Guns or Other Firearms and Ammunition
This is not a Court Order.
I believe the person in owns or possesses guns, firearms, or ammunition.
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.
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
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:
I ask the court to give only me temporary use, possession, and control of the property listed here:
I ask the court to order the person in to make these payments while the order is in effect:
Revised January 2, 2012
Request for Domestic Violence Restraining Order
(Domestic Violence Prevention)
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.
DV-100, Page 3 of 5
Child Custody and Visitation
I do not have a child custody or visitation order and I want one.
I have a child custody or visitation order and I want it changed.
If you ask for orders, you must fill out and attach Form DV-105, Request for Child Custody and Visitation
Child Support (Check all that apply):
I do not have a child support order and I want one.
I have a child support order and I want it changed.
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.
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