SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
201 North First Street, San José , CA 95113
191 North First Street
San José, California 95113
Family
Justice Center
PETITIONER:
RESPONDENT:
OTHER PARENT:
PEOPLE OF THE STATE OF CALIFORNIA
vs.
DEFENDANT:
FOR COURT USE ONLY
RESTRAINING ORDER WAIVER OF RIGHTS FORM -
DEFENDANT
FAMILY/CIVIL CASE NUMBER:
CRIMINAL CASE NUMBER:
Defendant’s Name: DOB:
This form has been given to you because you have agreed that the Family Court can change your
Criminal Protective Order. The following information advises you of your rights in this matter.
Please read and initial each paragraph and sign the bottom indicating that you understand.
INITIAL
HERE IF YOU
UNDERSTA
ND
THIS RIGHT
INITIAL
HERE IF YOU
GIVE UP THIS
RIGHT
I understand that the Criminal Protective Order can be changed to
be consistent with the Family Court Order
I understand that I do not have to agree to this matter being heard in
Family Court. I can request that it be heard instead in Criminal
Court.
I understand that any change of the Criminal Protective Order is a
change of my probation.
I understand that if I violate this Restraining Order, this is a violation
of my probation as well as a new misdemeanor.
I understand that the Criminal Protective Order can be changed
again later by the Criminal Court.
FM-1018 REV. 4/07 Page 1 of 3
(FAMILY)
RESTRAINING ORDER WAIVER OF RIGHTS FORM - DEFENDANT
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Family Case Title:
Family Case Number:
Criminal Case Title: People v.
Criminal Case Number:
The orders that are going to be made today are a modification (change) of
probation. I understand and give up the following rights:
INITIAL
HERE IF YOU
UNDERST
AND
THIS RIGHT
INITIAL
HERE IF YOU
GIVE UP THIS
RIGHT
I have the right to a hearing in Court and have the request to change
the Protective Order proved against me by clear and convincing
evidence.
At that hearing I have the right to be represented by an attorney (or
to have an attorney appointed to me if I cannot afford one).
At that hearing I have the right to remain silent and to have the
request proved by clear and convincing evidence.
At that hearing I have the right to present a defense-including the
right to subpoena witnesses, present evidence and to testify on my
own behalf.
At that hearing I have the right to cross-examine witnesses against
me.
I am eighteen (18) years of age or older.
I understand the above information contained in this waiver.
OR
All of the rights listed above have been translated for me. I understand the information
contained in this waiver.
Date:
Signature:
Defendant
FM-1018 REV. 4/07 Page 2 of 3
(FAMILY)
RESTRAINING ORDER WAIVER OF RIGHTS FORM - DEFENDANT
Family Case Title:
Family Case Number:
Criminal Case Title: People v.
Criminal Case Number:
ATTORNEY’S STATEMENT:
I am the attorney of record for the defendant. I have reviewed this form with my client. I have
explained each of the defendant’s rights to the defendant, and answered all of the defendant’s
questions with regard to this change in a criminal protective order and the consequences thereof. I
concur in the defendant’s waiver of his/her constitutional rights and agreement to this change of
conditions of probation.
Date: Signature:
INTERPRETER’S STATEMENT:
I, (name) , having been duly sworn, truly translated this
form to the defendant in the language. The defendant indicated that he/she
understood the contents of the form, and he/she then initialed and signed the form.
Date: Signature:
Interpreter
COURT’S FINDINGS AND ORDER:
The Court, having reviewed this form and having questioned the defendant concerning the
defendant’s constitutional rights and the defendant’s agreement to modify the terms of his
probation by a change in the criminal protective order, finds that the defendant has expressly,
knowingly, understandingly, and intelligently waived his or her constitutional rights. The Court
finds that the defendant’s agreements to the change in the criminal protective order are freely and
voluntarily made with an understanding of the nature and consequences thereof, and that there is a
factual basis for the change. The Court accepts the defendant’s agreement and modifies the
criminal protective order.
The Court orders this form filed and incorporated in the docket by reference as though fully set
forth therein.
Date:
Signature:
Judicial Officer of the Superior Court
FM-1018 REV. 4/07 Page 3 of 3
(FAMILY)
RESTRAINING ORDER WAIVER OF RIGHTS FORM - DEFENDANT
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