help Me?
No. After the order is issued, only the judge can change
or cancel it.
Can the restrained person and I agree to
cancel the order?
DV-500-INFO, Page 3 of 3
Can a Domestic Violence
Restraining Order Help Me?
(Domestic Violence Prevention)
Revised January 1, 2012
What if I am deaf or hard of hearing?
Assistive listening systems, computer-
assisted real-time captioning, or sign
language interpreter services are available if
you ask at least five days before the
proceeding. Contact the clerk's office or go
to www.courts.ca.gov/forms for Request for
Accommodations by Persons With
Disabilities and Response (Form MC-410).
(Civil Code, § 54.8.)
Fill out the forms you need and take them to the court clerk. The clerk will give your forms to the judge.
The judge will look at them and decide whether to make (“grant”) the temporary orders. Sometimes the judge will
want to talk to you. If so, the clerk will tell you.
Use this form as a checklist.
(Look at the numbers at the top of your forms.)
DV-505-INFO
How Do I Ask For a Temporary Restraining Order?
Judicial Council of California
www.courts.ca.gov
Revised January 1, 2012
DV-505-INFO, Page 1 of 3
1
DV-105 Request for Child Custody and Visitation Orders
DV-140 Child Custody and Visitation Order
FL-150* Income and Expense Declaration or
FL-155* Financial Statement (Simplified)
* Read Which Financial Form—FL-155 or FL-150? (Form DV-570) to know which one is right for you.
DV-120 Response to Request for Domestic Violence Restraining Order
DV-130 Restraining Order After Hearing (Order of Protection)
DV-200 Proof of Personal Service
How Do I Ask for a Temporary Restraining Order?
(Domestic Violence Prevention)
DV-109 Notice of Court Hearing
DV-100 Request for Domestic Violence Restraining Order
b. If you have children with the person you want protection
from, you also need:
c. If you want child support or spousal support, you also need:
d. Ask the clerk if your county has special forms or rules.
e. There are other forms you will need later (do not fill them out now):
a. For a restraining order you need:
1
2
1
3
6
6
4
•
Keep one copy with you, always. You may need to show it to the police.
Keep another copy in a safe place.
Give a copy to anyone else protected by the order.
Take copies to places where the restrained person is ordered not to go (school, work, child care, etc.)
Give a copy to the security officers in your apartment building and workplace.
•
•
•
•
Restraining orders get entered into CLETS, a statewide computer system that lets police know about your order.
The court will send the order to law enforcement or CLETS for you.
What to do with your copies:
Find out if the judge made the temporary restraining orders. Ask the clerk when to come back to see if
the judge signed the order (Form DV-110). The judge must decide by the next business day. If the judge grants a
temporary restraining order, check it carefully to see what the orders are. The judge might not order everything you
requested. The court will set a hearing date on Form DV-109 whether or not the judge grants any temporary orders.
“File” the judge’s order. The clerk will keep the original forms for the court and will file-stamp up to three
copies for you. If you need more, you may make them yourself.
DV-110 Temporary Restraining Order
CLETS-001 (Confidential CLETS Information)
Name of Person Asking for Ord
DV-109
Notice of Court Hea
1
Your lawyer in this case (if you
Revised January 1, 2012
DV-505-INFO, Page 2 of 3
How Do I Ask for a Temporary Restraining Order?
(Domestic Violence Prevention)
Look at Form DV-109 for the
date and time of your hearing.
6
6
5
You must go to your hearing to
get a permanent order.
The order you have now only
lasts for about three weeks. Any
orders made on Form DV-110
(Temporary Restraining Order)
will end on the hearing date.
DV-505-INFO
How Do I Ask For a Temporary Restraining Order?
You have the right to cancel the
hearing. Read page 2 of Form
DV-109 for information.
6
6
6
•
Law enforcement will serve the orders for free, but you have to ask.
A “process server” is a business you pay to deliver court forms. Look in the Yellow
Pages under “Process Serving.”
6
6
1
6
6
3
•
If law enforcement or the process server uses a different Proof of Service form,
make sure the form lists all the forms served.
6
6
7
4
•
“Serve” the restrained person.
Ask someone you know, a process
server, or law enforcement to
personally “serve” (give) the restrained
person a copy of the notice of hearing,
the order, and other papers. You
cannot serve the papers yourself. They
cannot be sent by mail. The server
must:
Know your hearing date: Form DV-109
Be 18 years of age or older
Not be listed in item or of Form DV-100, Request for Domestic Violence Restraining Order.
File the Proof of Personal Service (Form DV-200).
The Proof of Personal Service shows the judge and police that the restrained person
got a copy of the request for orders. Make three copies of the completed Proof of
Personal Service. Take the original and copies to the court clerk as soon as possible
before your hearing. The clerk will keep the original and give you back the copies
stamped “Filed.” Bring a copy to your hearing.
Keep one copy with you and another in a safe place in case you need to show it to the police. Give the other copies
out as you did in . The court will send your completed Proof of Personal Service to law enforcement or CLETS
for you. CLETS is a statewide computer system that lets police know about your order.
If the sheriff serves your order, he or she will send the Proof of Service to the court and to CLETS for
you.
Personal
Don’t serve it by mail!
After serving the orders, the server fills out and signs Form DV-200, Proof of Personal Service, and gives it to you.
Need help?
9
Which Financial Form—FL-155 or FL-150? (DV-570)
Need more help?
10
•
Revised January 1, 2012
DV-505-INFO, Page 3 of 3
How Do I Ask for a Temporary Restraining Order?
(Domestic Violence Prevention)
6
6
8
DV-505-INFO
How Do I Ask For a Temporary Restraining Order?
If the restrained person wasn’t served . . .
The restrained person must be served before the hearing.
If the restrained person wasn’t served, fill out Form
DV-115 (Request to Continue Hearing and Reissue
Temporary Restraining Order) and the top of Form
DV-116 (Notice of New Hearing Date and Order on
Reissuance) to ask the judge for a new hearing date. Do
this before or at your hearing. (If you wait until after the
hearing, you have to start from the beginning and complete
all of the forms again.)
•
File the signed order (Form DV-116) with the clerk. The
clerk will send it to law enforcement or CLETS for you.
•
•
•
If the judge signs Form DV-116, any restraining orders
will last until the new hearing date.
Attach Form DV-115 and Form DV-116 to your other
court papers and have the restrained person personally served.
Bring a copy of Form DV-115 and Form DV-116 to your hearing.
File the original Form DV-200, Proof of Personal Service, and bring a copy to your hearing.
How Can I Respond to a Request for Domestic Violence Restraining Order? (DV-120-INFO)
The clerk has information sheets that can help you. Or you can get them at: www.courts.ca.gov/forms
How Do I Ask the Court to Renew My Restraining Order? (DV-700-INFO)
•
•
•
Ask the court clerk about free or low-cost legal help.
For a referral to a local domestic violence or legal assistance
program, call the National Domestic Violence Hotline:
1-800-799-7233
TDD: 1-800-787-3224
It’s free and private.
They can help you in more than 100 languages.
What Is “Proof of Personal Service”? (DV-200-INFO)
How to Enforce Your Restraining Order (DV-530-INFO)
•
•
•
Can a Domestic Violence Restraining Order Help Me? (DV-500-INFO)
Get Ready for the Court Hearing (DV-520-INFO)
•
Save This Form
Print This Form
Page 1 of 1
Approved for Optional Use
Form # L-1120
Rev. May 5, 2010
FAMILY LAW NOTICE RE RELATED CASE
Superior Court of Orange County
Local Rule 701.5
www.occourts.org
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name & Address):
TELEPHONE NO.: FAX NO. (Optional):
E-MAIL ADDRESS (Optional):
ATTORNEY FOR (Name): BAR NO.:
FOR COURT USE ONLY
SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE
JUSTICE CENTER:
Central - 700 Civic Center Dr. West, Santa Ana, CA 92701-4045
Lamoreaux - 341 The City Drive, Orange, CA 92868-3205
PLAINTIFF/PETITIONER:
DEFENDANT/RESPONDENT:
FAMILY LAW NOTICE RE RELATED CASE
CASE NUMBER:
The parties must file this form with the Superior Court of Orange County, when a family law case is filed with the
Court and when a party discovers that there is a related case. A related case means one or both parties and/or
minor children of the parties are involved in other cases. Examples of related cases include another family law
case, a domestic violence case, a child support collection case, a criminal case, and a juvenile case involving a
minor child of one or both of the parties.
Fill in the requested information:
1. I also used the name(s):
2. The other party’s name is:
;
He/She has also used the name(s):
3.
Other court cases involving either party or a child of either party:
(If known, please include the case numbers)
Court Location/
Case Number Case Name Justice Center Person Involved
a.
b.
c.
d.
4.
There are no other court cases involving either party or a child of either party.
Date:
(TYPE OR PRINT NAME OF PARTY OR ATTORNEY)
(SIGNATURE OF PARTY OR ATTORNEY)
Page 1 of 1
Approved for Optional Use
L-1124 Rev. 7-16-09
DECLARATION RE: NOTICE OF EX PARTE APPLICATION
(FAMILY LAW)
California Rules of Court, rule 3.1203(a)
Orange County Local Rule 704
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name & Address):
TELEPHONE NO.: FAX NO. (Optional):
E-MAIL ADDRESS (Optional):
ATTORNEY FOR (Name): BAR NO.:
FOR COURT USE ONLY
SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE
JUSTICE CENTER:
Central – 700 Civic Center Dr. West, Santa Ana, CA 92701-4045
Lamoreaux - 341 The City Drive, Orange, CA 92868-3205
PETITIONER/PROTECTED PARTY:
RESPONDENT/RESTRAINED PARTY:
DECLARATION RE: NOTICE OF EX PARTE APPLICATION (FAMILY LAW)
CASE NUMBER:
Use one form for each person to whom notice was given.
I,
, declare that:
(PRINT NAME)
(Check and complete section 1 below if notice was given to the opposing party regarding the ex parte application.
Check and complete section 2 below if notice was not given.)
1.
I informed the other party in this action, (list party): , that I would be
seeking a
temporary restraining order other ex parte hearing (specify) .
a. Date and time informed:
b. How informed:
(1)
By telephone (name):
(2)
By telephone to the attorney (name):
(3)
By personally informing (name):
(4)
Other:
c. I informed the person listed above that he/she should appear at the following location on (date)
at (time) if he/she wished to be heard by the court:
(1)
Dept. located at Lamoreaux Justice Center, 341 The City Drive, Orange, CA 92868
(2)
Dept. located at Central Justice Center, 700 Civic Center Drive West, Santa Ana, CA 92701
(3)
Family Law Clerk’s Office located at Lamoreaux Justice Center, 341 The City Drive, 7
th
Floor, Orange,
CA 92868 (Give notice to appear in the Family Law Clerk’s Office if no courtroom has been assigned.)
2.
I have not given notice to the other party in this action for the following reason (Include any attempts made,
if you were unable to serve):
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:
(SIGNATURE OF DECLARANT)
INFORMATION SHEET—EX PARTE MATTERS
Rev. 7/16/09
INFORMATION SHEET—EX PARTE MATTERS
L-1124-INFO, Page 1 of 1
NOTICE REQUIREMENTS
ALL EX PARTE APPLICATIONS EXCEPT DOMESTIC VIOLENCE, ELDER AND DEPENDENT ADULT ABUSE
MATTERS AND DISCOVERY MOTIONS.
Notice must be given by telephone or in writing to the self-represented party or to the opposing attorney so that it is
received not later than 10:00 a.m. on the court day before the ex parte matter will be presented to the judicial
officer. A party may request the notice be waived by writing a declaration signed under penalty of perjury which
explains facts showing good cause not to give the notice. A judicial officer may approve a waiver of notice for good
cause.
EX PARTE APPLICATIONS WHICH INVOLVE DOMESTIC VIOLENCE, ELDER ABUSE, OR DEPENDENT ADULT
ABUSE MATTERS
Notice must be given by telephone or in writing to the self-represented party or to the opposing attorney so that it is
received not later than four (4) hours before the time the ex parte matter will be presented to the judicial officer.
A party may request the notice be waived by writing a declaration signed under penalty of perjury which explains facts
showing good cause not to give the notice. A judicial officer may approve a waiver of notice for good cause.
ALL EX PARTE APPLICATIONS
1. Notice of the Ex Parte Application must include:
a. A statement of the relief being requested from the court (example: a request to continue the trial; a
restraining order is requested)
b. A statement that the opposing party is entitled to attend the court hearing in person or by an attorney
when the Ex Parte Application is presented to the court
c. The name and address of the court where the Ex Parte Application will be presented.
(1) If a case is not previously assigned to a specific judicial officer, the notice must instruct the
responding party to appear at a specific time in the Family Law Clerk’s Office (7
th
Floor) at
Lamoreaux Justice Center, 341 The City Drive, Orange, California 92868. The Clerk’s Office will
direct the parties to the appropriate courtroom.
(2) If a case is previously assigned to a judicial officer for all purposes, then the notice must instruct the
responding party to appear in that Department at a specific time and date.
(a) Departments beginning with the letter “C” are located at Central Justice Center, 700 Civic Center
Drive West, Santa Ana, California 92701.
(b) Departments beginning with the letter “L” are located at Lamoreaux Justice Center, 341 The City
Drive, Orange, California 92868.
2. Ex parte family law discovery motions are governed by rule 3.1203(a) of the California Rules of Court.
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.
Save This Form
Print This Form
Clear This Form
We are now married or registered domestic partners.
a.
b
.
This is not a Court Order.
Request for Domestic Violence Restraining Order
(Domestic Violence Prevention)
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California, County of
Case Number:
Clerk fills in case number when form is filed.
DV-100
Request for Domestic
Violence Restraining Order
4
What is your relationship to the person in ? (Check all that apply):
We used to be married or registered domestic partners.
c.
We live together.
d.
We used to live together.
3
2
Name of person asking for protection:
Your lawyer in this case (if you have one):
Telephone:
1
2
You must also complete Form CLETS-001, Confidential CLETS Information
and give it to the clerk when you file this Request.
Age:
Name:
State Bar No.:
Address:
Address (If you have a lawyer for this case, give your lawyer’s
information. If you do not have a lawyer and want to keep your home
address private, give a different mailing address instead. You do not
have to give your telephone, fax, or e-mail.):
Fax:
Firm Name:
E-Mail Address:
Name of person you want protection from:
Zip:
State:
City:
Full name
M F Height:Sex:
Address (if known):
Race:
Date of Birth:
City:
Age:
Do you want an order to protect family or household members?
Description of person you want protection from:
Weight:
Hair Color: Eye Color:
State: Zip:
Yes
No
Sex
Age
Lives with you?
Yes
No
Relationship to you
Yes
No
Yes
No
Check here if you need more space. Attach a sheet of paper and write “DV-100, Protected People” for a title.
3
If yes, list them:
If you do not have one of these relationships,
the court may not be able to consider your
request. Read DV-500-INFO for help.
Child’s Name: Date of Birth:
e.
We are related by blood, marriage, or adoption (specify relationship):
f.
We are dating or used to date, or we are or used to be engaged to be married.
g.
We are the parents together of a child or children under 18:
Child’s Name: Date of Birth:
Child’s Name: Date of Birth:
Check here if you need more space. Attach a sheet of paper and write “DV-100, Children Under 18” for a
h.
We have signed a Voluntary Declaration of Paternity for our child or children. (Attach a copy if you have one).
title.
Judicial Council of California, www.courts.ca.gov
Revised January 2, 2012, Mandatory Form
Family Code, § 6200 et seq.
DV-100, Page 1 of 5
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.
Are there any domestic violence restraining/protective orders now (criminal, juvenile, family)?
b
.
No
Yes
If yes, attach a copy if you have one.
Check the orders you want.
6
Personal Conduct Orders
Harass, attack, strike, threaten, assault (sexually or otherwise), hit, follow, stalk, molest, destroy personal
a.
property, disturb the peace, keep under surveillance, or block movements
7
Stay-Away Order
I ask the court to order the person in to stay at least yards away from (check all that apply):
a.
2
If the person listed in is ordered to stay away from all the places listed above, will he or she still be able
b
.
2
to get to his or her home, school, job, workplace, school, or vehicle?
Yes
No
(If no, explain):
This is not a Court Order.
8
Move-Out Order
I ask the court to order the person in to move out from and not return to (address):
2
I have the right to live at the above address because (explain):
Case Number:
Revised January 2, 2012
Request for Domestic Violence Restraining Order
(Domestic Violence Prevention)
(If the person in lives with you and you want that person to stay away from your home, you must ask for
2
this move-out order)
Me
My home
My job or workplace
My school
My vehicle
The children’s school or child care
Each person listed in
Other (specify):
3
I ask the court to order the person in not to do the following things to me or anyone listed in :
2
3
5
Other Court Cases
Have you or any other person named in item been involved in another court case with the person in ?
a.
3
2
No
Yes
If yes, check each kind of case and indicate where and when each was filed:
Kind of Case
County or Tribe Where Filed
Year Filed
Case Number (if known)
Divorce, Nullity, Legal Separation
Civil Harassment
Domestic Violence
Criminal
Juvenile, Dependency, Guardianship
Child Support
Parentage, Paternity
Other (specify):
Check here if you need more space. Attach a sheet of paper and write “DV-100, Other Court Cases” for a
title.
DV-100, Page 2 of 5
Contact, either directly or indirectly, in any way, including but not limited to, by telephone, mail or
e-mail or other electronic means
b
.
The person in will be ordered not to take any action to get the addresses or locations of any protected
2
person unless the court finds good cause not to make the order.
Guns or Other Firearms and Ammunition
This is not a Court Order.
Property Restraint
2
I believe the person in owns or possesses guns, firearms, or ammunition.
2
Yes
No
I don’t know
guns or firearms that he or she owns or possesses.
Record Unlawful Communications
I ask for the right to record communications made to me by the person in that violate the judge’s orders.
2
Animals: Possession and Stay-Away Order
I ask for the sole possession, care, and control of the animals listed below. I ask the court to order the person in
2
to stay at least yards away from and not take, sell, transfer, encumber, conceal, molest, attack,
strike, threaten, harm, or otherwise dispose of the following animals:
I ask for the animals to be with me because:
Property Control
I ask the court to give only me temporary use, possession, and control of the property listed here:
Debt Payment
I ask the court to order the person in to make these payments while the order is in effect:
Pay to:
For:
Amount: $
Due date:
Case Number:
Revised January 2, 2012
Request for Domestic Violence Restraining Order
(Domestic Violence Prevention)
9
12
16
10
11
13
14
15
Check here if you need more space. Attach a sheet of paper and write “DV-100, Debt Payment” for a title.
I am married to or have a registered domestic partnership with the person in . I ask the judge to order
that the person in not borrow against, sell, hide, or get rid of or destroy any possessions or property, except
in the usual course of business or for necessities of life. I also ask the judge to order the person in to notify
me of any new or big expenses and to explain them to the court.
2
2
2
DV-100, Page 3 of 5
Child Custody and Visitation
I do not have a child custody or visitation order and I want one.
a.
I have a child custody or visitation order and I want it changed.
b
.
If you ask for orders, you must fill out and attach Form DV-105, Request for Child Custody and Visitation
Orders.
Child Support (Check all that apply):
I do not have a child support order and I want one.
a.
I have a child support order and I want it changed.
b
.
If you ask for child support orders, you must fill out and attach Form FL-150, Income and Expense
Declaration or Form FL-155, Financial Statement (Simplified).
I now receive or have applied for TANF, Welfare, CalWORKS, or Medi-Cal.
c.
You and the other parent may tell the court that you want to be legal parents of the children (use Form
DV-180, Agreement and Judgment of Parentage).
If the judge approves the order, the person in will be ordered not to own, possess, purchase or receive a
firearm or ammunition. The person will be ordered to sell to a gun dealer or turn in to law enforcement any
2
This is not a Court Order.
Other Orders
2
What other orders are you asking for?
Spousal Support
2
Payments for Costs and Services
I ask the court to order the person in to pay the following:
You can ask for lost earnings or your costs for services caused directly by the person in (damaged property,
medical care, counseling, temporary housing, etc.). You must bring proof of these expenses to your hearing.
Pay to:
For:
Amount: $
Pay to:
For:
Amount: $
Batterer Intervention Program
I ask the court to order the person listed in to go to a 52-week batterer intervention program and show proof
of completion to the court.
2
No Fee to Serve (Notify) Restrained Person
If you want the sheriff or marshal to serve (notify) the restrained person about the orders for free, ask the court
clerk what you need to do.
Court Hearing
Case Number:
Revised January 2, 2012
Request for Domestic Violence Restraining Order
(Domestic Violence Prevention)
21
17
18
19
20
22
23
24
Check here if you need more space. Attach a sheet of paper and write “DV-100, Other Orders” for a title.
Time for Service (Notice)
The papers must be personally served on the person in at least five days before the hearing, unless the
court orders a shorter time for service. If you want there to be fewer than five days between service and the
hearing, explain why below. For help, read Form DV-200-INFO, “What Is Proof of Personal Service?”
3
3
3
2
The court will schedule a hearing on your request. If the judge does not make the orders effective right away
(“temporary restraining orders”), the judge may still make the orders after the hearing. If the judge does not
make the orders effective right away, you can ask the court to cancel the hearing. Read Form DV-112, Waiver
of Hearing on Denied Request for Temporary Restraining Order for more information.
DV-100, Page 4 of 5
I am married to or have a registered domestic partnership with the person in and no spousal support order
exists. I ask the court to order the person in to pay spousal support. (You must fill out, file, and serve Form
FL-150, Income and Expense Declaration, before your hearing).
Lawyer’s Fees and Costs
I ask that the person in pay some or all of my lawyer’s fees and costs.
You must complete, file and serve Form FL-150, Income and Expense Declaration before your hearing.
2
2
2
This is not a Court Order.
Date:
Type or print your name
Sign your name
Case Number:
Revised January 2, 2012
Request for Domestic Violence Restraining Order
(Domestic Violence Prevention)
26
Other Persons to Be Protected
The persons listed in item need an order for protection because (describe):
2
2
Check here if you need more space. Attach a sheet of paper and write “DV-100, Recent Abuse” for a title.
27
25
Describe Abuse
Describe how the person in abused you. Abuse means to intentionally or recklessly cause or attempt to cause
bodily injury to you; or to place you or another person in reasonable fear of imminent serious bodily injury; or to
molest, attack, hit, stalk, threaten, batter, harass, telephone, or contact you; or to disturb your peace; or to destroy
your personal property. Abuse can be spoken, written, or physical. (For a complete definition, see Family Code
§§ 6203, 6320).
2
Date of most recent abuse:
a.
Who was there?
b
.
Describe how the person in abused you or your children:
c.
2
Did the person in use or threaten to use a gun or any other weapon?
d.
No
Yes
(If yes, describe):
Describe any injuries:
e.
Did the police come?
f.
No
Yes
If yes, did they give you or the person in an Emergency Protective Order?
2
Yes
No
I don’t know
Attach a copy if you have one.
The order protects
you or the person in
3
Has the person in abused you (or your children) other times?
g.
2
If yes, check here and use Form DV-101, Description of Abuse or a sheet of paper to describe any
previous abuse.
Number of pages attached to this form, if any:
I declare under penalty of perjury under the laws of the State of California that the information above is true and correct.
Lawyer’s signature
Date:
Lawyer’s name, if you have one
DV-100, Page 5 of 5
For your protection and privacy, please press the Clear This Form
button after you have printed the form.
Save This Form
Print This Form
Clear This Form
MC-025
CASE NUMBER:
SHORT TITLE:
ofPage
ATTACHMENT (Number):
(This Attachment may be used with any Judicial Council form.)
(Add pages as required)
(If the item that this Attachment concerns is made under penalty of perjury, all statements in this
Attachment are made under penalty of perjury.)
Form Approved for Optional Use
Judicial Council of California
MC-025 [Rev. July 1, 2009]
ATTACHMENT
www.courtinfo.ca.gov
to Judicial Council Form
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.
Save This Form
Print This Form
Clear This Form
The person in
If yes, did they give you or the person in an Emergency Protective Order?
DV-101
Description of Abuse
Case Number:
This form is attached to DV-100, Request for Domestic Violence Restraining Order.
Name of person asking for protection:
Name of person you want protection from:
Describe the 2nd most recent abuse.
Date of 2nd most recent abuse:
Who was there?
Describe how the person in
Describe any use or threatened use of guns or other weapons:
Describe any injuries:
YesDid the police or other law enforcement come?
Nof.
Yes I don’t know
No
DV-101, Page 1 of 2
Description of Abuse
Judicial Council of California, www.courts.ca.gov
Rev. January 1, 2012, Optional Form
Family Code, § 6200 et seq.
a.
b.
c.
d.
e.
Attach a copy of the Emergency Protective Order if you have one.
YouThe Emergency Protective Order protects
1
2
3
2
2
2
(Domestic Violence Prevention)
abused you or your children:
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.
Case Number:
Describe other recent abuse.
Date of other recent abuse:
Who was there?
Describe how the person in
abused you or your children:
Describe any use or threatened use of guns or other weapons:
Describe any injuries:
f.
Describe other abuse against you or your children.
Check here if you need more space. Attach a sheet of paper and write “DV-101—Description of Abuse” for a
title.
a.
b.
c.
d.
e.
If yes, did they give you or the person in an Emergency Protective Order?
YesDid the police or other law enforcement come?
No
Yes I don’t know
No
Attach a copy of the Emergency Protective Order if you have one.
YouThe Emergency Protective Order protects
The person in
4
2
2
2
5
DV-101, Page 2 of 2
Description of Abuse
Rev. January 1, 2012
(Domestic Violence Prevention)
For your protection and privacy, please press the Clear This Form
button after you have printed the form.
Save This Form
Print This Form
Clear This Form
This is not a Court Order.
This form is attached to DV-100, Request for Domestic Violence Restraining Order.
Your name: Mom Dad Other*
Mom Dad Other*
Other parent’s name:
Change Current Court Order
I want to change a current child custody or visitation court order.
Explain your current order and why you want a change.
Child’s Address
Child (a) lived with:
Dad OtherMom
Dates lived there:
to present
to
to
to
DV-105, Page 1 of 3
Judicial Council of California, www.courts.ca.gov
Rev. January 1, 2012, Mandatory Form
Family Code, § 3063
Request for Child Custody and Visitation Orders
(Domestic Violence Prevention)
Where has the child in (a) lived for the last 5 years? Give each city and state the child has lived unless it is
unknown to the other parent and you want to keep it confidential because of domestic violence or child abuse.
Start with where the child lives now and work backwards in time. (If the current address is confidential, check
the box below and just provide the current state).
Child (a) addresses (city and state):
Case Number:
DV-105
Request for Child Custody and
Visitation Orders
1
1
2
4
5
Check here if you need more space. Attach a sheet of paper and write “DV-105, Child’s Address” for a
title.
3
3
3
Confidential
*If Other, specify relationship to child:
Check here if you need more space. Attach a sheet of paper and write “DV-105, Change Current Court
Order” for a title.
Child Custody
Physical Custody to:
(Person you want the
child to live with)
I ask the court for custody as follows: Legal Custody to: (Person
who makes decisions about
health, education, and welfare)
Mom Date of BirthChild’s Name
a.
b.
c.
Check here if you need more space. Attach a sheet of paper and write “DV-105, Child Custody” for a title.
Dad Other Mom Dad Other
3
d.
Case Number (if you have it): ____________________________________ County:______________________
From
From
From
From
Check the orders you want .
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.
This is not a Court Order.
Case Number:
Other Custody Case
Were you involved in, or do you know of, any other custody case for any child listed in this form?
Yes
If yes, fill out below and attach a copy of any custody or visitation orders if you have them:
No
a. Name of each child in other custody case:
Domestic Violence
Divorce Guardianship
Juvenile/Dependency
b
. Type of case:
Witness
Partyc. I was a Other
(specify):
d. Court (name):
Address: County: State:
e. Date of court order:
Other People With or Claiming to Have Custody or Visitation Rights
Do you know of anyone who is not involved in this case who has or claims to have custody or visitation
Yes If yes, fill out below:
No
Has custody
Claims custody rights Claims visitation rights
For these children (name of each child):
Check here if you need more space. Attach a sheet of paper and write “DV-105, Other People With or
Claiming Custody or Visitation” for a title.
DV-105, Page 2 of 3
rights with any child listed on this form?
Name and address of that person:
1
7
8
Request for Child Custody and Visitation Orders
(Domestic Violence Prevention)
Other (specify):
Case number (if you have it):
Other Children’s Addresses
Check here if the other child’s (or children’s) address information is the same as listed in .
If it is different, check here. Attach a sheet of paper and write “DV-105, Other Children’s Addresses” for a
title. List other children’s address information, including dates, and name of person child lived with.
6
5
Visitation
No visitation until the hearing
a.
No visitation after the hearing
b.
I ask the court to order that the person in have the following temporary visitation rights:
(Check all that apply)
9
2
f.
Rev. January 1, 2012
Parentage (Paternity)
Child Support
The following visitation until the hearing after the hearing
c.
(1)
(The 1st weekend of the month is the 1st weekend with a Saturday.)
Weekends (starting):
1st 2nd 4th3rd
5th weekend of month
(2)
Weekdays
(starting):
from
at ata.m. a.m.p.m. to
p.m.
(time) (time)(day of week) (day of week)
from
at ata.m. a.m.p.m. to
p.m.
(time) (time)(day of week) (day of week)
Responsibility for Transportation
The parent will take or pick up the child or make arrangements for someone else to do so.
Mom Dad
take children to the visits.
a. Other
(name):
Mom
Dad
pick up children from the visits.
b.
Drop-off / pick-up of children will be at (address):
c.
Travel With Children
Mom Dad must have written permission Other (name):
from the other parent, or a court order, to take the children outside of:
The State of California
a.
b. Other place(s) (list):
Child Abduction Risk
I believe that there is a risk the other parent will take our child out of California and hide the child from me.
If you check this box you must fill out and attach Form DV-108, Request for Order: No Travel with Children.
You must tell the court if you find out any other information about a custody case in any court for the children
listed on this form.
If the court makes a temporary custody order, the parent receiving custody must not take the child out of
California without a noticed hearing. (See Family Code §3063.)
Other (name):
This is not a Court Order.
Rev. January 1, 2012
DV-105, Page 3 of 3
Request for Child Custody and Visitation Orders
(Domestic Violence Prevention)
Case Number:
11
13
14
I ask the court to order that:
I ask the court to order that:
County of: ________________________________________________
Other Visitation
Attach a sheet of paper with other visitation days and times, like summer vacation, holidays, and birthdays.
List dates and times. Write “DV-105, Visitation” for a title.
Check here if other arrangement. Attach a sheet of paper and write “DV-105, Responsibility for
Transportation” for a title.
d.
Supervised Visitation
a. I ask that the visitation in be supervised by
c. I ask that any costs for supervision be paid by:
Mom Dad
%%
%
Other (name)
12
A professional supervisor Other A non-professional supervisor
10
b. I ask that the visitation in be supervised by
9
10
•
•
Name and telephone number, if known: ______________________________________________________
Name and telephone number, if known: ______________________________________________________
A professional supervisor
Other A non-professional supervisor
Important Instructions
Save This Form
Print This Form
Clear This Form
For your protection and privacy, please press the Clear This Form
button after you have printed the form.
DV-140
This is a Court Order.
Case Number:
Child Custody and Visitation
Order
DV-130DV-110This form is attached to (check one):
Mom Dad Other*Name of Protected Person:
Mom Dad Other*
Other Parent’s Name:
The Court Orders:
Physical Custody to:
(Person the child lives with.
Check at least one.)
Legal Custody to: (Person
who makes decisions about
health, education. Check at
least one.)
Child Custody is ordered as follows:
Mom Dad Other* Mom Dad Other*Date of BirthChild’s Name
a.
b.
c.
If more children, check here. Attach a sheet of paper and write “DV-140, Child Custody” for a title.
* If Other, specify relationship to child and name of person:
Child Visitation is ordered as follows:
Mom DadNo visitation toa. Other (name):
See the attachedb. - page document, dated:
The parties must go to mediation at:
c.
Mom Dad Other (name):Until the next court order, visitation for
will be:d.
(1) (The 1st weekend of the month is the 1st weekend with a Saturday.)
Weekends (starting):
1st 2nd 4th3rd
5th weekend of month
from
at ata.m. a.m.p.m. to
p.m.
(time) (time)(day of week) (day of week)
(2)
Weekdays
(starting):
from
at ata.m. a.m.p.m. to
p.m.
(time) (time)(day of week) (day of week)
Other Visitation(3)
Check here and attach a sheet of paper if there are other visitation days and times, like holidays,
birthdays, sports events. List dates and times. Write “DV- 140, Other Visitation” for a title.
Supervised Visitation or Exchange
Judicial Council of California, www.courts.ca.gov
Rev. January 1, 2012, Mandatory Form
Family Code, §§ 3020, 3022, 3040–3043, 3100, 6340,7604
DV-140, Page 1 of 2
Child Custody and Visitation Order
5
* If Other, specify relationship to child:
1
2
3
4
5
(Domestic Violence Prevention)
Visits and/or exchanges of children are supervised as specified on Form DV-150, Supervised Visitation and
Exchange Order.
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.
This is a Court Order.
Case Number:
Travel with Children
Mom Dad must have written permission from the Other (name):
other parent, or a court order, to take the children outside of:
The State of California
a.
Other place(s) (list):
Child Abduction
There is a risk that one of the parents will take the children out of California without the other parent’s
permission. The orders in Form DV-145, Order: No Travel with Children, are attached and must be
obeyed. (Fill out and attach Form DV-145 to this form.)
Other Orders
Check here and attach any other orders to this form. Write “DV-140, Other Orders” as a title.
Jurisdiction
This court has jurisdiction to make child custody orders in this case under the Uniform Child Custody Jurisdiction
and Enforcement Act (part 3 of the California Family Code starting with § 3400).
Notice and Opportunity to Be Heard
The responding party was given reasonable notice and an opportunity to be heard as provided by the laws of the
State of California.
Country of Habitual Residence
The country of habitual residence of the child or children in this case is The United States of America
or
Other (specify):
Penalties for Violating This Order
If you violate this order, you may be subject to civil or criminal penalties, or both.
Rev. January 1, 2012
DV-140, Page 2 of 2
.
Duration of Child Custody, Visitation, and Support Orders
If this form is attached to Form DV-130 (Restraining Order After Hearing), the custody and visitation orders in this
form remain in effect after the restraining orders on Form DV-130 end.
6
5
7
6
5
8
6
5
9
6
5
10
6
5
11
6
5
12
6
5
13
6
5
14
c.
Child Custody and Visitation Order
(Domestic Violence Prevention)
The United States of America
b.
Responsibility for Transportation for Visitation
“Responsibility for transportation” means the parent will take or pick up the child or make arrangements for
someone else to do so.
Drop-off / pick-up of children will be at (address):
c.
6
Mom Dad take children to the visits.a. Other (name):
Mom Dad pick up children from the visits.
b.
Other (name):
5
6
For your protection and privacy, please press the Clear This Form
button after you have printed the form.
Save This Form
Print This Form
Clear This Form
This is a Court Order.
Name of Protected Person:
Your lawyer in this case (if you have one):
Zip:
State:City:
Telephone:
Full name
Additional Protected Persons
This order expires at the date and time of the hearing below:
DV-110, Page 1 of 5
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California, County of
Case Number:
Clerk fills in case number when form is filed.
DV-110
Temporary Restraining Order
1
2
4
Person in must complete items , , and only.
Name:
State Bar No.:
Address:
Address (If you have a lawyer for this case, give your lawyer’s
information. If you do not have a lawyer and want to keep your home
address private, give a different mailing address instead. You do not have
to give your telephone, fax, or e-mail.):
Fax:
Firm Name:
E-Mail Address:
Name of Restrained Person:
Description of restrained person:
Sex AgeRelationship to person in
In addition to the person named in , the following persons are protected by temporary orders as indicated in items
3
Expiration Date
1 31 2
1
6
1
and (family or household members):
7
Check here if there are additional protected persons. List them on an attached sheet of paper and write,
“DV-110, Additional Protected Persons” as a title.
The court will complete the rest of this form.
Hearing Date: Time:
a.m. p.m.
M F Height:Sex:
Address (if known):
Race:
Date of Birth:
City:
Age:
Weight: Hair Color: Eye Color:
State: Zip:
Relationship to protected person:
Judicial Council of California, www.courts.ca.gov
Revised January 1, 2012, Mandatory Form
Family Code, § 6200 et seq.
Approved by DOJ
Temporary Restraining Order
(CLETS—TRO)
(Domestic Violence Prevention)
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.
Criminal Protective Order
A criminal protective order on Form CR-160, Criminal Protective Order–Domestic Violence, is in effect.
Case Number:
County: Expiration Date:
a.
The court has granted the temporary orders checked below. If you do not obey these orders,
you can be arrested and charged with a crime. You may be sent to jail for up to one year, pay a
fine of up to $1,000, or both.
You must take only personal clothing and belongings needed until the hearing and move out immediately from
No information has been provided to the judge about a criminal protective order.
b
.
To the person in
2
(address):
This is a Court Order.
DV-110, Page 2 of 5
Case Number:
5
1
6
Personal Conduct Orders
You must not do the following things to the person in and
a.
Not requested
Denied until the hearing
Granted as follows:
persons in :
3
Harass, attack, strike, threaten, assault (sexually or otherwise), hit, follow, stalk, molest, destroy personal
property, disturb the peace, keep under surveillance, or block movements
3
1
1
7
Stay-Away Order
You must stay at least (specify): yards away from:
a.
The person in
The persons in
Home of person in
The job or workplace of person in
School of person in
The children’s school or child care
Other (specify):
Peaceful written contact through a lawyer or process server or another person as needed to serve Form
DV-120 (Response to Request for Domestic Violence Restraining Order) or other legal papers is allowed
and does not violate this order.
b
.
1
8
Move-Out Order
3
Contact, either directly or indirectly, in any way, including but not limited to, by telephone, mail, e-mail or
other electronic means
Take any action, directly or through others, to obtain the addresses or locations of the persons in
and . (If this item is not checked, the court has found good cause not to make this order.)
Exceptions: Brief and peaceful contact with the person in , and peaceful contact with children in , as
required for court-ordered visitation of children, is allowed unless a criminal protective order says
otherwise.
c.
Not requested
Denied until the hearing
Granted as follows:
3
1
1
1
1
Vehicle of person in
1
3
Exceptions: Brief and peaceful contact with the person in , and peaceful contact with children in , as
required for court-ordered visitation of children, is allowed unless a criminal protective order says
otherwise.
b
.
Not requested Denied until the hearing Granted as follows:
Temporary Restraining Order
(CLETS—TRO)
(Domestic Violence Prevention)
Revised January 1, 2012
You and the person in must follow the orders listed in attached Form DV-140, Child Custody and Visitation
Order. The parent with temporary custody of the child must not remove the child from California until a noticed
hearing (Family Code Section 3063).
You cannot own, possess, have, buy or try to buy, receive or try to receive, or in any other way get guns, other
firearms, or ammunition.
2
The person in is given the sole possession, care, and control of the animals listed below. The person in
must stay at least ______ yards away from and not take, sell, transfer, encumber, conceal, molest, attack, strike,
threaten, harm, or otherwise dispose of the following animals:
1
Until the hearing, only the person in can use, control, and possess the following property and things:
You must:
Sell to a licensed gun dealer or turn in to a law enforcement agency any guns or other firearms within your
immediate possession or control. This must be done within 24 hours of being served with this order.
•
File a receipt with the court within 48 hours of receiving this order that proves guns have been turned in or
sold. (You may use Form DV-800, Proof of Firearms Turned In or Sold, for the receipt.)
•
1
1
If the people in and are married to each other or are registered domestic partners,
21
must not transfer, borrow against, sell, hide, or get rid of or destroy
Peaceful written contact through a lawyer or a process server or other person for service of legal papers related
to a court case is allowed and does not violate this order.
The court has received information that you own or possess a firearm.
This is a Court Order.
DV-110, Page 3 of 5
Case Number:
Temporary Restraining Order
(CLETS—TRO)
(Domestic Violence Prevention)
Revised January 1, 2012
No Guns or Other Firearms or Ammunition
a.
b
.
c.
9
Not requested Denied until the hearing Granted as follows:
10
Record Unlawful Communications
The person in can record communications made by you that violate the judge’s orders.
1
11
Care of Animals
Not requested Denied until the hearing Granted as follows:
12
Child Custody and Visitation
Not requested Denied until the hearing Granted as follows:
13
Child Support
14 Property Control
Not ordered now but may be ordered after a noticed hearing.
Not requested Denied until the hearing Granted as follows:
2
15
Debt Payment
The person in must make these payments until this order ends:
Pay to:
For: Amount: $ Due date:
Pay to: For: Amount: $ Due date:
Denied until the hearing Granted as follows:
16
Property Restraint
Not requested Denied until the hearing Granted as follows:
Not requested
the person in
1
the person in
2
any property, including animals, except in the usual course of business or for necessities of life. In addition,
each person must notify the other of any new or big expenses and explain them to the court. (The person in
cannot contact the person in if the court has made a “no contact” order.)
2
1
9
You Cannot Have Guns, Other Firearms or Ammunition
You cannot own, have, possess, buy or try to buy, receive or try to receive, or otherwise get guns, other firearms, or
ammunition while this order is in effect. If you do, you can go to jail and pay a $1,000 fine. You must sell to a licensed
gun dealer or turn in to a law enforcement agency any guns or other firearms that you have or control as stated in item
above. The court will require you to prove that you did so.
No Fee to Serve (Notify) Restrained Person
If the sheriff serves this order, he or she will do it for free.
Date:
Judge (or Judicial Officer)
Warnings and Notices to the Restrained Person in
2
If You Do Not Obey This Order, You Can Be Arrested and Charged With a Crime
•
It is a felony to take or hide a child in violation of this order.
•
If you travel to another state or to tribal lands or make the protected person do so, with the intention of disobeying this
order, you can be charged with a federal crime.
•
If you do not obey this order, you can go to jail or prison and/or pay a fine.
This is a Court Order.
DV-110, Page 4 of 5
Case Number:
Temporary Restraining Order
(CLETS—TRO)
(Domestic Violence Prevention)
Revised January 1, 2012
2
If the judge makes a restraining order at the hearing, which has the same orders as in this form, you will get a copy of that
order by mail at your last known address, which is written in . If this address is not correct, or to know if the orders
were made permanent, contact the court.
Service of Order by Mail
18
Lawyer’s Fees and Costs
Not ordered now but may be ordered after a noticed hearing.
19
Payments for Costs and Services
Not ordered now but may be ordered after a noticed hearing.
20
Batterer Intervention Program
Not ordered now but may be ordered after a noticed hearing.
Not requested
Denied until the hearing
Granted as follows:
21
Other Orders
17
Spousal Support
Not ordered now but may be ordered after a noticed hearing.
22
Check here if there are additional orders. List them on an attached sheet of paper and write “DV-110, other
Orders” as a title.
Child Custody, Visitation, and Support
•
Child custody and visitation: If you do not go to the hearing, the judge can make custody and visitation orders for
your children without hearing from you.
•
Child support: The judge can order child support based on the income of both parents. The judge can also have that
support taken directly from your paycheck. Child support can be a lot of money, and usually you have to pay until the
child is age 18. File and serve a Financial Statement (Simplified) (Form FL-155) or an Income and Expense
Declaration (Form FL-150) so the judge will have information about your finances.
•
Spousal support: File and serve an Income and Expense Declaration (Form FL-150) so the judge will have
information about your finances. Otherwise, the court may make support orders without hearing from you.
Instructions for Law Enforcement
This order is effective when made. It is enforceable by any law enforcement agency that has received the order, is shown
a copy of the order, or has verified its existence on the California Law Enforcement Telecommunications System
(CLETS). If the law enforcement agency has not received proof of service on the restrained person, and the restrained
person was not present at the court hearing, the agency shall advise the restrained person of the terms of the order and
then shall enforce it. Violations of this order are subject to criminal penalties.
Arrest Required If Order Is Violated
If an officer has probable cause to believe that the restrained person had notice of the order and has disobeyed the order,
the officer must arrest the restrained person. (Penal Code, §§ 836(c)(1), 13701(b).) A violation of the order may be a
violation of Penal Code section 166 or 273.6.
—Clerk’s Certificate—
I certify that this Temporary Restraining Order is a true and correct copy of the
original on file in the court.
Clerk’s Certificate
[seal]
Clerk, by
, Deputy
(Clerk will fill out this part.)
Date:
This is a Court Order.
DV-110, Page 5 of 5
Case Number:
Temporary Restraining Order
(CLETS—TRO)
(Domestic Violence Prevention)
Revised January 1, 2012
Certificate of Compliance With VAWA
This temporary protective order meets all “full faith and credit” requirements of the Violence Against Women Act,
18 U.S.C. § 2265 (1994) (VAWA) upon notice of the restrained person. This court has jurisdiction over the parties
and the subject matter; the restrained person has been or will be afforded notice and a timely opportunity to be
heard as provided by the laws of this jurisdiction. This order is valid and entitled to enforcement in each
jurisdiction throughout the 50 states of the United States, the District of Columbia, all tribal lands, and
all U.S. territories, commonwealths, and possessions and shall be enforced as if it were an order of that
jurisdiction.
For your protection and privacy, please press the Clear This Form
button after you have printed the form.
Save This Form
Print This Form
Clear This Form
Get copies.
DV-530-INFO, Page 1 of 1
Judicial Council of California, www.courts.ca.gov
Revised January 1, 2012
How to Enforce Your Restraining Order
(Domestic Violence Prevention)
DV-530-INFO
How to Enforce Your Restraining Order
•
•
•
•
•
When should I call the police?
•
Write down what happened, when, where, and the names of any witnesses.
Get copies of police reports.
If you are hurt, get copies of medical reports.
•
•
Even if you haven’t served the orders yet, call the police.
Show the police a copy of your orders. If the restrained person is there,
ask the officer to serve the orders. If the officer serves the orders, he or
she will send the Proof of Service to the court and CLETS for you.
CLETS is a statewide computer system that lets police know about
your orders.
What can the police do?
It is a crime to disobey the judge’s orders.
The restrained person can be arrested, pay a fine, and/or go to jail or prison.
Ask your local district attorney (D.A.) how he or she will handle your case. The D.A. may file criminal or
contempt charges. You can always call the D.A. for information about a criminal case.
You can also file a civil contempt action. Ask the court clerk for forms or visit www.courts.ca.gov.
Guns, Other Firearms and Ammunition
The restrained person cannot
•
own
have
buy or try to buy
•
•
a gun or firearm or ammunition while the order is in effect. If the person does any
of these things, he or she can go to jail and be ordered to pay a fine of $1,000.
•
Get copies of your restraining order (DV-110 or DV-130) and Proof of Service (Form DV-200 or DV-250) from the
court clerk if you don’t already have them:
Always keep a copy with you. You may need to show it to the police.
Keep another copy in a safe place and consider keeping a copy in your car.
Give a copy to anyone else protected by the order.
Take copies to places where you and the other protected people go (e.g. school, work, daycare, etc.).
Give a copy to the security officers in your apartment building and workplace.
Staple the restraining order (DV-110 or DV-130) to the Proof of Service (DV-200 or DV-250).
Call the police right away if the restrained person violates any of the orders. Also:
A law enforcement officer can give you information about any firearms the
restrained person has registered, transferred, or sold. (Penal Code section 11106).
You may disclose the information as needed to protect yourself or someone else.
Tell law enforcement if you have any information about any guns the restrained
person has or where they are located.
Save This Form
Print This Form
Name of Person Asking for Order:
DV-109, Page 1 of 3
Judicial Council of California, www.courts.ca.gov
Revised January 1, 2012, Mandatory Form
Family Code, § 242, Approved by DOJ
Notice of Court Hearing
DV-109
Notice of Court Hearing
Name of Person to Be Restrained:
1
2
Notice of Court Hearing
A court hearing is scheduled on the request for restraining orders against the person in .
3
Name and address of court if different from above:
Date: Time:
Room:Dept.:
This is a Court Order.
The court will fill out the rest of this form.
(Domestic Violence Prevention)
Hearing
Date
Clerk fills in case number when form is filed.
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California, County of
Case Number:
Your lawyer in this case (if you have one):
Zip:
State:City:
Telephone:
Fax:
Address (If you have a lawyer for this case, give your lawyer’s
information. If you do not have a lawyer and want to keep your home
address private, give a different mailing address instead. You do not
have to give your telephone, fax, or e-mail.):
Name:
State Bar No.:
Firm Name:
Address:
E-Mail Address:
2
All denied until the court hearing (specify reasons for denial in (b)):
Partly granted and partly denied until the court hearing (specify reasons for denial in (b)):
4
Temporary Restraining Orders (any orders granted are attached on Form DV-110)
Temporary restraining orders for personal conduct, stay away, and protection of animals, as requested in Form
DV-100, Request for Domestic Violence Restraining Order, are:
a
.
(1)
All granted until the court hearing
(2)
(3)
Requested temporary restraining orders for personal conduct, stay away, and protection of animals are denied
because:
b
.
(1)
The facts as stated in form DV-100 do not show reasonable proof of a past act or acts of abuse. (Family
Code, §§ 6320 and 6320.5)
(2)
The facts do not describe in sufficient detail the most recent incidents of abuse, such as what happened,
the dates, who did what to whom, or any injuries or history of abuse.
(3)
Further explanation of reason for denial, or reason not listed above:
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.
This is a Court Order.
DV-109, Page 2 of 3
Revised January 1, 2012
Case Number:
Service of Documents and Time for Service—for Person in
At least five or ___ days before the hearing, someone age 18 or older—not you or anyone else to be
protected—must personally give (serve) a court’s file-stamped copy of this form (DV-109, Notice of Court
Hearing) to the person in along with a copy of all the forms indicated below:
Form DV-100, Request for Domestic Violence Restraining Order, (file-stamped) with applicable attachments
a.
Form DV-120, Response to Request for Domestic Violence Restraining Order (blank form)
c.
5
Form DV-110, Temporary Restraining Order (file-stamped) with applicable attachments if granted by the
judge
b
.
Other (specify):
e.
Form DV-250, Proof of Service by Mail (blank form)
d.
2
Notice of Court Hearing
(Domestic Violence Prevention)
1
Date:
Judicial Officer
At the hearing, the judge will consider whether denial of any requested orders will jeopardize your safety and the
safety of children for whom you are requesting custody or visitation.
•
You must come to the hearing if you want the judge to make restraining orders or continue any orders already made.
If you cancel the hearing or do not come to the hearing, any restraining orders made on Form DV-110 will end on the
date of the hearing.
•
Right to Cancel Hearing: Information for the Person in
If item (a)(2) or (a)(3) is checked, the judge has denied some or all of the temporary orders you requested until
the court hearing. The judge may make the orders you want after the court hearing. You can keep the hearing date, or
you can cancel your request for orders so there is no court hearing.
•
If you want to cancel the hearing, use Form DV-112, Waiver of Hearing on Denied Request for Temporary
Restraining Order. Fill it out and file it with the court as soon as possible.You may file a new request for orders, on
the same or different facts, at a later time.
If you want to keep the hearing date, you must have all of the documents listed in item served on the other person
within the time listed in item .
5
If you cancel the hearing, do not serve the documents listed in item on the other person.
5
5
•
•
•
1
4 4
To the Person in
For information about service, read Form DV-210-INFO, What Is “Proof of Personal Service”?
1
The court cannot make the restraining orders after the court hearing unless the person in has been
personally given (served) a copy of your request and any temporary orders. To show that the person in
has been served, the person who served the forms must fill out a proof of service form. Form DV-200,
Proof of Personal Service may be used.
•
•
If you are unable to serve the person in in time, you may ask for more time to serve the documents.
Read Form DV-115-INFO, How to Ask for a New Hearing Date.
•
2
2
2
DV-109, Page 3 of 3
Revised January 1, 2012
Case Number:
Notice of Court Hearing
(Domestic Violence Prevention)
—Clerk’s Certificate—
I certify that this Notice of Court Hearing is a true and correct copy of the original on file
in the court.
Clerk’s Certificate
[seal]
Clerk, by
, Deputy
(Clerk will fill out this part.)
Date:
Request for Accommodations
Assistive listening systems, computer-assisted real-time captioning, or sign language interpreter
services are available if you ask at least five days before the hearing. Contact the clerk’s office or go to
www.courts.ca.gov/forms for Request for Accommodations by Persons With Disabilities and Response
(Form MC-410). (Civil Code, § 54.8.)
This is a Court Order.
To the Person in
2
If you want to respond in writing, mail a copy of your completed Form DV-120, Response to Request for Domestic
Violence Restraining Order, to the person in and file it with the court. You cannot mail Form DV-120 yourself.
Someone age 18 or older—not you—must do it.
•
1
To show that the person in has been served by mail, the person who mailed the forms must fill out a proof of
service form. Form DV-250, Proof of Service by Mail, may be used. File the completed form with the court before
the hearing and bring it with you to the hearing.
•
1
For information about responding to a restraining order and filing your answer, read Form DV-120-INFO, How
Can I Respond to a Request for Domestic Violence Restraining Order?.
•
•
•
•
Whether or not you respond in writing, go to the court hearing if you want the judge to hear from you before
making orders. You may tell the judge why you agree or disagree with the orders requested. You may bring
witnesses and other evidence.
At the hearing, the judge may make restraining orders against you that could last up to five years.
The judge may also make other orders about your children, child support, spousal support, money, and
property and may order you to turn in or sell any firearms that you own or possess.
For your protection and privacy, please press the Clear This Form
button after you have printed the form.
Save This Form
Print This Form
Clear This Form
2
I gave the person in
a.
DV-110 (Temporary Restraining Order)
b.
DV-105 and DV-140 (Request for Child Custody and Visitation Orders, Child Custody and Visitation Order)
c.
FL-150 with a blank FL-150 (Income and Expense Declaration)
d.
FL-155 with a blank FL-155 (Financial Statement (Simplified))
e.
DV-116 (Notice of New Hearing Date and Order on Reissuance)
g.
Other (specify):
i.
I declare under penalty of perjury under the laws of the State of California that the information above is true and
correct.
Date:
Type or print server’s name
Server to sign here
DV-200, Page 1 of 1
Judicial Council of California, www.courts.ca.gov
Revised January 1, 2012, Optional Form
Family Code, §§ 6344 6340-6344
(Domestic Violence Prevention)
a copy of all the documents checked:
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California, County of
Case Number:
Fill in case number:
DV-200
Name of Person Asking for Protection:
Name of Person to Be Restrained:
1
2
Notice to Server
The server must:
Be 18 years of age or older.
Not be listed in items or
of form DV-100, Request
for Domestic Violence
Restraining Order.
•
•
•
3
2
4
1
3
4
b. Time:
a. Date:
a.m.
p.m.
c. At this address:
Zip:
State:City:
5
2
Server’s Information
Name:
Address:
Zip:
State:City:
Telephone:
Registration number:
County of registration:
6
7
DV-115 (Request to Continue Hearing and Reissue Temporary Restraining Order)
f.
DV-130 (Restraining Order After Hearing)
h.
I personally gave copies of the documents checked above to the person in on:
(If you are a registered process server):
Proof of Personal Service (CLETS)
DV-109 with DV-100 and a blank DV-120 (Notice of Court
Hearing; Request for Domestic Violence Restraining Order;
blank Response to Request for Domestic Violence Restraining Order)
1
Proof of Personal Service
Give a copy of all documents checked in to the restrained person
in . (You cannot send them by mail.) Then complete and sign this
form, and give or mail it to the person in .
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.
Save This Form
Print This Form
Clear This Form
DV-200-INFO, Page 1 of 2
Judicial Council of California, www.courts.ca.gov
Revised January 1, 2012
What Is “Proof of Personal Service”?
(Domestic Violence Prevention)
DV-200-INFO
What Is “Proof of Personal Service”?
• What orders you are asking for
The hearing date
How to respond
•
•
Who can serve?
Ask someone you know, a process server, or a law enforcement agency (for
example, a sheriff) to personally serve (give) a copy of the orders to the person to
be restrained. You cannot send the forms to that person by mail.
The server must:
• Be 18 years of age or over
Not be you or anyone to be protected by the orders
•
(If a law enforcement agency or the process server uses a different Proof of
Service form, make sure it lists the forms served.)
How to Serve
•
Walk up to the person to be served.
Make sure it’s the right person. Ask the person’s name.
•
• Give the person copies of all papers checked on Form DV-200,
Proof of Personal Service.
Fill out and sign Form DV-200.
Give the signed Form DV-200 to you.
•
•
What if the person won’t take the papers or tears
them up?
•
If the person won’t take the papers, just leave them near him or her.
It doesn’t matter if the person tears them up.
•
A “registered process server” is a business you pay to deliver court forms.
Look for “Process Serving” in the Yellow Pages or on the Internet.
•
The police cannot arrest anyone for violating an order unless the restrained person knows about the order.
The judge cannot make the orders permanent unless the restrained person was served.
•
Service lets the other person know:
A sheriff can serve the order at no cost to you.
Ask the server to:
Why do I have to get the orders served?
What is “service”?
Service is the act of giving your legal papers to the other person. There
are many kinds of service—in person, by mail, and others. This form is
about personal or “in-person” service. The Notice of Court Hearing
(Form DV-109), Request for Domestic Violence Restraining Order
(Form DV-100) and Temporary Restraining Order (Form DV-110)
must be served “in person.” That means someone—not you or anyone
else protected by the order—must personally “serve” (give) the person
to be restrained a copy of the forms. You cannot send them by mail.
Don’t serve it by mail!
you must have the papers served at least 5 days before the hearing.
When do the orders have to be served?
It depends. To know the exact date, you have to look at two things on Form DV-109:
First, look at the hearing date on page 1 of Form DV-109. Next, look at the number of days written in item on page 2.
DV-200-INFO, Page 2 of 2
Revised January 1, 2012
What Is “Proof of Personal Service”?
(Domestic Violence Prevention)
DV-200-INFO
What Is “Proof of Personal Service”?
Look at a calendar. Subtract the number of days in item from the hearing date. That’s the final date to have the orders
served. It’s always OK to serve earlier than that date.
5
5
5
Who signs the Proof of Personal Service?
Only the person who serves the orders can sign the Proof of Personal Service (Form DV-200). You do not sign it. The
person to be restrained does not sign it.
What do I do with the completed Proof of Personal Service?
•
If possible, file the original Proof of Personal Service (Form DV-200) with the court at least 2 days before your
hearing. If you were unable to do this, bring the original Proof of Personal Service to your hearing.
The clerk will send it to CLETS.
Always keep an extra copy of the restraining orders with you for your safety.
•
•
If someone other than the sheriff serves the orders, you should:
If the sheriff serves the orders, he or she will send the Proof of Personal Service to the court and CLETS (California
Law Enforcement Telecommunications System), a statewide computer system that lets police know about your order,
for you.
Bring a copy of the original Proof of Personal Service (Form DV-200) to your hearing.
What happens if I cannot get the papers served before the hearing date?
You must attach a copy of Form DV-115 and DV-116 to a copy of your original order. That way, the police will know
your orders are still in effect. And the restrained person will be served with notice of the new hearing date. For more
information on getting a new hearing date, read Form DV-115-INFO, How to Ask for a New Hearing Date.
If nothing is written in item
Before your hearing, fill out and file a Request to Continue Hearing and Reissue Temporary Restraining Order (Form
DV-115) and Notice of New Hearing Date and Order on Reissuance (Form DV-116). These forms ask the judge for a
new hearing date and make any temporary orders last until then. Ask the clerk for the forms or go to www.courts.ca.gov.
Service of Documents and Time for
At least five or ___ days before the h
protected—must personally give (serve) a cou
Hearing) to the person in along with a copy
Form DV-100, Request for Domestic Viol
a.
Form DV-120, Response to Requ
c.
5
Form DV-110, Temporary Restrain
b.
Form DV-250, Proof of
Notice of Court Hearing
A court hearing is scheduled on the reque
3
Date: Time:
Room:Dept.:
Hearing
Date
judge
2
Domestic Violence Booklet
This packet contains the forms necessary to initiate the DV process. Please browse
through “Additional Forms and Information” to see if any other forms are
needed for your case. Especially in matters in which children are involved or
support is an issue.
Reminder:
National Domestic Violence Hotline: 800-799-SAFE (7233)
All documents must be typed or printed neatly. Please use black ink.
Domestic Violence papers are accepted at the Lamoreaux Justice Center,
7
th
Floor, Family Law Clerk’s Office.
The Domestic Violence Assistance Program Office has staff available to provide
information and assist with the completion of Domestic Violence forms. The
office is located at the Lamoreaux Justice Center, 6
th
Floor.
Revised 12/24/2012
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