INSTRUCTIONS: ORDER FOR VICTIM RESTITUTION
CR-112/JV-792
Attorney or Person Without Attorney
Write the name of your attorney. If you are representing
yourself, your name goes here.
Telephone Number
Your telephone number goes here. You may also give a
number where the court can leave a message for you.
Fax Number
You may write in your fax number here or you may leave
this line blank.
E-mail Address
You may write in your e-mail address here or you may
leave this line blank.
Name and Address of Court
Ask the clerk of your court for this information, including
the court’s address.
Case Name
Use the assigned case name. Example: In re John D. or
People of the State of California v. Doe.
Case Number
Write the assigned case number in this space. You need
to write this number at the top of every page of this form.
For Court Use Only
Leave blank. After this form is filed, the clerk will stamp
this box on the copies so everyone knows they are copies
of an official court document.
Order for Restitution
If the person was convicted in criminal court, write in the date of the defendant’s conviction and the defendant’s name.
In cases where a child has been found to be a person described in Welfare and Institutions Code section 602, check item b
and fill in the date of the hearing and the child’s name.
If the parents or guardians are jointly and severally liable, write the names in the space provided.
If co-offenders were found jointly and severally liable, write the names in the space provided.
This section must be completed by either you or the court. A separate order and abstract of judgment should be completed for
each defendant or child ward found guilty of an offense.
Judicial Determination of Restitution
The defendant or child has a right to a restitution hearing. The hearing can be waived if the defendant or child agrees to give up his
or her right to have a hearing. The amount of restitution may also be stipulated if the amount of restitution to be ordered is agreed
to by all parties and the judge makes an order for the amount based on an agreement by all parties. It is very important to check
the appropriate boxes to indicate whether the defendant or child has had a hearing or has waived the hearing. If you do not have all
of the relevant information to complete this section, then the court should complete it for you.
Restitution Ordered to Pay
If the court ordered the offender to pay you, write your name as the victim and the amount of restitution ordered by the court.
Make sure the amount of restitution is not left blank or “to be determined.” A dollar amount must be listed for the order to be
enforceable.
Check this box if the court ordered the California Victim Compensation Board to receive reimbursement for funds previously
paid to you or your service provider by the Restitution Fund. Make sure the amount of reimbursement is not left blank or “to be
determined.” A dollar amount must be listed for the order to be enforceable.
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www.courts.ca.gov
INSTRUCTIONS: ORDER FOR VICTIM RESTITUTION
Form Approved for Optional Use
Judicial Council of California
CR-112/JV-792 [Rev. September 1, 2018]
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