Fillable PKT006.PDF (California)

Fill Online, Printable, Fillable, Blank PKT006.PDF (California) Form

Use Fill to complete blank online CALIFORNIA pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

PKT006.PDF (California)

On average this form takes 109 minutes to complete

The PKT006.PDF (California) form is 39 pages long and contains:

  • 0 signatures
  • 237 check-boxes
  • 324 other fields

Country of origin: US
File type: PDF

BROWSE CALIFORNIA FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
PKT-006 (Rev. 9/20)
SUPERIOR COURT OF CALIFORNIA
COUNTY OF SAN DIEGO
DOMESTIC VIOLENCE –
RESTRAINING ORDER
APPLICANT PACKET
FORMS INCLUDED IN THIS PACKET
Can a Domestic Violence Restraining Order Help Me?
Judicial Council Form #DV-500-INFO
Family Law General Self-Help Information
SDSC Form #D-280
Family Law Certificate of Assignment – Venue Declaration
SDSC Form #D-049
Request for Domestic Violence Restraining Order
Judicial Council Form #DV-100
Description of Abuse Judicial Council Form #DV-101
Additional page to attach to Judicial Council form or other court paper Judicial Council Form #MC-020
Temporary Restraining Order (CLETS-TRO)
Judicial Council Form #DV-110
Notice of Court Hearing
Judicial Council Form #DV-109
How to Ask for a New Hearing Date
Judicial Council Form #DV-115-INFO
Order for Removal from Residence
SDSC Form #D-072
Confidential CLETS Information
Judicial Council Form #CLETS-001
For your protection and privacy, press the Clear This Packet button on the last page after printing.
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).
* Yo
u 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.)
SDSC D-280 (Rev. 12/17) FAMILY LAW SELF-HELP GENERAL INFORMATION
Informational Form
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO
FAMILY LAW SELF-HELP GENERAL INFORMATION
The information contained in this form is intended to provide self-help guidance on family law cases. San Diego City and County Public
Libraries, as well as the San Diego Law Library, have computers with free Internet access available.
STATE SELF-HELP RESOURCES. The California Courts website, maintained by the Judicial Council of California, contains information
about resources for self-help. Go to the California Courts Home page (http://www.courts.ca.gov/home.htm) and click on the category that
best matches your needs from the “Self-Help” drop down menu. The primary categories for family law are: (1) Divorce or Separation
(
http://www.courts.ca.gov/selfhelp-divorce.htm); (2) Families & Children (http://www.courts.ca.gov/selfhelp-family.htm); and (3) Abuse &
Harassment (http://www.courts.ca.gov/selfhelp-abuse.htm). Each category includes basic information with links to subcategories that
include FAQs, step-by-step instructions for filing and serving the necessary documents, and links to the required forms with video
instructions on how to complete each form. Click on the blue links of each category and subcategories that match your needs and follow
the instructions. Parentage cases, also known as paternity cases, can be found as a subcategory under “Families & Children”
(
http://www.courts.ca.gov/selfhelp-parentage.htm).
LOCAL SELF-HELP RESOURCES. Visit the San Diego Superior Court’s website at www.sdcourt.ca.gov. On the Home page, click on
the “Family” category (drop down menu) for information about various case types and Self-Help Services within family law, including
family law rules and forms.
FAMILY LAW FACILITATORS (FLF). Relying solely on information obtained from the Internet is not the only option. FLF provides
hands-on help to any Self-Represented Litigant (SRL). FLF offices are located at every division of the court. They offer both one-on-one
services and group workshops. The services are free but offered on a first-come, first-served basis. Click on the link to “Self-Help
Services” in the “Family” drop down menu on the court's website for detailed information about FLF.
REQUEST FOR ORDER (RFO). An RFO is the process used to get most court orders both before and after a judgment has been entered
in a case. The most common temporary orders requested are child custody and visitation, and child and spousal support. As in most
family law matters, there are mandatory forms and procedures. Detailed information and instructions are on the California Courts website.
Go to the Self-Help drop down menu and click on “Families & Children” (http://www.courts.ca.gov/selfhelp-family.htm
). Follow the links
to the subcategories that best match your needs.
DOMESTIC VIOLENCE (DV). Detailed information, forms, and step-by-step instructions can be found on the California Courts website.
Click on the “Domestic Violence” subcategory under “Abuse & Harassment” (http://www.courts.ca.gov/selfhelp-domesticviolence.htm
).
Any person may also get free help at any Domestic Violence Restraining Order Clinic. Detailed information about the clinics can be found
on the San Diego Superior Court’s website at www.sdcourt.ca.gov by clicking on “Domestic Violence” in the “Family” drop down menu.
Domestic Violence Hotline (800) 799-SAFE (7233) / Domestic Violence Restraining Order Clinics listed below:
Central Courthouse
1100 Union St.
San Diego, CA 92101
Operated by San Diego
Volunteer Lawyer
Program (SDVLP)
www.sdvlp.org
Downtown San Diego
Family Justice Center
1122 Broadway,
Suite 200
San Diego, CA 92101
(619) 533-6000
www.sandiegofjc.org
El Cajon Courthouse
250 E. Main Street
El Cajon, CA 92020
Operated by San Diego
Volunteer Lawyer
Program (SDVLP)
www.sdvlp.org
& Center
for Community Solutions
www.ccssd.org
North County
Vista Courthouse
325 S. Melrose Drive
Vista, CA 92081
Operated by San Diego
Volunteer Lawyer
Program (SDVLP)
www.sdvlp.org
South County
South Bay Courthouse
500 Third Avenue
Chula Vista, CA 91911
Operated by Legal Aid
Society of San Diego
www.lassd.org
ALTERNATIVE DISPUTE RESOLUTION (ADR). Mediation, arbitration, collaborative family law, and the use of a privately compensated
temporary judge are methods of ADR available to litigants in most family law cases. ADR is offered through private businesses at the
parties' own cost. The court does not provide a list of these outside resources, nor does it endorse any private business.
OTHER INFORMATIONAL FORMS. The court’s website has other local court forms which provide detailed information on topics not
included in this form. Click on “Forms” in the “Family” drop down menu and find the forms listed in alphabetical order.
• Family Centered Case Resolution Process General Information (SDSC Form #D-080)
• Mandatory Settlement Conference General Information (SDSC Form #D-047)
NOTE: This form is intended to provide only general information. It is not legal advice, and should not be used as a substitute for legal
advice from an attorney licensed by the State Bar of California. If you have any questions about your legal rights, you should talk to an
attorney. Also, the San Diego Superior Court does not control or maintain the websites on this form and cannot be responsible for the
accuracy of the information or content they contain. In addition, the content of a website may change, and the court would not necessarily
be aware of the change. When you access one of these websites, you are subject to the terms of use and privacy policies of that website.
SDSC D-049 (Rev. 4/16) FAMILY LAW CERTIFICATE OF ASSIGNMENT Code Civ. Proc. §§ 395, 402
Mandatory Form VENUE DECLARATION
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
FAX NO. (Optional):
TELEPHONE NO.:
E
MAIL ADDRESS (Optional):
ATTORNEY FOR (Name):
FOR COURT USE ONLY
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO
CENTRAL DIVISION, CENTRAL COURTHOUSE, 1100 UNION ST., SAN DIEGO, CA 92101
EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020
NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081
SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910
PETITIONER(S)
RESPONDENT(S)
OTHER
FAMILY LAW CERTIFICATE OF ASSIGNMENT-VENUE DECLARATION
CASE NUMBER
INS
TRUCTIONS: In order for the court to assign your case to the proper court location, this venue declaration is required
when an individual files a new family law case, including domestic violence cases. For active cases with the Family Support
Division (FSD), filed by the Department of Child Support Services, this venue declaration must be submitted with the first
papers filed by a party requesting custody or visitation orders after both parents have become parties to the FSD case, or
when a party files a request for domestic violence restraining orders.
SA
NCTIONS: Notice is hereby given that knowingly or purposefully filing a case in the improper venue is good
cause for imposing monetary sanctions.
I (type or print name), , declare that this action is filed in the proper venue
within the County of San Diego based on the type of case and the applicable residential Zip Code in accordance with the Code of Civil
Procedure §§ 395(a), 402, the California Rules of Court, and the San Diego Superior Court Rules.
(Check one)
Petitioner resides in the County of San Diego within Zip Code
Respondent resides in the County of San Diego within Zip Code
In the FSD case, the party requesting custody, visitation, or domestic violence restraining orders resides in the County of San Diego
within Zip Code
In the FSD case, the other parent resides in the County of San Diego within Zip Code
Other (specify–include type of case and venue statute)
The Zip Code stated above is within the filing boundaries of the family court location marked below, according to the Zip Code List of the
San Diego Superior Court (SDSC Form #ADM-254).
(Check one)
Central Division (1100 Union St., San Diego, CA 92101)
East County Division (250 E. Main St., El Cajon, CA 92020)
North County Division (325 S. Melrose Dr., Vista, CA 92081)
South County Division (500 3rd Ave., Chula Vista, CA 91910)
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:
Signature of Party or Attorney
Request for Domestic Violence Restraining Order
(Domestic Violence Prevention)
Request for Domestic
Violence Restraining Order
What is your relationship to the person in ?
(Check all that apply):
You must also complete Form CLETS-001, Confidential CLETS Information,
and give it to the clerk when you file this Request.
Age:
Name of Person You Want Protection From:
Full name
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:
Sex
Age
Lives with you?
Relationship to you
If yes, list them:
If you do not have one of these relationships,
the court may not be able to consider your
request. Read Form DV-500-INFO for help.
Child’s Name:
Date of Birth:
Child’s Name:
Date of Birth:
Child’s Name:
Date of Birth:
Judicial Council of California, www.courts.ca.gov
Revised July 1, 2016, Mandatory Form
Family Code, § 6200 et seq.
DV-100, Page 1 of 6
DV-100
Name of Person Asking for Protection:
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.):
Firm Name:
Your lawyer in this case (if you have one):
Name:
State Bar No.:
Telephone:
Address:
Fax:
E-Mail Address:
Zip:State:City:
M F
Height:
Yes No
Yes
No
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.
a.
b.
We are now married or registered domestic partners.
We used to be married or registered domestic partners.
c.
We live together.
d.
We used to live together.
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:
Check here if you need more space. Attach a sheet of paper and write “DV-100, Additional Children” for a
title.
h.
We have signed a Voluntary Declaration of Paternity for our child or children. (Attach a copy if you have
one).
This is not a Court Order.
1
2
3
4
2
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California, County of San Diego
Court fills in case number when form is filed.
Case Number:
CENTRA
L DIVISION, CENTRAL COURTHOUSE,
1100 UNION ST., SAN DIEGO, CA 92101
EAST COUNTY DIVISION,
250 E. MAIN ST., EL CAJON, CA 92020
NORTH COUNTY DIVISION,
325 S. MELROSE DR., VISTA, CA 92081
SOUTH COUNTY DIVISION,
500 3RD AVE., CHULA VISTA, CA 91910
Check the orders you want.
I ask the court to order the person in to stay at least yards away from (check all that apply):
Me
My home
My job or workplace
My school
My vehicle
The child(ren)’s school or child care
Each person listed in
Other (specify):
a.
b.
Revised July 1, 2016
(If the person in lives with you and you want that person to stay away from your home, you must ask for
this move-out order.)
I ask the court to order the person in not to do the following things to me or anyone listed in :
Other Restraining Orders and Court Cases
Have you or any other person named in been involved in another court case with the person in ?
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)
DV-100, Page 2 of 6
The person in will be ordered not to take any action to get the addresses or locations of any protected
person unless the court finds good cause not to make the order.
If the person listed in is ordered to stay away from all the places listed above, will he or she still be able to
get to his or her home, school, job, workplace, or vehicle?
Case Number:
b.
No
Yes
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.
Move-Out Order
I ask the court to order the person in to move out from and not return to (address):
I have the right to live at the above address because (explain):
This is not a Court Order.
Request for Domestic Violence Restraining Order
(Domestic Violence Prevention)
Harass, attack, strike, threaten, assault (sexually or otherwise), hit, follow, stalk, molest, destroy personal
property, disturb the peace, keep under surveillance, impersonate (on the Internet, electronically or
otherwise), or block movements
Personal Conduct Orders
;
a.
b.
Contact, either directly or indirectly, in any way, including but not limited to, by telephone, mail or e-mail
or other electronic means
Stay-Away Order
Yes
No (If no, explain):
5
6
7
8
3
2
2
2
2
2
3 2
32
Are there any restraining/protective orders currently in place OR that have expired in the last six months
(emergency protective orders, criminal, juvenile, family)?
a.
No Yes
(date of order): and (expiration date): (Attach a copy if you have one).
I believe the person in owns or possesses guns, firearms, or ammunition.
I ask for the right to record communications made to me by the person in that violate the judge’s orders.
Revised July 1, 2016
DV-100, Page 3 of 6
If you ask for orders, you must fill out and attach Form DV-105, Request for Child Custody and Visitation Orders.
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).
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, or store with, a licensed gun dealer, or turn in to law
enforcement, any guns or firearms that he or she owns or possesses.
Case Number:
Guns or Other Firearms or Ammunition
I don’t knowYes No
Record Unlawful Communications
Care of Animals
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:
Child Custody and Visitation
a.
b.
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.
Child Support (Check all that apply):
a.
b.
I do not have a child support order and I want one.
I have a child support order and I want it changed.
c.
I now receive or have applied for TANF, Welfare, CalWORKS, or Medi-Cal.
Property Control
I ask the court to give only me temporary use, possession, and control of the property listed here:
This is not a Court Order.
Request for Domestic Violence Restraining Order
(Domestic Violence Prevention)
2
2
2
2
11
9
10
12
13
14
Debt Payment
Check here if you need more space. Attach a sheet of paper and write “DV-100, Debt Payment” for a title.
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:
2
Property Restraint
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
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 complete, file, and serve Form
FL-150, Income and Expense Declaration, before your hearing).
Spousal Support
2
2
15
16
17
What other orders are you asking for?
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: $
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.
Revised July 1, 2016
DV-100, Page 4 of 6
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.
Case Number:
Insurance
I ask the court to order the person in NOT to cash, borrow against, cancel, transfer, dispose of, or change the
beneficiaries of any insurance or coverage held for the benefit of me or the person in , or our child(ren), for
whom support may be ordered, or both.
Lawyer’s Fees and Costs
Payments for Costs and Services
Batterer Intervention Program
Other Orders
Check here if you need more space. Attach a sheet of paper and write “DV-100, Other Orders” for a title.
Request for Domestic Violence Restraining Order
(Domestic Violence Prevention)
This is not a Court Order.
19
22
23
20
21
2
2
2
2
2
2
Rights to Mobile Device and Wireless Phone Account
(including area code):
(including area code): number of child in my caremy number
my number number of child in my care(including area code):
number of child in my caremy number
Check here if you need more space. Attach a sheet of paper and write “DV-100, Rights to Mobile Device
and Wireless Phone Account” for a title.
If the judge makes this order, you will be financially responsible for these accounts, including monthly service
fees and costs of any mobile devices connected to these phone numbers. You may be responsible for other fees.
You must contact the wireless service provider to find out what fees you will be responsible for and whether you
are eligible for an account.
I ask the court to give only me temporary use, possession, and control of the following mobile devices:
and the wireless phone account for the
following wireless phone numbers because the account currently belongs to the person in :
2
18
a.
Property control of mobile device and wireless phone account
b.
Debt Payment
I ask the court to order the person in to make the payments for the wireless phone accounts listed in 18a
because:
2
Name of the wireless service provider is: Amount: $ Due Date:
If you are requesting this order, you must complete, file, and serve Form FL-150, Income and Expense
Declaration, before your hearing.
c.
Transfer of Wireless Phone Account
I ask the court to order the wireless service provider to transfer the billing responsibility and rights to the
wireless phone numbers listed in 18a to me because the account currently belongs to the person in .
2
Describe how the person in abused you or your child(ren):
Revised July 1, 2016
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
harass, attack, strike, threaten, assault (sexually or otherwise), hit, follow, stalk, molest, keep you under
surveillance, impersonate (on the Internet, electronically or otherwise), batter, telephone, or contact you; or to
disturb your peace; or to destroy your personal property. (For a complete definition, see Fam. Code, §§ 6203, 6320.)
Date of most recent abuse:
Who was there?
Did the person in use or threaten to use a gun or any other weapon?
2
Describe any injuries:
Did the police come?
If yes, did they give you or the person in an Emergency Protective Order?
Attach a copy if you have one.
The order protects
DV-100, Page 5 of 6
Case Number:
Describe Abuse
a.
1.
2.
Check here if you need more space. Attach a sheet of paper and write “DV-100, Recent Abuse” for a title.
3.
4.
5.
No Yes (If yes, describe):
No Yes
you or the person in
This is not a Court Order.
I don’t knowYes No
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.
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.
Court Hearing
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”?
2
2
2
2
2
27
25
26
24
Time for Service (Notice)
Request for Domestic Violence Restraining Order
(Domestic Violence Prevention)
I don’t knowYes No
Revised July 1, 2016
The persons listed in item need an order for protection because (describe):
I declare under penalty of perjury under the laws of the State of California that the information above is true and correct.
DV-100, Page 6 of 6
Case Number:
Other Persons to Be Protected
Number of pages attached to this form, if any:
Date:
Type or print your name
Sign your name
Lawyer’s name, if you have one
Lawyer’s signature
Date:
This is not a Court Order.
Request for Domestic Violence Restraining Order
(Domestic Violence Prevention)
Has the person in abused you (or your child(ren)) other times?
Describe Abuse (continued)
Date of abuse:
Who was there?
Did the person in use or threaten to use a gun or any other weapon?
Describe any injuries:
Did the police come?
If yes, did they give you or the person in an Emergency Protective Order?
Attach a copy if you have one.
The order protects
b.
1.
2.
Describe how the person in
abused you or your child(ren):
Check here if you need more space. Attach a sheet of paper and write “DV-100, Recent Abuse” for a
title.
3.
4.
5.
No Yes (If yes, describe):
No Yes
you or the person in
If the person in abused you other times, check here and use Form DV-101, Description of Abuse
or describe any previous abuse on an attached sheet of paper and write “DV-100, Previous Abuse” for a
title.
28
29
27
2
3
2
2
2
2
2
DV-101, Page 1 of 2
Judicial Council of California, www.courts.ca.gov
Rev. January 1, 2017, Optional Form
Family Code, § 6200 et seq.
3
1
2
Describe abuse to you or your children.
Name of person asking for protection:
Name of person you want protection from:
Case Number:
DV-101
Description of Abuse
a. Date of abuse:
d.
This form is attached to DV-100, Request for Domestic Violence Restraining Order .
b.
Who was there?
2
Describe how the person in abused you or your children:
Description of Abuse
(Domestic Violence Prevention)
Describe any use or threatened use of guns or other weapons:
e.
Did the police or other law enforcement come?
If yes, did they give you or the person in an Emergency Protective Order?
2
The Emergency Protective Order protects
Attach a copy of the Emergency Protective Order if you have one.
f.
YesNo
Yes No
I don’t know
2
You
The person in
Describe any injuries:
Case Number:
4
5
Describe abuse to you or your children.
a.
Date of abuse:
d.
b.
c.
e.
Did the police or other law enforcement come?
If yes, did they give you or the person in an Emergency Protective Order?
2
The Emergency Protective Order protects
Attach a copy of the Emergency Protective Order if you have one.
f.
YesNo
Yes No
I don’t know
2
You
The person in
Has the person in abused you (or your children) other times?
2
Describe abuse to 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.
DV-101, Page 2 of 2
Rev. January 1, 2017
Description of Abuse
(Domestic Violence Prevention)
Who was there?
2
Describe how the person in abused you or your children:
Describe any use or threatened use of guns or other weapons:
Describe any injuries:
CASE NUMBER:
SHORT TITLE:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
(Required for verified pleading) The items on this page stated on information and belief are (specify item numbers, not line
numbers):
26
27
This page may be used with any Judicial Council form or any other paper filed with the court.
Page
ADDITIONAL PAGE
Attach to Judicial Council Form or Other Court Paper
Form Approved by the
Judicial Council of California
MC-020 [New January 1, 1987] Optional
CRC 201, 501
SDSC CIV-299(Rev. 12-03)
Full name
This order expires at the end of the hearing stated below:
DV-110, Page 1 of 6
Person in must complete items , , and only.
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
and (family or household members):
1 31 2
1
6
1
The court will complete the rest of this form.
Hearing Date: Time:
Relationship to protected person:
Judicial Council of California, www.courts.ca.gov
Revised July 1, 2016, Mandatory Form
Family Code, § 6200 et seq.
Approved by DOJ
Temporary Restraining Order
(CLETS—TRO)
(Domestic Violence Prevention)
Temporary Restraining Order
1
Name of Protected Person:
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.):
Firm Name:
Your lawyer in this case (if you have one):
Name:
State Bar No.:
Telephone:
Address:
Fax:
E-mail Address:
Zip:State:City:
2
Name of Restrained Person:
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California, County of San Diego
Court fills in case number when form is filed.
Case Number:
Sex:
Address (if known):
Race:
Date of Birth:
City:
Age:
Weight: Hair Color: Eye Color:
State: Zip:
M F
Height:
3
Additional Protected Persons
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.
a.m. p.m.
4
This is a Court Order.
DV-110
7
Court Hearing
CENTRAL DIVISION, CENTRAL COURTHOUSE,
1100 UNION ST., SAN DIEGO, CA 92101
EA
ST COUNTY DIVISION,
250 E. MAIN ST., EL CAJON, CA 92020
NORTH COUNTY DIVISION,
325 S. MELROSE DR., VISTA, CA 92081
SOUTH COUNTY DIVISION,
500 3RD AVE., CHULA VISTA, CA 91910
Case Number:
County: Expiration Date:
No information has been provided to the judge about a criminal protective order.
A criminal protective order on Form CR-160, Criminal Protective Order—Domestic Violence, is in effect.
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
b.
To the person in
DV-110, Page 2 of 6
You must not do the following things to the person in and persons in :
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.)
Peaceful written contact through a lawyer or process server or another person for service of Form DV-120
(Response to Request for Domestic Violence Restraining Order) or other legal papers related to a court case is
allowed and does not violate 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.
Harass, attack, strike, threaten, assault (sexually or otherwise), hit, follow, stalk, molest, destroy personal
property, disturb the peace, keep under surveillance, impersonate (on the Internet, electronically or
otherwise), or block movements
1 3
3
1
1
3
a.
You must stay at least (specify):
yards away from (check all that apply):
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.
1
3
a.
c.
b.
Revised July 1, 2016
Case Number:
Criminal Protective Order
Not requested Denied until the hearing Granted as follows:
b.
(address):
Not requested Denied until the hearing Granted as follows:
Not requested Denied until the hearing Granted as follows:
5
7
6
8
2
This is a Court Order.
Personal Conduct Orders
Stay-Away Order
Move-Out Order
Temporary Restraining Order
(CLETS—TRO)
(Domestic Violence Prevention)
The person in
The persons in Home of person in
The job or workplace of person in
School of person in
1
3
Vehicle of person in 1
1
1
1
The child(ren)’s school or child care
Other (specify):
Child custody and visitation are ordered on the attached Form DV-140, Child Custody and Visitation Order or
. The parent with temporary custody of the child must not remove
the child from California unless the court allows it after a noticed hearing (Fam. Code, § 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.
You must:
Sell to, or store with, a licensed gun dealer, or turn in to a law enforcement agency, any guns or other firearms
within your immediate possession or control. Do so within 24 hours of being served with this order.
•
Within 48 hours of receiving this order, file with the court a receipt that proves guns have been turned in,
stored, or sold. (You may use Form DV-800, Proof of Firearms Turned In, Sold, or Stored, for the receipt.)
Bring a court filed copy to the hearing.
•
DV-110, Page 3 of 6
Revised July 1, 2016
No Guns or Other Firearms or Ammunition
a.
c.
Property Control
Not ordered now but may be ordered after a noticed hearing.
Case Number:
b.
The court has received information that you own or possess a firearm.
Record Unlawful Communications
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:
Child Support
Until the hearing, only the person in can use, control, and possess the following property:
This is a Court Order.
Care of Animals
Child Custody and Visitation
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:
Not requested Denied until the hearing Granted as follows:
(specify other form):
Not requested Denied until the hearing Granted as follows:
Not requested Denied until the hearing Granted as follows:
Not requested Denied until the hearing Granted as follows:
Not requested
Denied until the hearing Granted as follows:
The person in can record communications made by you that violate the judge’s orders.
12
9
10
11
13
14
2
1
1
1
2
Temporary Restraining Order
(CLETS—TRO)
(Domestic Violence Prevention)
If the people in and are married to each other or are registered domestic partners,
must not transfer, borrow against, sell, hide, or get rid of or destroy 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.)
21
1
the person in
2
the person in
2
1
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.
Property Restraint
Not requested Denied until the hearing Granted as follows:
15
16
No Fee to Serve (Notify) Restrained Person
If the sheriff serves this order, he or she will do so for free.
Judge (or Judicial Officer)
DV-110, Page 4 of 6
Revised July 1, 2016
Case Number:
Spousal Support
Not ordered now but may be ordered after a noticed hearing.
Insurance
is ordered NOT to cash, borrow against, cancel, transfer, dispose
of, or change the beneficiaries of any insurance or coverage held for the benefit of the parties, or their child(ren), if
any, for whom support may be ordered, or both.
The person in the person in
Lawyer's Fees and Costs
Not ordered now but may be ordered after a noticed hearing.
Payments for Costs and Services
Not ordered now but may be ordered after a noticed hearing.
Batterer Intervention Program
Not ordered now but may be ordered after a noticed hearing.
Other Orders
Check here if there are additional orders. List them on an attached sheet of paper and write “DV-110, Other
Orders” as a title.
Date:
This is a Court Order.
Temporary Restraining Order
(CLETS—TRO)
(Domestic Violence Prevention)
23
20
19
21
22
24
1
2
Not requested Denied until the hearing Granted as follows:
17
18
Rights to Mobile Device and Wireless Phone Account
a.
Property control of mobile device and wireless phone account
Not requested Denied until the hearing
Granted as follows:
Until the hearing, only the person in can use, control, and possess the following property:
1
Mobile device (describe) and account (phone number):
Mobile device (describe)
and account (phone number):Mobile device (describe)
and account (phone number):
Check here if you need more space. Attach a sheet of paper and write "DV-110 Rights to Mobile Device and
Wireless Phone Account" as a title.
b.
Debt Payment
Not requested Denied until the hearing Granted as follows:
The person in must make these payments until this order ends:
2
Pay to (wireless service provider): Amount: $ Due date:
c.
Transfer of Wireless Phone Account
Not ordered now but may be ordered after a noticed hearing.
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.
DV-110, Page 5 of 6
Revised July 1, 2016
Case Number:
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 Custody, Visitation, and Support
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 a parent's 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) if you want the judge to have information about your finances. Otherwise, the court may
make support orders without hearing from you.
•
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.
•
This is a Court Order.
Service of Order by Mail
You Cannot Have Guns, Firearms, And/Or Ammunition.
You cannot own, have, possess, buy or try to buy, receive or try to receive, or otherwise get
guns, other firearms, and/or ammunition while the order is in effect. If you do, you can go
to jail and pay a $1,000 fine. You must sell to or store with a licensed gun dealer or turn in
to a law enforcement agency any guns or other firearms that you have or control. The judge
will ask you for proof that you did so. If you do not obey this order, you can be charged
with a crime. Federal law says you cannot have guns or ammunition while the order is in
effect.
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 incorrect, or to find out if the orders
were made permanent, contact the court.
2
It is a felony to take or hide a child in violation of this order.
If You Do Not Obey This Order, You Can Be Arrested And Charged With a Crime.
•
•
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.
•
Warnings and Notices to the Restrained Person in
2
Temporary Restraining Order
(CLETS—TRO)
(Domestic Violence Prevention)
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. (Pen. Code, §§ 836(c)(1), 13701(b).) A violation of the order may be a
violation of Penal Code section 166 or 273.6.
DV-110, Page 6 of 6
Revised July 1, 2016
Case Number:
This is a Court Order.
—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:
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.
3.
4.
Criminal Order: If none of the orders includes a no-contact order, a domestic violence protective order issued in a
criminal case takes precedence in enforcement over any conflicting civil court order. Any nonconflicting terms of the
civil restraining order remain in effect and enforceable.
Child Custody and Visitation
•
•
The custody and visitation orders are on form DV-140, items and . They are sometimes also writ
ten on
additional pages or referenced in
DV-140 or other orders that are not part of the restraining order.
Forms DV-100 and DV-105 are not orders. Do not enforce them.
3 4
Conflicting Orders–Priorities for Enforcement
If more than one restraining order has been issued protecting the protected person from the restrained person, the
orders must be enforced according to the following priorities (see Pen. Code, § 136.2, and Fam. Code, §§ 6383(h),
6405(b)):
1.
2.
EPO: If one of the orders is an Emergency Protective Order (form EPO-001), and it is more restrictive than other
restraining or protective orders, it has precedence in enforcement over all other orders.
If the Protected Person Contacts the Restrained Person
Even if the protected person invites or consents to contact with the restrained person, the orders remain in effect and must
be enforced. The protected person cannot be arrested for inviting or consenting to contact with the restrained person. The
orders can be changed only by another court order. (Pen. Code, §13710(b).)
Temporary Restraining Order
(CLETS—TRO)
(Domestic Violence Prevention)
No-Contact Order: If there is no EPO, a no-contact order that is included in a restraining or protective order has
precedence in enforcement over any other restraining or protective order.
Family, Juvenile, or Civil Order: If more than one family, juvenile, or other civil restraining or protective order has
been issued, the one that was issued last must be enforced.
Temporary Restraining Orders for personal conduct and stay-away orders as requested in form DV-100, Request
for Domestic Violence Restraining Order, are (check only one box below):
Notice of Hearing
A court hearing is scheduled on the request for restraining orders against the person in :
a
.
(1)
(2)
(3)
Temporary Restraining Orders (Any orders granted are attached on form DV-110.)
The court will fill out the rest of this form.
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California, County of San Diego
Court fills in case number when form is filed.
Case Number:
All GRANTED until the court hearing.
All DENIED until the court hearing. (Specify reasons for denial in b, below.)
Partly GRANTED and partly DENIED until the court hearing. (Specify reasons for denial in b, below.)
DV-109
Notice of Court Hearing
Judicial Council of California, www.courts.ca.gov
Rev. September 1, 2020, Mandatory Form
Family Code § 242
Approved by DOJ
Notice of Court Hearing
(Domestic Violence Prevention)
DV-109, Page 1 of 3
1
2
3
2
4
Name of Person Asking for Order:
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.)
Firm Name:
Your lawyer in this case (if you have one):
Name:
State Bar No.:
Telephone:
Address:
Fax:
E-Mail Address:
Zip:State:City:
Name of Person to Be Restrained:
Reasons for denial of some or all of those personal conduct and stay-away orders as requested in form DV-100,
Request for Domestic Violence Restraining Order, are:
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)
(3)
Further explanation of reason for denial, or reason not listed above:
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.
Date: Time:
Room:Dept.:
Hearing
Date
Name and address of court if different from above:
CENTRAL DIVISION, CENTRAL COURTHOUSE,
1100 UNION ST., SAN DIEGO, CA 92101
EAST COUNTY DIVISION,
250 E. MAIN ST., EL CAJON, CA 92020
NORTH COUNTY DIVISION,
325 S. MELROSE DR., VISTA, CA 92081
SOUTH COUNTY DIVISION,
500 3RD AVE., CHULA VISTA, CA 91910
At least days before the hearing, someone age 18 or older—not you or anyone to be
protected—must personally give (serve) a court 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:
Service of Documents by the Person in
DV-100, Request for Domestic Violence Restraining Order (file-stamped)a.
DV-120, Response to Request for Domestic Violence Restraining Order (blank form)c.
e.
DV-120-INFO, How Can I Respond to a Request for Domestic Violence Restraining Order?
g.
d.
2
b.
DV-250, Proof of Service by Mail (blank form)
Date:
Judicial Officer
five
DV-110, Temporary Restraining Order (file-stamped) IF GRANTED
Rev.September 1, 2020
Notice of Court Hearing
(Domestic Violence Prevention)
DV-109, Page 2 of 3
1
6
Case Number:
Confidential Information Regarding Minor
a.
A Request to Keep Minor's Information Confidential (form DV-160) was made and GRANTED (see form
DV-165, Order on Request to Keep Minor's Information Confidential, served with this form.)
5
If the request was granted, the information described on the order (form DV-165, item )) must be kept
CONFIDENTIAL. The disclosure or misuse of the information is punishable as a sanction, with a fine of
up to $1,000 or other court penalties.
b.
f
.
DV-170, Notice of Order Protecting Information of a Minor, and DV-165, Order on Request to Keep
Minor's Information Confidential (file-stamped), IF GRANTED
Right to Cancel Hearing: Information for the Person in
1
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.
•
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 .
If you cancel the hearing, do not serve the documents listed in item on the other person.
•
•
•
4
4
6
6
6
7
Other (specify):
—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, 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). (Civ. Code, § 54.8.)
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.
•
•
•
Whether or not you respond in writing, go to the hearing if you want the judge to hear from you before making an
order. 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.
To show that the person in has been served by mail, the person who mailed the form 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 a copy with you to the hearing.
1
•
Clerk’s Certificate
[seal]
•
Rev. September 1, 2020
Notice of Court Hearing
(Domestic Violence Prevention)
DV-109, Page 3 of 3
To the Person in :
2
Case Number:
2
•
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.
•
For information about service, read form DV-200-INFO, What Is “Proof of Personal Service”?
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.
•
2
To the Person in :
1
2
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?
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.
How to Ask for a New Hearing Date
You may need to ask for a new court date if:
What does form DV-115 do?
Use form DV-115 to ask the court to reschedule your court date. If your court date is rescheduled and a
Temporary Restraining Order (form DV-110) was granted, that order will be extended until the end of your new
court date, unless the court decides to modify or terminate it. “Extend” means to keep any temporary orders in
effect until the new court date.
Follow these steps:
•
Fill out all of form DV-115.
•
Fill out items
• The judge will need to review your papers. In some courts, you must give your papers to the clerk. Ask the
court clerk for information on how you ask the judge to review your papers.
• After you turn in your forms as required by your local court, check with the clerk’s office to see if the judge
approved (granted) your request to reschedule your court date.
• If the judge signed form DV-116
, you will have a new court date. If the judge did NOT sign the form, you
should go to court at the date, time, and location that is on form DV-109
.
• Next, file both forms DV-115 and DV-116
with the clerk. The clerk will make up to three file-stamped
copies for you. Keep at least one copy to bring to your court date.
The other party must be served a copy of the court papers as described in item
• Ask the person who serves the papers to complete a proof of service form and give it to you. If service
was in person, use form DV-200, Proof of Personal Service. If service was by mail, use form DV-250
,
Proof of Service by Mail. Make two copies of the completed forms.
•
If the court reschedules your court date and extends the expiration date of the temporary restraining order
to the end of your new court date, the clerk will send the restraining order to law enforcement or CLETS
for you. CLETS is a statewide computer system that lets police know about the order.
Need help?
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.
Judicial Council of California, www.courts.ca.gov
Revised January 1, 2020, Optional Form
Family Code, § 245
How to Ask for a New Hearing Date
(Domestic Violence Prevention)
DV-115-INFO, Page 1 of 1
DV-115-INFO
6
1 2
Go to your court date
Take at least two copies of your documents and filed forms to your court date. Include a copy of the filed
proof of service form.Your documents may include exhibits, declarations, and financial statements, and the
court may enter them into evidence at its discretion.
You are the protected party and are unable to have form DV-109, Notice of Court Hearing, and other papers
served in time before your court date.
You are the restrained party and it is your first time asking the court to reschedule your court date.
You have a good reason for needing a new court date (the court may grant your request to reschedule your court
date on a showing of “good cause”).
•
•
•
File the completed and signed proof of service form with the clerk’s office before your court date.•
If the protected party does not go to the court date, the temporary domestic violence restraining orders will
expire on the date and time of the court date. If the restrained party does not go to the court date, the court
can still make orders against them that can last for up to five years.
•
•
1
2
3
4
5
on form DV-116, Order on Request to Continue Hearing.through
on form DV-116
.
•
SDSC D-072 (Rev. 5/16) ORDER FOR REMOVAL FROM RESIDENCE
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
FAX NO. (Optional):
TELEPHONE NO.:
EMAIL ADDRESS (Optional):
ATTORNEY FOR (Name):
FOR COURT USE ONLY
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO
CENTRAL DIVISION, CENTRAL COURTHOUSE, 1100 UNION ST., SAN DIEGO, CA 92101
CENTRAL DIVISION, HALL OF JUSTICE, 330 W. BROADWAY, SAN DIEGO, CA 92101
CENTRAL DIVISION, JUVENILE COURT, 2851 MEADOW LARK DR., SAN DIEGO, CA 92123
EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020
NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081
SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910
PETITIONER(S)
RESPONDENT(S)
JUDGE/DEPT
ORDER FOR REMOVAL FROM RESIDENCE
CASE NUMBER
TO: SAN DIEGO COUNTY SHERIFF
YOU
ARE ORDERED to remove (name of party to be removed):
from the residence located at:
in the city of , California.
YOU ARE FURTHER ORDERED to remain on the premises of said residence for a reasonable period in order to provide
an opportunity for the removed party to take personal effects from those premises.
Date:
Judge/Commissioner of the Superior Court
CLERK'S CERTIFICATE
The foregoing document, consisting of _____ page(s), is a full, true, and correct copy of the
original copy on file in this office.
Clerk of the Superior Court
Date: by , Deputy
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
Clear This Packet
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

PKT006.PDF (California)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 3 December 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document