Fillable Huntington Beach Police Department Custody Visitation Court Order (City of Huntington Beach)

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Huntington Beach Police Department Custody Visitation Court Order (City of Huntington Beach)

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Huntington Beach Police Department
Custody Visitation Court Order Violation Report
Important – See Page 2 for Instructions
I agree and understand that by submitting this form I am declaring under penalty of perjury that the information I
supplied is true and correct.
Created 03/20 – SC2635
Information Completed By Police Department Personnel
Case Number: By: Badge No.: Date:
Your Name/Date of Birth/Driver’s License/Email Address
Last: First: Middle: DOB:
Driver’s License No.: Email:
Your Street Address/City/ State/ZIP
Number/Street: City:
State:
Zip:
Your
Contact Numbers
Primary: Secondary:
Your Relationship to the Child
Mother Father Legal Guardian Other-Specify
Child Information – Name/Date of Birth
Child 1 – Last: First: Middle: DOB:
Child 2 – Last: First: Middle: DOB:
Child 3 – Last: First: Middle: DOB:
Child 4 – Last: First: Middle: DOB:
Person Violating Order – Name/Date of Birth/Driver’s License/Email Address
Last: First: Middle: DOB:
Driver’s License No.: Email:
Person Violating Order – Street Address/City/ State/ZIP
Number/Street: City:
State:
Zip:
Person Violating Order – Contact Numbers
Prim
ary: Secondary:
Person Violating Order – Relationship to the Child
Mother Father Legal Guardian Other-Specify
When Did You Last See Your Children?
Have You Reported Violations to the Police Department This Year?
Yes No Case N
umber:
Family Court Information
Family Court Case No.: Name of Court: Date Issued:
You Have: Visitation Supervised Visitation Joint Legal Custody Joint Physical Custody
Sole Physical Custody Guardianship Other – Specify
Explain how the violation occurred. Include date(s), times(s) and locations(s):
RESET
Huntington Beach Police Department
Custody Visitation Court Order Violation Instruction and Info Sheet
Created 03/20 – SC2635
Instructions: Use this form to self-report violation(s) of a Family Court Order related to visitation. Please fill out this form as
completely as possible - required fields are indicated in RED. Please email this form to police records personnel at
records@hbpd.org
. Police department personnel will process your report and return via the email address provided with a case
number, keep a copy for your records. Please allow up to (5) business days for the police department’s response.
Important Notice
Upon acceptance of this report, NO FURTHER ACTION WILL BE TAKEN by the Huntington Beach Police Department or the District
Attorney's Office. Should you need assistance in pursuing a civil enforcement remedy, contact a private attorney. After you complete
this report, it will be kept on file with the Huntington Beach Police Department and forwarded to the Orange County District
Attorney’s Office.
Options and Resources if a parent does not follow the Custody/Visitation Court Order:
Should you have to go back to court, keep accurate records of all visitation violations. Keep a journal, or mark up a calendar, or use
the Child Custody Visitation Violation form with the dates and times that the other parent did not follow the order and did not show
up, or showed up late, or created other problems.
Contact the Family Court Services office at Lamoreaux Justice Center – Click Here
. They offer, at no cost, mediation services to
parents who want to resolve custody or visitation disputes without filing for a court hearing. This is called "informal mediation" and
can be scheduled by calling (657) 622-6196 for an appointment.
If there is a dispute or disagreement regarding the terms of custody and visitation, you can ask for modification of child custody or
visitation orders – Click Here
. This can help prevent situations where one or both parents are trying to take matters in their own
hands and are trying to create a new arrangement. Any changes should be approved by the court first before they are
implemented.
Consider filing an action for “contempt” with the court. In contempt actions, you ask the court to enforce the order and make a
finding that the other parent willfully disobeyed the court order. This is very complicated and can have serious consequences. Talk to
a lawyer to find out what is best in your case.
Helpful Links:
Child custody-visitation frequently asked questions
Family Court Services of Superior Court of Orange County – Parenting Plan Guideline
OC Courts Legal Resource Sheet
OC Courts Supervised Visitation and Keeping Kids Safe Program
Orange County Superior Court Family Law information
Parenting Plan Guideline – Family Court Services of Superior Court of Orange County
Reducing Custody-Related Conflicts
Helpful Videos:
Orientation to Family Court Mediation and Child Custody Recommending
Orientation to Mediation
Child Custody Information Sheets:
Child Custody Mediation
Child Custody Information Sheet
Direct Numbers of Community Resources are:
Parenting Classes and Counseling Referrals, Info Link: (949) 646-4357
Child Abuse Registry: (714) 940-1000
National Domestic Violence Hotline: (800) 799-7233
Local Domestic Violence Hotlines: Human Options (877) 854-3594, Interval House (714) 891-8121, Laura's House (866) 498-1511,
WTLC (714) 992-1934
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Huntington Beach Police Department Custody Visitation Court Order (City of Huntington Beach)

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Completed 4 February 2022

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