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SHC-CH-01 (Rev. 11/20/2020)

LamoreauxJusticeCenter

Room C-190

341TheCityDrive

Orange,CA

 

HarborJusticeCenter

oom107,Self‐HelpWindow

4601JamboreeRoad

NewportBeach,CA

Cen

tralJusticeCenter

RoomG‐100

700CivicCenterDrive

SantaAna,CA

 

SuperiorCourt

Ser

viceCenter

27573PuertaReal

MissionViejo,CA

NorthJusticeCenter

oom355

1275N.BerkeleyAvenue

Fullerton,CA

 

WestJusticeCenter

Floor

814113thStreet

Westminster,CA

SUPERIOR COURT OF CALIFORNIA

COUNTY

OF ORANGE

SELF-HELP CENTER

www.occourts.org/self-help

CIVIL HARASSMENT RESTRAINING ORDER

The Self-Help Center provides a free document review

service. To obtain an appointment to have your documents

reviewed, you must first fully complete the forms.

Pleaseuseblackink.

Self-Help Center Locations:

SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE

CIVIL PROTECTIVE ORDERS

Elder or Dependent Adult

Abuse Protective Order

Domestic Violence

Restraining Order

Civil Harassment

Restraining Order

Workplace Violence

This order may be

appropriate for

you if:

You are:

•

A person 65 years of age or older

•

A person between 18 and 64 years of

age and who has a mental or physical

condition that prevents you from

carrying out normal activities (a

dependent adult)

And you have been:

•

Physically or financially abused

•

Mentally or emotionally abused

•

Neglected, abandoned or abducted

•

Isolated

•

Deprived by a caregiver of goods or

services needed to avoid harm or

suffering

*The order may also protect other

family or household members.

You have one of the following relationships

with the restrained person:

•

Spouse or former spouse

•

Cohabitant or former cohabitant

(with a

romantic or close

relationship)

•

Current or past dating relationship

•

Parent or child

•

Brother, sister, grandparent or grandchild

•

Step-parent, step-child, step-brother, step-

sister, step-grandchild, step-grandparent (if

blood parent of step-parent)

•

In-laws: Any relationship to a spouse’s blood

relatives (parent, son, daughter, brother,

sister, grandparent, grandchild)

And you have been:

•

Abused

(physical, spoken or written)

*The order may also protect other family

or household members.

You and the restrained person:

•

Do not have a Domestic

Violence case open

And you have been:

•

Stalked

•

Harassed

•

Sexually Assaulted

•

Threatened with violence

*The order may also

protect other family or

household members.

You are:

•

An employer of employee

(including volunteer or

independent contractor who

performs services at the worksite,

member of the board of directors

or public officer)

And employee has:

•

Suffered violence at the

workplace

•

Received threats of violence at

the workplace

Note: An employee cannot ask for a

workplace violence restraining order.

Only an employer

may request this

type of protective order.

*The order may also prot

ect other

family or household members.

If granted, the

court

can order

someone to:

•

Not contact you

•

Stay away from you and your home

•

Move out of your home

•

Not own or possess a gun

•

Not molest, attack, strike, stalk, assault,

batter, threaten, sexually assault, or harass

(personally or by telephone) you

•

Not destroy your personal property

•

Not come within a specified distance

•

Not own or possess a gun

•

Move from the home you share

The Court may also order:

Child custody, visitation, supervised visitation or no

visitation; child support, spousal support, and

repayment of monies lost due to the violence or

threats

•

Not contact you

•

Stay away from you, your

home (unless you are

roommates) and your work

•

Not assault, batter, threaten,

stalk, or harass (personally

or by telephone) you

•

Not own or posses a gun

•

Not assault, batter or stalk you

•

Not telephone or send

correspondence to you

•

Not enter the workplace

•

Stay a specific distance away

from you

•

Not own or possess a gun

You may get additional help from the resources listed on the back of this pamphlet.

Form# L-0779 (Rev. Mar. 2019)

A cohabitant is a person who regularly resides in the household. Tenants or roommates subletting rooms in the same house do not meet the relationship requirement for a Domestic Violence

Restraining Order unless they have a romantic or close relationship.

A close relationship is one where the persons share a common goal and mutual interests beyond that of roommates.

Abuse means to hit, kick, grab, choke, hurt, scare, throw things, pull hair, push, follow, harass, assault with a weapon, force to participate in unwanted, unsafe or degrading sexual activity, or

threaten to do any of these things.

Employer is defined as the following:

 Every person engaged in any business or enterprise in this state that has one or more persons in service under any appointment, contract of hire, or apprenticeship, express or implied, oral or

written, irrespective of whether such person is the owner of the business or is operating on a concessionaire or other basis. Labor Code 350(a)

 A federal agency, the state, a state agency, a city, county, or district, and a private, public or quasi-public corporation, or any public agency thereof or therein. Code of Civil Procedure 527.8(d)

If you are in

immediate danger,

you may need an

EMERGENCY

PROTECTIVE ORDER

Emergency Protective Order

This order may

be appropriate

for you if:

You are in immediate

danger.

If granted, the

court can order

someone to:

•

Stay away from you,

your home, and your

work.

•

Immediately move

from your residence.

•

Not own or possess a

gun.

The Court may also order:

Temporary care and control

of a minor child to the

protected person.

The order lasts: Up to 7 days.

You may get

help from:

Any Law Enforcement

Officer can help you with

an Emergency Protective

Order.

If you need protection for

longer than 7 days, you

must come to court and

ask for another type of

restraining order.

SUPERIOR COURT

OF CALIFORNIA

COUNTY OF ORANGE

GUIDE TO

PROTECTIVE

ORDERS

Court Designation List

The Presiding Judge has designated cases to be heard and tried according to the following matrix below. In order to expedite the processing

of your case documents please file them at the assigned justice center. (Local Rule 365)

Limited Civil, Unlimited Civil cases will heard/tried at the Center Justice Center (CJC). Complex Civil cases will be heard/tried at the Complex

Center (CXC).

Probate, Mental Health and Elder Abuse and Dependent Adult Abuse Restraining Orders cases will be heard/tried at the Central Justice Center

(CJC).

Small Claims, Unlawful Detainer (i.e., landlord-tenant) and Civil Harassment matters will be heard/tried as designated according to the city in

which the action arose or where a defendant resides. If the defendant is a business, use the city where the business is located. If the action

concerns real property, use the city where the real property is located. (See matrix below)

Juvenile Delinquency, Dependency, Family Law, Domestic Violence will be heard/tried at the Lamoreaux Justice Center (LJC).

Criminal cases will be filed according to the matrix below. Unless otherwise designated by the Court, misdemeanor cases will be tried as

designated below. Felony trials will be assigned based on availability of open trial courtrooms at any of the justice centers.

Traffic cases will be filed and trials heard according to the matrix below. Traffic case payments or other inquiries may be handled at any of the

justice centers with a Criminal/Traffic Clerk’s Office.

Aliso Viejo

CJC

HJC

LJC

HJC

Anaheim

CJC

LJC

NJC

Brea

CJC

LJC

NJC

Buena Park

CJC

LJC

NJC

Costa Mesa

CJC

LJC

WJC

Cypress

CJC

LJC

WJC

Dana Point

CJC

LJC

HJC

Fountain Valley

CJC

LJC

WJC

Fullerton

CJC

LJC

NJC

Garden Grove

CJC

LJC

WJC

Huntington Beach

CJC

LJC

WJC

Irvine

CJC

LJC

HJC

La Habra

CJC

LJC

NJC

La Palma

CJC

LJC

NJC

Laguna Beach

CJC

LJC

HJC

Laguna Hills

CJC

LJC

HJC

Laguna Niguel

CJC

LJC

HJC

Laguna Woods

CJC

LJC

HJC

Lake Forest

CJC

LJC

HJC

Los Alamitos

CJC

LJC

WJC

Mission Viejo

CJC

LJC

HJC

Newport Beach

CJC

LJC

HJC

Orange

CJC

LJC

CJC

Placentia

CJC

LJC

NJC

Rancho Santa Margarita

CJC

LJC

HJC

San Clemente

CJC

LJC

HJC

San Juan Capistrano

CJC

LJC

HJC

Santa Ana

CJC

LJC

CJC

Seal Beach

CJC

LJC

WJC

Stanton

CJC

LJC

WJC

Tustin

CJC

LJC

CJC

Villa Park

CJC

LJC

CJC

Westminster

CJC

LJC

WJC

Yorba Linda

CJC

LJC

NJC

CJC ‐ Central Justice Center: 700 Civic Center Drive, Santa Ana

92701;

CXC/Civil Complex Center

: 751 W. Santa Ana Blvd., Santa Ana, CA 92701

HJC - Harbor Justice Center: 4601 Jamboree Road, Newport Beach, CA

92660;

LJC ‐ Lamoreaux Justice Center: 341 The City Drive, Orange, CA

92870;

NJC ‐ North Justice Center: 1275 North Berkeley, Fullerton, CA

92838;

WJC ‐ West Justice Center: 8141 13th Street, Westminster, CA

92683

*Civil and Probate actions must be eFiled. http://www.occourts.org/online-services/efiling/.

** For filing Juvenile citations, Law Enforcement should refer to the Superior Court of Orange County Juvenile Violation Filing Guidelines.

Rev. 05/22/2020

Information

L-1075 (Rev. April. 2019) Page 2 of 2

INSTRUCTIONS TO FOLLOW AFTER THE INITIAL TEMPORARY RESTRAINING

ORDER HEARING

 Give Copies of the Following Forms to Each Law

Enforcement Agency Listed on the Order by

Midnight of the Day on Which the Order Was

Issued.

✓ Certified copy of the Temporary Restraining Order

 Have a Copy of the Court Papers Delivered to the

Other Party.

You must arrange to have the court papers delivered

to the defendant at least 5 days prior to the hearing,

unless the Judge has shortened the time for service.

This is commonly called “service.” The scheduled

hearing cannot proceed unless the other side has

received copies of all documents.

You cannot give the papers to the defendant

yourself. The court papers may be delivered (served)

by a licensed process server, the Sheriff, or person

not a party to the action who is at least 18 years of

age. This service is not done by local police

departments.

Sheriff’s Office, for service of documents:

(714) 569-3700; 909 N. Main Street, Santa Ana

 What Papers Are Delivered?

There are a total of six papers that the defendant

must receive.

✓ Notice of Court Hearing

✓ Certified copy of Temporary Restraining Order

✓ Request for Civil Harassment Restraining

Orders

✓ Response to Request for Civil Harassment

Restraining Orders (blank form)

✓ How Can I Respond to a Request for Civil

Harassment Restraining Orders?

✓ Proof of Firearms Turned in or Sold (blank form)

 After Having the Defendant Served, Return the

Completed Proof of Personal Service to the

Court before the Hearing Date.

✓ Give a copy of the completed proof of service for

each law enforcement agency listed on your

order.

✓ File the original Proof of Personal Service with

the clerk’s office any time BEFORE the hearing

date.

 Keep a Certified Copy of the Temporary

Restraining Order with You at All Times in Case

You Need to Show it to a Law Enforcement

Officer.

Any other protected persons that are listed on the

order should also keep a copy with them. If you are

unable to serve the defendant, you may complete a

Request to Continue Court Hearing and to Reissue

Temporary Restraining Order.

 Be Prepared for the Hearing!

You must arrange to have all witnesses and

evidence present at the hearing. It is your

responsibility to have a subpoena served on any

witness in order to guarantee the witness’s presence

at the hearing.

Court proceedings are conducted in English. The

Court cannot always provide interpreters for civil

proceedings. If you will need an interpreter to

understand the proceedings and assure that the

judicial officer will be able to understand what you

have to say, you must arrange to have an interpreter

present.

If you do not know an interpreter, you are welcome

to use the list of qualified interpreters maintained by

the Court. The list is available in the 3

floor offices

of Court Reporter and Interpreter Services at Central

Justice Center. The list contains interpreter names

and telephone numbers so you may contact them

directly and arrange to pay them for their services.

 Instructions to Follow after the Hearing for

Permanent Restraining Order.

✓ If the defendant was not present at the hearing,

serve the defendant with a certified copy of the

Restraining Order. Remember, you cannot do the

serving yourself.

✓ After service is complete, have the server

complete and sign the Proof of Personal Service.

✓ Make copies.

✓ Again, the original Proof of Service form must be

filed with the Court.

✓ Provide the following copies to the law

enforcement agencies named on the order:

• Certified copy of the Civil Harassment

Restraining Order after Hearing.

• Copy of Proof of Personal Service

✓ Keep a copy of the Civil Harassment Restraining

Order after Hearing with you at all times. Any

protected persons should also keep a copy with

them.

CH-100-INFO

Can a Civil Harassment Restraining Order Help Me?

What is a civil harassment restraining

order?

It is a court order that helps protect people from

harassment.

Can I get a civil harassment restraining

order?

You can ask for one if you are worried about your

safety because someone:

•

Is harassing you

•

Is stalking you

•

Has committed acts of violence against you, or

•

Has threatened you with violence

How will the order help me?

The court can order a person to:

Not harass or threaten you

Not contact or go near you, and

Not have a gun

What forms do I need to get the order?

You must fill out all of Form CH-100, Request for Civil

Harassment Restraining Orders, and Form CLETS-001,

Confidential CLETS Information. If you need

attachments, you may use Form MC-025. You must also

fill out items 1 and 2 on Form CH-109, Notice of Court

Hearing, and items 1, 2, and 3 on Form CH-110,

Temporary Restraining Order (CLETS).

Where can I get these forms?

Judicial Council of California

www.courts.ca.gov

Revised July 1, 2014, Optional Form

Code of Civil Procedure, § 527.6

You can also ask for protection for people who live with

you and family members.

Can a Civil Harassment Restraining Order Help Me?

(Civil Harassment Prevention)

CH-100-INFO, Page 1 of 3

What do I need to do to get the order?

You must go to the superior court in the county where

the harassment took place or the person to be restrained

lives. At the court, ask where you should file your

request for a civil harassment restraining order. (A self-

help center or legal aid association may be able to assist

you in filing your request.)

At the court, give your forms to the clerk of the court.

The clerk will give you a hearing date on the Notice of

Court Hearing form, and if your request for immediate

orders is granted, a copy of the Temporary Restraining

Order signed by a judicial officer.

In a civil harassment case, the court cannot:

•

Order a person to move out of your residence

•

Order a person to pay child support to you

•

Make orders for custody and visitation

If you need these orders, you should proceed under the

Domestic Violence Protection Act. File Form DV-100.

The court also cannot:

If you need these remedies, you must file a civil action.

These instructions cannot cover all of the questions that may arise in a particular case. If you

do not know what to do to protect your rights, you should see a lawyer.

•

Order a person to pay money that he or she owes

you

•

Order someone to move out of rental property

that you own

•

Order someone to stop creating a nuisance that

doesn't involve harassment

You can get the forms from legal publishers or on the

Internet at www.courts.ca.gov. You also may be able to

find them at your local courthouse or county law library.

How much does it cost?

That depends on the type of harassment. If the restrained

person has used or threatened to use violence against

you or has stalked you, you do not have to pay a filing

fee; otherwise, you must pay the fee.

If you cannot afford to pay the filing fee, ask the clerk

how to apply for a fee waiver. Form FW-001 is available

for this purpose.

If the order is based on prior acts of violence, a credible

threat of violence, or stalking, you are entitled to free

service of the order by a sheriff or marshal. Also, if you

are eligible for a fee waiver, you can ask the sheriff or

marshal to serve the order for free. If you are not eligible

for free service, you may pay the sheriff or marshal to

serve the order.

•

Do I have to go to court?

Yes. Go to court on the date the clerk gives you.

Do I need a lawyer?

Rev. July 1, 2014

Can a Civil Harassment Restraining Order Help Me?

(Civil Harassment Prevention)

CH-100-INFO, Page 2 of 3

Having a lawyer is always a good idea, but it is not

required and you are not entitled to a free court-

appointed attorney. Ask the court clerk about free and

low-cost legal services and self-help centers in your

county

What if the restrained person does not

obey the order?

Call the police. The restrained person can be arrested

and charged with a crime.

How soon can I get the order?

If you ask for a temporary restraining order, the court

will decide within 24 hours whether or not to make the

order. Sometimes the court decides sooner. Ask whether

you should wait or come back later to get the signed

Notice of Court Hearing and Temporary Restraining

Order.

How long does the order last?

If the court makes a temporary order, it will last until

your hearing date. At that time, the court will decide to

continue or cancel the order. The order could last for up

to five years.

How will the person to be restrained know

about the order?

Someone age 18 or older—not you or anyone else to be

protected by the order—must “serve” (give) the person

to be restrained a copy of the order. The server must then

fill out Form CH-200, Proof of Personal Service, and

give it to you to file with the court. For help with

service, ask the court clerk for Form CH-200-INFO,

What Is “Proof of Personal Service?”.

The court may or may not let witnesses speak at the

hearing. So, if possible, you should bring their written

statements under oath to the hearing. (You can use

Form MC-030, Declaration, for this.).

Do I need to bring a witness to the court

hearing?

Witnesses are not required, but it helps to have more

proof of the harassment than just your word. You can

bring:

•

Witnesses

•

Written statements from witnesses made under oath

•

Photos

•

Medical or police reports

•

Damaged property

•

Threatening letters, e-mails, or telephone messages

Will I see the restrained person at the court

hearing?

If the 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.

Can I bring someone with me to court?

Yes. You can bring someone to sit with you during the

hearing. But that person cannot speak for you in court.

Only you or your lawyer (if you have one) can speak for

you.

CH-100-INFO

Can a Civil Harassment Restraining Order Help Me?

What if I am deaf or hard of hearing?

For help in your area, contact:

[Local information may be inserted.]

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.)

Can I agree with the restrained person to

cancel the order?

No. Once the order is issued, only the judge can change

or cancel it. You or the restrained person would have to

file a request with the court to cancel the order.

What if I don't speak English?

When you file your papers, ask the clerk if a court

interpreter is available. You may have to pay a fee for

the interpreter. If an interpreter is not available for your

court date, you should ask someone who is not listed as a

person to be protected on your Request and who is over

age 18 to interpret for you .

CH-100-INFO

Can a Civil Harassment Restraining Order Help Me?

Rev. July 1, 2014

Can a Civil Harassment Restraining Order Help Me?

(Civil Harassment Prevention)

CH-100-INFO, Page 3 of 3

CH-100

Request for Civil Harassment

Restraining Orders

Clerk stamps date here when form is filed.

Fill in court name and street address:

Superior Court of California, County of

Orange

Court fills in case number when form is filed.

Case Number:

Read Can a Civil Harassment Restraining Order Help Me? (form CH-100-

INFO) before completing this form. Also fill out Confidential CLETS

Information (form CLETS-001) with as much information as you know.

Person Seeking Protection

Your Full Name:

Age:

Your Lawyer (if you have one for this case)

Name: State Bar No.:

Firm Name:

Your Address (If you have a lawyer, give your lawyer’s

information. If you do not have a lawyer and want to keep your

home address private, you may give a different mailing address

instead. You do not have to give telephone, fax, or e-mail.)

Address:

City: State: Zip:

Telephone: Fax:

E-Mail Address:

Person From Whom Protection Is Sought

Full Name: Age:

Address (if known):

City: State: Zip:

Additional Protected Persons

a. Are you asking for protection for any other family or household members?

Yes

If yes, list them:

Full Name Sex Age Lives with you? How are they related to you?

Yes

Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of

paper or form MC-025 and write “Attachment 3b—Why Others Need Protection” for a title.

Check here if there are more persons. Attach a sheet of paper and write “Attachment 3a—Additional Protected

Persons” for a title. You may use form MC-025, Attachment.

b. Why do these people need protection? (Explain below):

This is not a Court Order.

Judicial Council of California, www.courts.ca.gov

Revised January 1, 2018, Mandatory Form

Code of Civil Procedure, §§ 527.6 and 527.9

Request for Civil Harassment Restraining Orders

(Civil Harassment Prevention)

CH-100, Page 1 of 6

700 Civic Center Drive

Santa Ana, CA 92701

Central Justice Center

Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of

paper or form MC-025 and write “Attachment 4—Relationship of Parties” for a title.

The person in lives in this county.

I was harassed by the person in in this county.

Other (specify):

Description of Harassment

Harassment means violence or threats of violence against you, or a course of conduct that seriously alarmed,

annoyed, or harassed you and caused you substantial emotional distress. A course of conduct is more than one act.

Tell the court about the last time the person in harassed you.

(1)

When did it happen? (provide date or estimated date):

(2)

Who else was there?

Are there now any protective or restraining orders in effect relating to you or any of the persons in and the

person in ?

Other Court Cases

Have you or any of the persons named in been involved in another court case with the person in ?

How do you know the person in ? (Explain below):

Relationship of Parties

Why are you filing in this county? (Check all that apply):

Venue

(If yes, attach a copy if you have one.)

Yes

This is not a Court Order.

Revised January 1, 2018

Request for Civil Harassment Restraining Orders

(Civil Harassment Prevention)

CH-100, Page 2 of 6

(1)

Civil Harassment

Domestic Violence

Divorce, Nullity, Legal Separation

Paternity, Parentage, Child Custody

Elder or Dependent Adult Abuse

Eviction

Guardianship

Workplace Violence

Small Claims

Criminal

Other (specify):

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

Kind of Case Filed in (County/State)

(If yes, check each kind of case and indicate where and when each was filed.)

Yes No

Year Filed

Case Number (if known)

Case Number:

(3)

How did the person in harass you? (Explain below):

Check here if there is not enough space for your answer. Put your complete answer on the attached

sheet of paper or form MC-025 and write “Attachment 7a(3)—Describe Harassment” for a title.

(4) Did the person in use or threaten to use a gun or any other weapon?

(If yes, explain below):

NoYes

Check here if there is not enough space for your answer. Put your complete answer on the attached

sheet of paper or form MC-025 and write “Attachment 7a(4)—Use of Weapons” for a title.

(5)

Were you harmed or injured because of the harassment?

(If yes, explain below):

Yes

Check here if there is not enough space for your answer. Put your complete answer on the attached

sheet of paper or form MC-025 and write “Attachment 7a(5)—Harm or Injury” for a title.

Did the police come?

Yes

If yes, did they give you or the person in an Emergency Protective Order?

Yes

If yes, the order protects (check all that apply):

The person in

The persons in

3 .

(Attach a copy of the order if you have one.)

b. Has the person in harassed you at other times?

Yes No (If yes, describe prior incidents and provide dates of harassment below):

Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of

paper or form MC-025 and write “Attachment 7b—Previous Harassment” for a title.

This is not a Court Order.

Revised January 1, 2018

Request for Civil Harassment Restraining Orders

(Civil Harassment Prevention)

CH-100, Page 3 of 6

(6)

Case Number:

Personal Conduct Orders

Harass, intimidate, molest, attack, strike, stalk, threaten, assault (sexually or otherwise), hit, abuse, destroy

personal property of, or disturb the peace of the person.

Contact the person, either directly or indirectly, in any way, including, but not limited to, in person, by

telephone, in writing, by public or private mail, by interoffice mail, by e-mail, by text message, by fax, or by

other electronic means.

Other (specify):

Check here if there is not enough space for your answer. Put your complete answer on the attached

sheet of paper or form MC-025 and write “Attachment 8c—Other Personal Conduct Orders,” for a

title.

Yes No I don’t know

If the judge grants a protective order, the person in will be prohibited from owning, possessing, purchasing,

receiving, or attempting to purchase or receive a gun, other firearm, and ammunition while the protective order

is in effect. The person in will also be ordered to turn in to law enforcement, or sell to or store with a

licensed gun dealer, any guns or firearms within his or her immediate possession or control.

Does the person in own or possess any guns or other firearms?

Check the orders you want.



I ask the court to order the person in not to do any of the following things to me or to any person to be

protected listed in :

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.

Guns or Other Firearms and Ammunition

Request for Civil Harassment Restraining Orders

(Civil Harassment Prevention)

CH-100, Page 4 of 6

This is not a Court Order.

I ask the court to order the person in to stay at least yards away from (check all that apply):

Me.

The other persons listed in .

My home.

My job or workplace.

My school.

My children’s school.

My children’s place of child care.

My vehicle.

Other (specify):

If the court orders the person in to stay away from all the places listed above, will he or she still be able

to get to his or her home, school, or job?

(If no, explain below):

(3)

(4)

(5)

(6)

(8)

(9)

(1)

(2)

(7)

Yes No

Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of

paper or form MC-025 and write “Attachment 9b—Stay-Away Orders,” for a title.

Stay-Away Orders

Case Number:

Revised January 1, 2018

Has the person in been told that you were going to go to court to seek a TRO against him/her?

Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of

paper or form MC-025 and write “Attachment 11—Temporary Restraining Order” for a title.

Request to Give Less Than Five Days' Notice of Hearing

Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of

paper or form MC-025 and write “Attachment 12—Request to Give Less Than Five Days’ Notice” for a title.

No Fee for Filing or Service

There should be no filing fee and the sheriff or marshal should serve the person in for free because I

am entitled to a fee waiver. (You must complete and file form FW-001, Application for Waiver of Court

Fees and Costs .)

The sheriff or marshal should serve (notify) the person in about the orders for free because my request

for orders is based on unlawful violence, a credible threat of violence, or stalking.

There should be no filing fee because the person in has used or threatened to use violence against me,

has stalked me, or has acted or spoken in some other way that makes me reasonably fear violence.

Lawyer's Fees and Costs

lawyer’s fees

Court costs.

$ $

Check here if there are more items. Put the items and amounts on the attached sheet of paper or form

MC-025 and write “Attachment 14—Lawyer’s Fees and Costs” for a title.

You must have your papers personally served on the person in at least five days before the hearing, unless the

court orders a shorter time for service. (Form CH-200-INFO explains What Is “Proof of Personal Service”? Form

CH-200, Proof of Personal Service, may be used to show the court that the papers have been served.)

(If you answered no, explain why below):

If you want there to be fewer than five days between service and the hearing, explain why below:

I ask the court to order payment of my

Item Amount Item Amount

Request for Civil Harassment Restraining Orders

(Civil Harassment Prevention)

CH-100, Page 5 of 6

This is not a Court Order.

Yes

The amounts requested are:

Case Number:

Revised January 1, 2018

Temporary Restraining Order

I request that a Temporary Restraining Order (TRO) be issued against the person in to last until the hearing. I

am presenting form CH-110, Temporary Restraining Order, for the court’s signature together with this Request.

Possession and Protection of Animals

Number of pages attached to this form, if any:

Date:

Lawyer’s name (if any)

Lawyer’s signature

Sign your name

I declare under penalty of perjury under the laws of the State of California that the information above and on all

attachments is true and correct.

I ask the court to order the following:

Request for Civil Harassment Restraining Orders

(Civil Harassment Prevention)

CH-100, Page 6 of 6

This is not a Court Order.

Date:

Type or print your name

Case Number:

a. That I be given the sole possession, care, and control of the animals listed below, which I own, possess,

lease, keep, or hold, or which reside in my household.

(Identify animals by, e.g., type, breed, name, color, sex.)

That 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 animals listed above.

Revised January 1, 2018

Check here if there is not enough space for your answer. Put your complete answer on the attached

sheet of paper or form MC-025 and write “Attachment 15a—Possession of Animals” for a title.

I request sole possession of the animals because (specify good cause for granting order):

Additional Orders Requested

I ask the court to make the following additional orders (specify):

Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of

paper or form MC-025 and write “Attachment 16—Additional Orders Requested,” for a title.

ATTORNEY OR PARTY WITHOUT ATTORNEY:

STATE BAR NO.:

FOR COURT USE ONLY

NAME:

FIRM NAME:

STREET ADDRESS:

CITY:

STATE:

ZIP CODE:

TELEPHONE NO.:

FAX NO.:

E-MAIL ADDRESS:

ATTORNEY FOR (name):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE

JUSTICE CENTER:

 Central - 700 Civic Center Dr. West, Santa Ana, CA 92701-4045

 Harbor-Newport Beach Faclility-4601 Jamboree Rd., Newport Beach, CA 92660-2595

 North - 1275 N. Berkeley Ave., P. O. Box 5000, Fullerton, CA 92838-0500

 West – 8141 13

Street, Westminster, CA 92683-4593

PLAINTIFF / PETITIONER:

DEFENDANT / RESPONDENT:

DECLARATION RE: NOTICE

Temporary Restraining Order

Civil Harassment, Workplace Violence, Transitional Housing, Postsecondary

Educational Institution, Elder or Dependent Adult Abuse, Gun Violence

Restraining Order

CASE NUMBER:



On (date) at (time) ,

I telephoned Plaintiff/Petitioner or Defendant/Respondent (name)

I said that on (date) at (time) , I would ask the Court for a Temporary

Restraining Order (describe order, e.g. “against violence”):

I gave the location of the Courthouse as Dept. at (address)



I have been unable to give notice to the Plaintiff/Petitioner or Defendant/Respondent for the following reasons:

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Date:

(TYPE OR PRINT NAME) (SIGNATURE OF DECLARANT)

Approved for Optional Use

L-0889 (Rev. Nov. 2016)

DECLARATION RE: NOTICE

Temporary Restraining Order

Civil Harassment, Workplace Violence, Transitional Housing, Postsecondary

Educational Institution and Elder or Dependent Adult Abuse, Gun Violence

Restraining Order

California Rules of Court,

Rule 3.1204(b)

Print This Form

Clear This Form

CM-010

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):

FOR COURT USE ONLY

TELEPHONE NO.: FAX NO.:

ATTORNEY FOR (Name):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF

STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

CASE NAME:

CIVIL CASE COVER SHEET

Complex Case Designation

LimitedUnlimited

Counter Joinder

(Amount(Amount

demanded isdemanded Filed with first appearance by defendant

(Cal. Rules of Court, rule 3.402)

$25,000 or less)exceeds $25,000)

Items 1–6 below must be completed (see instructions on page 2).

1. Check one box below for the case type that best describes this case:

Auto Tort

Contract

Provisionally Complex Civil Litigation

(Cal. Rules of Court, rules 3.400–3.403)

Auto (22)

Breach of contract/warranty (06)

Uninsured motorist (46)

Other collections (09)

Antitrust/Trade regulation (03)

Other PI/PD/WD (Personal Injury/Property

Damage/Wrongful Death) Tort

Construction defect (10)

Insurance coverage (18)

Mass tort (40)

Rule 3.740 collections (09)

Asbestos (04)

Securities litigation (28)

Real Property

Product liability (24)

Environmental/Toxic tort (30)

Eminent domain/Inverse

condemnation (14)

Medical malpractice (45)

Insurance coverage claims arising from the

above listed provisionally complex case

types (41)

Other PI/PD/WD (23)

Wrongful eviction (33)

Non-PI/PD/WD (Other) Tort

Enforcement of Judgment

Business tort/unfair business practice (07)

Enforcement of judgment (20)

Civil rights (08)

Commercial (31)

Miscellaneous Civil Complaint

Defamation (13)

Residential (32)

RICO (27)

Fraud (16)

Drugs (38)

Other complaint (not specified above) (42)

Intellectual property (19)

Judicial Review

Miscellaneous Civil Petition

Asset forfeiture (05)

Partnership and corporate governance (21)

Petition re: arbitration award (11)

Employment

Writ of mandate (02)

Wrongful termination (36)

Other judicial review (39)

is2. This case is not complex under rule 3.400 of the California Rules of Court. If the case is complex, mark the

factors requiring exceptional judicial management:

Extensive motion practice raising difficult or novel

issues that will be time-consuming to resolve

Large number of witnesses a.

3. Remedies sought (check all that apply):

punitive

monetary

nonmonetary; declaratory or injunctive relief

4. Number of causes of action (specify):

is not a class action suit.

5. This case

Date:

(TYPE OR PRINT NAME)

(SIGNATURE OF PARTY OR ATTORNEY FOR PARTY)

NOTICE

Plaintiff must file this cover sheet with the first paper filed in the action or proceeding (except small claims cases or cases filed

under the Probate Code, Family Code, or Welfare and Institutions Code). (Cal. Rules of Court, rule 3.220.) Failure to file may result

in sanctions.

File this cover sheet in addition to any cover sheet required by local court rule.

If this case is complex under rule 3.400 et seq. of the California Rules of Court, you must serve a copy of this cover sheet on all

other parties to the action or proceeding.

Unless this is a collections case under rule 3.740 or a complex case, this cover sheet will be used for statistical purposes only.

Page 1 of 2

Cal. Rules of Court, rules 2.30, 3.220, 3.400–3.403, 3.740;

Cal. Standards of Judicial Administration, std. 3.10

www.courtinfo.ca.gov

Form Adopted for Mandatory Use

Judicial Council of California

CM-010 [Rev. July 1, 2007]

CIVIL CASE COVER SHEET

Other non-PI/PD/WD tort (35)

Professional negligence (25)

Other real property (26)

Other petition (not specified above) (43)

Other employment (15)

Substantial amount of documentary evidence

Large number of separately represented parties

Coordination with related actions pending in one or more courts

in other counties, states, or countries, or in a federal court

Substantial postjudgment judicial supervision

Unlawful Detainer

CASE NUMBER:

JUDGE:

DEPT:

•

If there are any known related cases, file and serve a notice of related case. (You may use form CM-015.)

Other contract (37)

700 Civic Center Drive

Santa Ana, CA 92701

Central Justice Center

ORANGE

✔

Auto (22)–Personal Injury/Property

Auto Tort

case involves an uninsured

motorist claim subject to

arbitration, check this item

instead of Auto)

Uninsured Motorist (46) (if the

Damage/Wrongful Death

INSTRUCTIONS ON HOW TO COMPLETE THE COVER SHEET

To Plaintiffs and Others Filing First Papers. If you are filing a first paper (for example, a complaint) in a civil case, you must

complete and file, along with your first paper, the Civil Case Cover Sheet contained on page 1. This information will be used to compile

statistics about the types and numbers of cases filed. You must complete items 1 through 6 on the sheet. In item 1, you must check

one box for the case type that best describes the case. If the case fits both a general and a more specific type of case listed in item 1,

check the more specific one. If the case has multiple causes of action, check the box that best indicates the primary cause of action.

To assist you in completing the sheet, examples of the cases that belong under each case type in item 1 are provided below. A cover

sheet must be filed only with your initial paper. Failure to file a cover sheet with the first paper filed in a civil case may subject a party,

its counsel, or both to sanctions under rules 2.30 and 3.220 of the California Rules of Court.

To Parties in Complex Cases

. In complex cases only, parties must also use the Civil Case Cover Sheet to designate whether the

case is complex. If a plaintiff believes the case is complex under rule 3.400 of the California Rules of Court, this must be indicated by

completing the appropriate boxes in items 1 and 2. If a plaintiff designates a case as complex, the cover sheet must be served with the

complaint on all parties to the action. A defendant may file and serve no later than the time of its first appearance a joinder in the

plaintiff's designation, a counter-designation that the case is not complex, or, if the plaintiff has made no designation, a designation that

the case is complex.

CASE TYPES AND EXAMPLES

Contract

Provisionally Complex Civil Litigation (Cal.

Rules of Court Rules 3.400–3.403)

Breach of Contract/Warranty (06)

Breach of Rental/Lease

Contract (not unlawful detainer

Antitrust/Trade Regulation (03)

Construction Defect (10)

Claims Involving Mass Tort (40)

Securities Litigation (28)

Environmental/Toxic Tort (30)

or wrongful eviction)

Contract/Warranty Breach–Seller

Plaintiff (not fraud or negligence)

Negligent Breach of Contract/

Warranty

Insurance Coverage Claims

Other Breach of Contract/Warranty

(arising from provisionally complex

case type listed above) (41)

Collections (e.g., money owed, open

Other PI/PD/WD (Personal Injury/

Property Damage/Wrongful Death)

Tort

book accounts) (09)

Collection Case–Seller Plaintiff

Asbestos (04)

Enforcement of Judgment

Other Promissory Note/Collections

Enforcement of Judgment (20)

Asbestos Property Damage

Case

Asbestos Personal Injury/

Insurance Coverage (not provisionally

Abstract of Judgment (Out of

Wrongful Death

complex) (18)

County)

Confession of Judgment (non-

Product Liability (not asbestos or

Auto Subrogation

toxic/environmental) (24)

domestic relations)

Other Coverage

Other Contract (37)

Medical Malpractice (45)

Sister State Judgment

Medical Malpractice–

Administrative Agency Award

Contractual Fraud

Physicians & Surgeons

(not unpaid taxes)

Petition/Certification of Entry of

Judgment on Unpaid Taxes

Other Contract Dispute

Other Professional Health Care

Malpractice

Real Property

Eminent Domain/Inverse

Other PI/PD/WD (23)

Other Enforcement of Judgment

Premises Liability (e.g., slip

Condemnation (14)

Case

and fall)

Wrongful Eviction (33)

Intentional Bodily Injury/PD/WD

Other Real Property (e.g., quiet title) (26)

Miscellaneous Civil Complaint

RICO (27)

(e.g., assault, vandalism)

Writ of Possession of Real Property

Mortgage Foreclosure

Intentional Infliction of

Other Complaint (not specified

above) (42)

Emotional Distress

Quiet Title

Negligent Infliction of

Declaratory Relief Only

Other Real Property (not eminent

domain, landlord/tenant, or

foreclosure)

Injunctive Relief Only (non-

Emotional Distress

Other PI/PD/WD

harassment)

Mechanics Lien

Non-PI/PD/WD (Other) Tort

Unlawful Detainer

Other Commercial Complaint

Business Tort/Unfair Business

Case (non-tort/non-complex)

Commercial (31)

Residentia

l (32)

Practice (07)

Civil Rights (e.g., discrimination,

false arrest) (not civil

Other Civil Complaint

(non-tort/non-complex)

Drugs (38) (if the case involves illegal

drugs, check this item; otherwise,

report as Commercial or Residential)

Miscellaneous Civil Petition

harassment) (08)

Defamation (e.g., slander, libel)

Partnership and Corporate

(13)

Governance (21)

Judicial Review

Fraud (16)

Other Petition (not specified

Asset Forfeiture (05)

above) (43)

Intellectual Property (19)

Petition Re: Arbitration Award (11)

Civil Harassment

Professional Negligence (25)

Writ of Mandate (02)

Workplace Violence

Legal Malpractice

Other Professional Malpractice

(not medical or legal)

Other Non-PI/PD/WD Tort (35)

Writ–Administrative Mandamus

Writ–Mandamus on Limited Court

Elder/Dependent Adult

Abuse

Case Matter

Election Contest

Writ–Other Limited Court Case

Petition for Name Change

Review

Petition for Relief From Late

Employment

Claim

Other Judicial Review (39)

Wrongful Termination (36)

Other Employment (15)

Review of Health Officer Order

Notice of Appeal–Labor

Commissioner Appeals

Other Civil Petition

CM-010 [Rev. July 1, 2007]

Page 2 of 2

CIVIL CASE COVER SHEET

CM-010

To Parties in Rule 3.740 Collections Cases. A "collections case" under rule 3.740 is defined as an action for recovery of money

owed in a sum stated to be certain that is not more than $25,000, exclusive of interest and attorney's fees, arising from a transaction in

which property, services, or money was acquired on credit. A collections case does not include an action seeking the following: (1) tort

damages, (2) punitive damages, (3) recovery of real property, (4) recovery of personal property, or (5) a prejudgment writ of

attachment. The identification of a case as a rule 3.740 collections case on this form means that it will be exempt from the general

time-for-service requirements and case management rules, unless a defendant files a responsive pleading. A rule 3.740 collections

case will be subject to the requirements for service and obtaining a judgment in rule 3.740.

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

Sex:

Height:

Weight:

Race:

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):

CLETS-001, Page 1 of 1

Eye Color: Date of Birth: Hair Color:

Age:

Sex:

Height:

Weight:

Race:

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

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.

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

Temporary Restraining Orders for personal conduct and stay-away orders as requested in form CH-100, Request

for Civil Harassment Restraining Orders, are (check only one box below):

Notice of Hearing

A court hearing is scheduled on the request for restraining orders against the person in :

Your Full Name:

Your Address (If you have a lawyer, give your lawyer’s information.

If you do not have a lawyer and want to keep your home address

private, you may give a different mailing address instead. You do not

have to give telephone, fax, or e-mail.)

Person Seeking Protection

Your Lawyer (if you have one for this case):

Name: State Bar No.:

Firm Name:

Address:

City: State: Zip:

Telephone: Fax:

E-Mail Address:

Person From Whom Protection Is Sought

Full Name:

Hearing

Date

Date: Time:

Room:Dept.:

Name and address of court if different from above:

(1)

(2)

(3)

Temporary Restraining Orders (Any orders granted are on form CH-110, served with this notice.)

The court will complete the rest of this form.

Fill in court name and street address:

Superior Court of California, County of

Court fills in case number when form is filed.

Case Number:

Clerk stamps date here when form is filed.

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.)

CH-109

Notice of Court Hearing

Judicial Council of California, www.courts.ca.gov

Rev. September 1, 2020, Mandatory Form

Code of Civil Procedure, § 527.6

Approved by DOJ

Notice of Court Hearing

(Civil Harassment Prevention)

CH-109, Page 1 of 3

700 Civic Center Drive

Santa Ana, CA 92701

Central Justice Center

Orange

At least before the hearing, someone age 18 or older—not you or anyone to be

protected—must personally give (serve) a court’s file-stamped copy of this form CH-109 to the person in

along with a copy of all the forms indicated below:

Service of Documents for the Person in

CH-100, Request for Civil Harassment Restraining Orders (file-stamped)a.

CH-120, Response to Request for Civil Harassment Restraining Orders (blank form)c.

CH-120-INFO, How Can I Respond to a Request for Civil Harassment Restraining Orders?

(specify):g.

Reasons for denial of some or all of those personal conduct and stay-away orders as requested in form CH-100,

Request for Civil Harassment Restraining Orders, are:

(1)

(2)

CH-250, Proof of Service of Response by Mail (blank form)

Date:

Judicial Officer

As set forth on Attachment 4b.

The facts as stated in form CH-100 do not sufficiently show acts of violence, threats of violence, or a

course of conduct that seriously alarmed, annoyed, or harassed the person in and caused substantial

emotional distress.

Other (specify):

five

days

CH-110, Temporary Restraining Order (file-stamped) IF GRANTED

Rev. September 1, 2020

Notice of Court Hearing

(Civil Harassment Prevention)

CH-109, Page 2 of 3

Case Number:

CH-170, Notice of Order Protecting Information of Minor and CH-165, Order on Request to Keep Minor’s

Information Confidential (file-stamped) IF GRANTED

Confidential Information Regarding Minor

A Request to Keep Minor’s Information Confidential (form CH-160) was made and GRANTED. (See form

CH-165, Order on Request to Keep Minor's Information Confidential, served with this form.)

If the request was granted, the information described in item on the order (form CH-165) 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 penalities.

Other

—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 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 to the request for orders in writing, file form CH-120, Response to Request for Civil

Harassment Restraining Orders, and have someone age 18 or older—not you or anyone to be protected—mail it to

the person in .

•

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 and may order you to

turn in to law enforcement, or sell to or store with a licensed gun dealer, any firearms that you own or possess.

The person who mailed the form must fill out a proof of service form. Form CH-250, Proof of Service of Response by

Mail, may be used. File the completed form with the court before the hearing and bring a copy with you to the court

hearing.

•

Clerk’s Certificate

[seal]

•

Rev. September 1, 2020

Notice of Court Hearing

(Civil Harassment Prevention)

CH-109, Page 3 of 3

To the Person in :

Case Number:

•

If you are unable to serve the person in in time, you may ask for more time to serve the documents.

Use form CH-115, Request to Continue Court Hearing and to Reissue Temporary Restraining Order.

•

For information about service, read form CH-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 CH-200, Proof of Personal Service, may be used.

•

To the Person in :

, Deputy

Clerk, by

Print this form

Save this form

Clear this form

For your protection and privacy, please press the Clear

This Form button after you have printed the form.

Description:

Protected Person

Restrained Person

Your Full Name:

Name: State Bar No.:

Firm Name:

Address:

City: State: Zip:

Telephone: Fax:

E-Mail Address:

Person in must complete items , , and only.

In addition to the person named in , the following family or household members of that person are protected by

the temporary orders indicated below:

Sex:

Full Name:

Height: Weight:

Race:Hair Color:

Date of Birth:

Eye Color: Age:

Home Address (if known):

State:

City:

Zip:

Relationship to Protected Person:

Date: Time:

Expiration Date

This Order expires at the end of the hearing scheduled for the date and time below:

The court will complete the rest of this form.

Full Name

Your Address (If you have a lawyer, give your lawyer’s information.

If you do not have a lawyer and want to keep your home address

private, you may give a different mailing address instead. You do not

have to give telephone, fax, or e-mail.):

Your Lawyer (if you have one for this case):

Yes No

Check here if there are additional persons. List them on an attached sheet of paper and write “Attachment 3—

Additional Protected Persons” as a title. You may use form MC-025, Attachment.

Yes No

Sex Age Household Member? Relation to Protected Person

a.m. p.m.

Additional Protected Persons

Clerk stamps date here when form is filed.

Fill in court name and street address:

Superior Court of California, County of

Orange

Court fills in case number when form is filed.

Case Number:

CH-110

Temporary Restraining Order

Judicial Council of California, www.courts.ca.gov

Rev. March 15, 2019, Mandatory Form

Code of Civil Procedure, §§ 527.6 and 527.9

Approved by DOJ

Temporary Restraining Order (CLETS-TCH)

(Civil Harassment Prevention)

CH-110, Page 1 of 6

This is a Court Order.

1 1 2 3

700 Civic Center Drive

Santa Ana, CA 92701

Central Justice Center

(3)

(4)

(1)

(2)

and to the other protected persons listed in :

Other (specify):

Harass, intimidate, molest, attack, strike, stalk, threaten, assault (sexually or otherwise), hit, abuse,

destroy personal property of, or disturb the peace of the person.

Contact the person, either directly or indirectly, in any way, including, but not limited to, in person, by

telephone, in writing, by public or private mail, by interoffice mail, by e-mail, by text message, by fax,

or by other electronic means.

Take any action to obtain the person’s address or location. If this item (3) is not checked, the court has

found good cause not to make this order.

Personal Conduct Orders

You must not do the following things to the person named in

The court has granted the temporary orders checked as granted 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.

Other personal conduct orders are attached at the end of this Order on Attachment 5a(4).

No Guns or Other Firearms and Ammunition

a. 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.

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. However, you may have your papers served by mail

on the person in .

Stay-Away Order

You must stay at least yards away from (check all that apply):

(1)

(2)

(3)

(4)

(6)

(7)

(8)

(9)

Each person in

The home of the person in

The job or workplace of the person

The school of the children of the

person in

The place of child care of the children of

the person in

The vehicle of the person in

Other (specify):

The person in

(5)

The school of the person in

This stay-away order does not prevent you from going to or from your home or place of employment.

You must:

Sell to or store with a licensed gun dealer, or turn in to a law enforcement agency, any guns or other

firearms in your immediate possession or control. This must be done within 24 hours of being served with

this Order.

(1)

Case Number:

Not Requested

Denied Until the Hearing

Granted as Follows:

Not Requested Denied Until the Hearing

Granted as Follows:

To the Person in :

Rev. March 15, 2019

Temporary Restraining Order (CLETS-TCH)

(Civil Harassment Prevention)

CH-110, Page 2 of 6

This is a Court Order.

Case Number:

File a receipt with the court within 48 hours of receiving this Order that proves that your guns or

firearms have been turned in, sold, or stored. (You may use form CH-800, Proof of Firearms Turned In,

Sold, or Stored, for the receipt.)

(2)

The court has received information that you own or possess a firearm.

Possession and Protection of Animals

Not Requested Denied Until the Hearing

Granted as Follows (specify):

a. The person in is given the sole possession, care, and control of the animals listed below, which are

owned, possessed, leased, kept, or held by him or her, or reside in his or her household.

(Identify animals by, e.g., type, breed, name, color, sex.)

b. 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 animals listed above.

Other Orders

Not Requested Denied Until the Hearing

Granted as Follows (specify):

Additional orders are attached at the end of this Order on Attachment 9.

Mandatory Entry of Order Into CARPOS Through CLETS

This Order must be entered into the California Restraining and Protective Order System (CARPOS) through the

California Law Enforcement Telecommunications System (CLETS). (Check one):

To the Person in :

The clerk will enter this Order and its proof-of-service form into CARPOS.

The clerk will transmit this Order and its proof-of-service form to a law enforcement agency to be entered

into CARPOS.

By the close of business on the date that this Order is made, the person in or his or her lawyer should

deliver a copy of the Order and its proof-of-service form to the law enforcement agency listed below to

enter into CARPOS:

Name of Law Enforcement Agency

Address (City, State, Zip)

Additional law enforcement agencies are listed at the end of this Order on Attachment 10.

Rev. March 15, 2019

Temporary Restraining Order (CLETS-TCH)

(Civil Harassment Prevention)

CH-110, Page 3 of 6

This is a Court Order.

No Fee to Serve (Notify) Restrained Person

The sheriff or marshal will serve this Order without charge because:

Judicial Officer

Ordered

Not Ordered

The Order is based on unlawful violence, a credible threat of violence, or stalking.

The person in is entitled to a fee waiver.

Number of pages attached to this Order, if any:

Date:

Case Number:

If you have been personally served with this Temporary Restraining Order and form CH-109, Notice of Court Hearing,

but you do not appear at the hearing either in person or by a lawyer, and a restraining order that is the same as this

Temporary Restraining Order except for the expiration date is issued at the hearing, a copy of the order will be served on

you by mail at the address in item .

Notice Regarding Nonappearance at Hearing and Service of Order

If this address is not correct or you wish to verify that the Temporary Restraining Order was converted into a restraining

order at the hearing without substantive change, or to find out the duration of the order, contact the clerk of the court.

Warnings and Notices to the Restrained Person in

You Cannot Have Guns or Firearms

You cannot own, have, possess, buy or try to buy, receive or try to receive, or otherwise get guns, other firearms, or

ammunition while this 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 as

stated in item above. The court will require you to prove that you did so.

In addition to the response, you may file and have declarations served, signed by you and other persons who have

personal knowledge of the facts. You may use form MC-030, Declaration, for this purpose. It is available from the

clerk’s office at the court shown on page 1 of this form or at www.courts.ca.gov/forms. If you do not know how to

prepare a declaration, you should see a lawyer.

•

You must have form CH-120 served by mail on the person in or that person’s attorney. You cannot do this

yourself. The person who does the mailing should complete and sign form CH-250, Proof of Service of Response by

Mail. File the completed proof of service with the court clerk before the hearing date or bring it with you to the

hearing.

•

After You Have Been Served With a Restraining Order

Obey all the orders.

If you want to respond, fill out form CH-120, Response to Request for Civil Harassment Restraining Orders, and file

it with the court clerk. You do not have to pay any fee to file your response if the Request claims that you inflicted or

threatened violence against or stalked the person in .

•

Read form CH-120-INFO, How Can I Respond to a Request for Civil Harassment Restraining Orders?, to learn how

to respond to this Order.

•

Rev. March 15, 2019

Temporary Restraining Order (CLETS-TCH)

(Civil Harassment Prevention)

CH-110, Page 4 of 6

This is a Court Order.

Case Number:

Instructions for Law Enforcement

Enforcing the Restraining Order

This order 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 Restraining and Protective Orders System (CARPOS). If the law enforcement

agency has not received proof of service on the restrained person, the agency must advise the restrained person of the

terms of the order and then must enforce it. Violations of this order are subject to criminal penalties.

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. Agencies are encouraged to enter violation messages into CARPOS.

Start Date and End Date of Orders

This order starts on the date next to the judge’s signature on page 4. The order ends on the expiration date in item on

page 1.

At the hearing, the judge can make restraining orders against you that last for up to five years. Tell the judge why you

disagree with the orders requested.

•

Whether or not you file a response, you should attend the hearing. If you have any witnesses, they must also go to the

hearing.

•

If the Protected Person Contacts the Restrained Person

Even if the protected person invites or consents to contact with the restrained person, this order remains in effect and must

be enforced. The protected person cannot be arrested for inviting or consenting to contact with the restrained person. The

order can be changed only by another court order. (Pen. Code, § 13710(b).)

Notice/Proof of Service

The law enforcement agency must first determine if the restrained person had notice of the order. Consider the restrained

person “served” (given notice) if (Pen. Code, § 836(c)(2)):

•

The officer sees a copy of the Proof of Service or confirms that the Proof of Service is on file; or

•

The restrained person was informed of the order by an officer.

An officer can obtain information about the contents of the order and proof of service in CARPOS. If proof of service on

the restrained person cannot be verified, the agency must advise the restrained person of the terms of the order and then

enforce it.

Rev. March 15, 2019

Temporary Restraining Order (CLETS-TCH)

(Civil Harassment Prevention)

CH-110, Page 5 of 6

This is a Court Order.

If more than one restraining order has been issued, the orders must be enforced according to

the following priorities

(see Pen. Code, § 136.2; Fam. Code, §§ 6383(h)(2), 6405(b)):

1. EPO: If one of the orders is an Emergency Protective Order (form EPO-001) and is more restrictive than other

restraining or protective orders, it has precedence in enforcement over all other orders.

2. No Contact Order: If there is no EPO, a no-contact order that is included in a restraining or protective order has

precedence over any other restraining or protective order.

3. 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.

4. 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.

Conflicting Orders—Priorities for Enforcement

(Clerk will fill out this part.)

—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

Date:

Case Number:

Rev. March 15, 2019

Temporary Restraining Order (CLETS-TCH)

(Civil Harassment Prevention)

CH-110, Page 6 of 6

This is a Court Order.

CH-130, Page 1 of 6

Civil Harassment Restraining Order After Hearing

(CLETS-CHO)

(Civil Harassment Prevention)

Your Full Name:

Name:

State Bar No.:

Firm Name:

Your Address (If you have a lawyer, give your lawyer’s information.

If you do not have a lawyer and want to keep your home address

private, you may give a different mailing address instead. You do not

have to give telephone, fax, or e-mail.)

Address:

City: State: Zip:

Telephone: Fax:

E-Mail Address:

Your Lawyer (if you have one for this case)

Full Name:

Additional Protected Persons

Yes

Check here if there are additional persons. List them on an attached sheet of paper and write “Attachment 3—

Additional Protected Persons” as a title. You may use form MC-025, Attachment.

Yes

Judicial Council of California, www.courts.ca.gov

Rev. March 15, 2019, Mandatory Form

Code of Civil Procedure, §§ 527.6 and 527.9

Approved by DOJ

This Order, except for any award of lawyer’s fees, expires at

(date):

Time:

midnight onp.m.a.m.

Expiration Date

If no expiration date is written here, this Order expires three years from the date of issuance.

Height:

Weight:

Race:

Hair Color:

Date of Birth:

Eye Color:

Age:

Home Address (if known):

State:City: Zip:

Relationship to Protected Person:

M FSex:

Description:

Restrained Person

Person in must complete items , , and only.

How are they related to you?AgeSex Lives with you?

In addition to the person named in , the following family or household members of that person are protected by

the orders indicated below:

Protected Person

CH-130

Civil Harassment Restraining

Order After Hearing

Clerk stamps date here when form is filed.

Fill in court name and street address:

Superior Court of California, County of

Orange

Court fills in case number when form is filed.

Case Number:

Full Name

This is a Court Order.

700 Civic Center Drive

Santa Ana, CA 92701

Central Justice Center

CH-130, Page 2 of 6

Rev. March 15, 2019

Civil Harassment Restraining Order After Hearing

(CLETS-CHO)

(Civil Harassment Prevention)

This is a Court Order.

(date): at (time): in Dept.: Room:

(Name of judicial officer):

The person in .

The lawyer for the person in

(name):

The person in .

The lawyer for the person in

(name):

Additional persons present are listed at the end of this Order on Attachment 5.

The hearing is continued. The parties must return to court on (date): at (time):

These people were at the hearing:

(1)

(2)

(3)

(4)

Hearing

There was a hearing on

made the orders at the hearing.

The court has granted the 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 not do the following things to the person named in

(3)

(4)

(1)

(2)

and to the other protected persons listed in :

Harass, intimidate, molest, attack, strike, stalk, threaten, assault (sexually or otherwise), hit, abuse,

destroy personal property of, or disturb the peace of the person.

Contact the person, either directly or indirectly, in any way, including, but not limited to, in person, by

telephone, in writing, by public or private mail, by interoffice mail, by e-mail, by text message, by fax,

or by other electronic means.

Take any action to obtain the person’s address or location. If this item (3) is not checked, the court has

found good cause not to make this order.

Other (specify):

Personal Conduct Orders

Other personal conduct orders are attached at the end of this Order on Attachment 6a(4).

Stay-Away Orders

You must stay at least yards away from (check all that apply):

(1)

(2)

(3)

(4)

(6)

(7)

(8)

(9)

Each person in .

The home of the person in .

The job or workplace of the person

in .

The school of the children of the

person in .

The place of child care of the children of

the person in .

The vehicle of the person in .

Other (specify):

The person in .

(5) The school of the person in .

To the Person in :

Peaceful written contact through a lawyer or process server or other person for service of legal papers related to

a court case is allowed and does not violate this Order.

Case Number:

This stay-away order does not prevent you from going to or from your home or place of employment.

The court has made the necessary findings and applies the firearm relinquishment exemption under Code of

Civil Procedure section 527.9(f). Under California law, the person in is not required to relinquish this

firearm (specify make, model, and serial number of firearm(s)):

The firearm must be in his or her physical possession only during scheduled work hours and during travel to

and from his or her place of employment. Even if exempt under California law, the person in may be

subject to federal prosecution for possessing or controlling a firearm.

Lawyer's Fees and Costs

The person in must pay to the person in the following amounts for

lawyer’s fees

costs:

Additional items and amounts are attached at the end of this Order on Attachment 9.

Item

Amount Item Amount

If you have not already done so, you must:

Within 24 hours of being served with this Order, sell to or store with a licensed gun dealer, or turn in to a

law enforcement agency, any guns or other firearms in your immediate possession or control.

File a receipt with the court within 48 hours of receiving this Order that proves that your guns or firearms

have been turned in, sold, or stored. (You may use form CH-800, Proof of Firearms Turned In, Sold, or

Stored, for the receipt.)

•

No Guns or Other Firearms and Ammunition

a. 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.

Case Number:

The person in is given the sole possession, care, and control of the animals listed below, which are

owned, possessed, leased, kept, or held by him or her, or reside in his or her household.

(Identify animals by, e.g., type, breed, name, color, sex.)

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 animals listed above.

Other Orders (specify):

CH-130, Page 3 of 6

Rev. March 15, 2019

Civil Harassment Restraining Order After Hearing

(CLETS-CHO)

(Civil Harassment Prevention)

This is a Court Order.

Additional orders are attached at the end of this Order on Attachment 11.

Possession and Protection of Animals

The court has received information that you own or possess a firearm.c.

CH-130, Page 4 of 6

Rev. March 15, 2019

Civil Harassment Restraining Order After Hearing

(CLETS-CHO)

(Civil Harassment Prevention)

This is a Court Order.

The clerk will enter this Order and its proof-of-service form into CARPOS.

The clerk will transmit this Order and its proof-of-service form to a law enforcement agency to be entered

into CARPOS.

By the close of business on the date that this Order is made, the person in or his or her lawyer should

deliver a copy of the Order and its proof-of-service form to the law enforcement agency listed below to

enter into CARPOS:

Name of Law Enforcement Agency

Address (City, State, Zip)

Additional law enforcement agencies are listed at the end of this Order on Attachment 12.

Mandatory Entry of Order Into CARPOS Through CLETS

This Order must be entered into the California Restraining and Protective Order System (CARPOS) through the

California Law Enforcement Telecommunications System (CLETS). (Check one):

To the Person in :

Case Number:

The person in personally attended the hearing. No other proof of service is needed.

The person in did not attend the hearing.

Service of Order on Restrained Person

The judge’s orders in this form are different from the temporary restraining orders in form CH-110.

Someone—but not anyone in or —must personally serve a copy of this Order on the person

in .

Proof of service of form CH-110, Temporary Restraining Order, was presented to the court. The

judge’s orders in this form are the same as in form CH-110 except for the expiration date. The person in

must be served with this Order. Service may be by mail.

(2)

(1)

No Fee to Serve (Notify) Restrained Person

The Order is based on unlawful violence, a credible threat of violence, or stalking.

The person in is entitled to a fee waiver.

The sheriff or marshal will serve this Order without charge because:

Number of pages attached to this Order, if any:

Date:

Judicial Officer

You Cannot Have Guns or Firearms

CH-130, Page 5 of 6

Rev. March 15, 2019

This is a Court Order.

Civil Harassment Restraining Order After Hearing

(CLETS-CHO)

(Civil Harassment Prevention)

Unless item 8d is checked, you cannot own, have, possess, buy or try to buy, receive or try to receive, or otherwise get

guns, other firearms, or ammunition while this 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 as stated in item above. The court will require you to prove that you did so.

Instructions for Law Enforcement

Enforcing the Restraining Order

This Order 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 Restraining and Protective Order System (CARPOS). 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 must advise the restrained person of the terms of the Order and then must enforce it. Violations of

this Order are subject to criminal penalties.

Warning and Notice to the Restrained Person in :

Case Number:

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 it, 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. Agencies are encouraged to enter violation messages into CARPOS.

Notice/Proof of Service

The law enforcement agency must first determine if the restrained person had notice of the order. Consider the restrained

person “served” (given notice) if (Pen. Code, § 836(c)(2)):

The officer sees a copy of the Proof of Service or confirms that the Proof of Service is on file; or

The restrained person was at the restraining order hearing or was informed of the order by an officer.

An officer can obtain information about the contents of the order and proof of service in CARPOS. If proof of service on

the restrained person cannot be verified and the restrained person was not present at the court hearing, the agency must

advise the restrained person of the terms of the order and then enforce it.

•

Start Date and End Date of Orders

This Order starts on the date next to the judge’s signature on page 4 and ends on the expiration date in item on page 1.

If the Protected Person Contacts the Restrained Person

Even if the protected person invites or consents to contact with the restrained person, this Order remains 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).)

If more than one restraining order has been issued, the orders must be enforced according to

the following priorities: (See Pen. Code, § 136.2; Fam. Code, §§ 6383(h)(2), 6405(b).)

1. EPO: If one of the orders is an Emergency Protective Order (form EPO-001) and is more restrictive than other

restraining or protective orders, it has precedence in enforcement over all other orders.

2. No-Contact Order: If there is no EPO, a no-contact order that is included in a restraining or protective order has

precedence over any other restraining or protective order.

3. 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.

4. 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.

—Clerk's Certificate—

I certify that this Civil Harassment Restraining Order After Hearing 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.)

CH-130, Page 6 of 6

Rev. March 15, 2019

Civil Harassment Restraining Order After Hearing

(CLETS-CHO)

(Civil Harassment Prevention)

This is a Court Order.

Conflicting Orders—Priorities of Enforcement

Date:

Case Number:

Clerk stamps date here when form is filed.

Fill in court name and street address:

Superior Court of California, County of

Orange

Fill in case number:

Case Number:

Order on Request to Continue Hearing

Next Court Date

Complete items

1 2

Protected Party:

Restrained Party:

Temporary Restraining Order

The court will complete the rest of this form

CH-116, Page 1 of 3

Warning and Notice to

the Restrained Party:

If 4 b is checked, a civil

harassment restraining

order has been issued

against you. You must

follow the orders until

they expire.

There is no Temporary Restraining Order (TRO) in this case until the next court date because:.

A TRO was not previously granted by the court.

A Temporary Restraining Order (TRO) is still in full force and effect because:

(1)

(specify):

Other

(2)

(1)

(2)

The court changes the TRO previously granted and signs a new TRO (form

CH-110).

(date)

It now expires on (date):

The court extends the TRO previously granted on :

(If no date is listed, the TRO expires at the end of the court date listed in 3b.)

(1) Any Temporary Restraining Order (form CH-110) already granted

stays in full force and effect until the next court date.

The request to reschedule the court date is denied.

Your court date is:

The request to reschedule the court date is granted. Your court date is rescheduled for the day and time

Date:

Time:

Room:

Dept.:

New

Court

Date



Name and address of court, if different from above:

(2) Your court date is not rescheduled because:

The court terminates (cancels) the previously granted TRO because:

Judicial Council of California, www.courts.ca.gov

Revised January 1, 2020, Mandatory Form

Code of Civil Procedure, §§ 527.6 and 527.9

only.and

listed below. See

This is a Court Order.

Order on Request to Continue Hearing

(Temporary Restraining Order) (CLETS-TCH)

(Civil Harassment Prevention)

4 – 8

for more information.

CH-116

700 Civic Center Drive

Santa Ana, CA 92701

Central Justice Center

Case Number:

CH-116,

Page 2 of 3

Serving (Giving) Order to Other Party

The request to reschedule was made by the:

Reason Court Date Is Rescheduled

(2)

(1)

The protected party has not served the restrained party.

This is the first time that the restrained party has asked for more time to prepare.

There is good cause to reschedule the court date (check one):

The court reschedules the court date on its own motion.

Other:

Revised January 1, 2020

This is a Court Order.

Order on Request to Continue Hearing

(Temporary Restraining Order) (CLETS-TCH)

(Civil Harassment Prevention)

You must have the protected

party served with a copy of

this order. This can be done

by mail. You must serve by

You must have the restrained

party served with a copy of

this order. This can be done

by mail. You must serve by

You do not have to serve the

restrained party because they

or their lawyer were at the

court date or agreed to

reschedule the court date.

(1)

You must have the protected

party personally served with a

copy of this order by

(2)

(date):

Protected party Restrained partyb. Courtc.

Further notice is not required.(1)

(2)

You do not have to serve the

protected party because they

or their lawyer were at the

court date or agreed to

reschedule the court date.

(1)

(3)

(4)

(date):

(3)

(4)

(date):

(2)

The court will mail a copy of

this order to all parties by

(date):

(3)

Other:

You must have the restrained

party personally served with a

copy of this order and a copy

of all documents listed on

form

CH-109

, item

, by

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.htm for Request for Accommodations by Persons With Disabilities and

Response (form MC-410

). (Civ. Code, § 54.8.)

—Clerk's Certificate—

I certify that this Order on Request to Continue Hearing (Temporary Restraining

Order) (CLETS-TCH) is a true and correct copy of the original on file in the court.

Clerk’s Certificate

[seal]

Clerk, by

, Deputy

Date:

Judicial Officer

CH-116, Page 3 of 3

Case Number:

No Fee to Serve (Notify) Restrained Person

The sheriff or marshal will serve this order for free because:

Ordered

Not Ordered

The order is based on unlawful violence, a credible threat of violence, or stalking.

The person in

Revised January 1, 2020

Other Orders

Instructions to Clerk

If the hearing is rescheduled and the court extended, modified, or terminated a temporary restraining order, then the

court must enter this order into CLETS or send this order to law enforcement to enter into CLETS. This must be

done within one business day from the day the order is made.

is entitled to a fee waiver.

This is a Court Order.

Order on Request to Continue Hearing

(Temporary Restraining Order) (CLETS-TCH)

(Civil Harassment Prevention)

CH-200-INFO, Page 1 of 2

What Is ''Proof of Personal Service''?

(Civil Harassment Prevention)

CH-200-INFO

What Is “Proof of Personal Service”?

What is “Service”?

Service is the act of giving your legal papers to the other party. There are many kinds of service—in person, by mail, and

others. This form is about personal or “in-person” service. The Request for Civil Harassment Restraining Orders (Form

CH-100), the Notice of Court Hearing (Form CH-109), and the Temporary Restraining Order (Form CH-110) must be

served “in person.” That means that someone must personally “serve” (give) a copy of the forms to the person to be

restrained. These forms cannot be served by mail.

Judicial Council of California, www.courts.ca.gov

Revised January 1, 2012, Optional Form

Service lets the other person know:

What orders you are asking for

The hearing date

How to respond

Who can serve?

Ask someone you know, a process server, or a law enforcement agency to

personally serve (give) a copy of the forms to the person to be restrained. You

cannot send the forms to that person by mail.

The server must:

Be 18 years of age or older

The sheriff or marshal may be authorized to serve the court’s orders for free if the

orders are based on claims of stalking, unlawful violence, or a credible threat of

violence, or if you are entitled to a fee waiver.

A “registered process server” is a business you pay to deliver court forms. Look for

“Process Serving” in the Yellow Pages or on the Internet.

Don’t serve it by mail!

(If a law enforcement agency or the process server uses a different proof-of-service

form, make sure it lists the forms served.)

How to serve

Ask the server to:

Walk up to the person to be served.

Make sure it is the right person. Ask the person’s name.

Give the person copies of all papers checked on Form CH-200, Proof of Personal Service.

Fill out and sign the Proof of Personal Service form.

Give the signed Proof of Personal Service to you.

Not be you or anyone whom you are asking to be protected by the orders

Why do I have to get the orders served?

The police cannot arrest anyone for violating an order unless that person knows about the order.

The judge cannot make the orders permanent unless the restrained person was served.

•

What if the person won’t take the papers or tears them up?

If the person won’t take the papers, just leave them near him or her.

It doesn’t matter if the person tears them up. Service is still complete.

•

It depends. To know the exact date, you have to look at two things on Form CH-109, Notice of Court Hearing:

First, look at the hearing date on page 1 of Form

CH-109.

When do the orders have to be served?

Look at a calendar. Subtract the number of days in from the hearing date. That is the final date to have the orders

served. It is always OK to serve earlier than that date.

If nothing is checked or written in , you must serve the orders at least five days before the hearing.

What do I do with the completed Proof of Personal Service?

Make several copies.

File the original with the court before your hearing

Ask the clerk to enter it into the California Law Enforcement Telecommunications System (CLETS), a special

computer system that lets police all over the state find out about the orders protecting you.

If the clerk tells you that the court cannot enter it into the computer, take a copy of the Temporary Restraining

Order (Form CH-110) and Proof of Personal Service (Form CH-200) to your local police. They will put the

information into the state computer system. That way, police all over the state will know that your restraining

order has been served.

Bring a copy of the completed Proof of Personal Service to your hearing.

CH-200-INFO, Page 2 of 2

Always keep an extra copy of the restraining orders with you for your safety.

Revised January 1, 2012

Notice of Hearing

Date: ________

Dept.: ________

Hearing

Date

Next, look at the number of days in item on page 2 of

Form CH-109.

What Is ''Proof of Personal Service''?

(Civil Harassment Prevention)

Who signs the Proof of Personal Service?

Only the person who serves the forms can sign Form CH-200, Proof of Personal Service. You do not sign it; the

restrained person does not need to sign it.

If someone other than the sheriff serves the papers, you should:

If the sheriff serves the papers, he or she will send the proof of service to the court and CLETS for you.

•

What happens if I can't get the orders served before the hearing date?

Before your hearing, fill out and file Form CH-115, Request to Continue Court Hearing and to Reissue Temporary

Restraining Order. This form asks the court for a new hearing date and makes your orders last until then. Ask the clerk

for the form. After the court has reissued the orders, attach a copy of Form CH-116, Notice of New Hearing Date and

Order on Reissuance, to a copy of your original orders. Ask the clerk to enter Form CH-116 into CLETS, or the clerk

may ask you or your attorney to deliver a copy to the police. That way, the police will know your orders are still in

effect.

At least five days before the hearing,

Service of Documents By the Person in

CH-200-INFO

What Is “Proof of Personal Service”?

CH-200

Proof of Personal Service

Clerk stamps date here when form is filed.

Fill in court name and street address:

Superior Court of California, County of

Orange

Court fills in case number when form is filed.

Case Number:

Notice to Server

The server must:

Be 18 years of age or older.

Not be listed in items or

of Form CH-100.

I gave the person in a copy of the forms checked below:

Give a copy of all documents checked in to the person in .

(You cannot send them by mail.) Then complete and sign this

form and give or mail it to the person in .

I personally gave copies of the documents checked above to the person in :

Zip:

State:

Server's Information

Name:

Address:

Zip:

City:

Telephone:

(If you are a registered process server):

Registration number:

County of registration:

State:

I declare under penalty of perjury under the laws of the State of California that the information above is true and

correct.

CH-200, Page 1 of 1

Proof of Personal Service

(Civil Harassment Prevention)

•

PROOF OF PERSONAL SERVICE

Person From Whom Protection Is Sought

Person Seeking Protection

Name:

CH-109, Notice of Court Hearing

CH-110, Temporary Restraining Order

CH-120, Response to Request for Civil Harassment Restraining Orders (blank form)

CH-100, Request for Civil Harassment Restraining Orders

CH-120-INFO, How Can I Respond to a Request for Civil Harassment Restraining Orders?

CH-800, Proof of Firearms Turned In, Sold, or Stored (blank form)

CH-130, Civil Harassment Restraining Order After Hearing

Other

(specify):

Server to sign here

Date:

Type or print server’s name

On (date):

At (time):

At this address:

City:

Judicial Council of California, www.courts.ca.gov

Revised July 1, 2014, Optional Form

Code of Civil Procedure, § 527.6

a.m.

p.m.

700 Civic Center Drive

Santa Ana, CA 92701

Central Justice Center

OCSD (Rev. 6/2019) Page 1 of 1

SERVICE INSTRUCTIONS FOR

TEMPORARY RESTRAINING ORDER

Court Case Number

To better assist our deputies in serving these documents, please provide as much information as possible.

SERVE DOCUMENT(S) ON: (Please Print)

Name

Address

City Zip Code Phone Number

Best time to attempt service:

PERSONAL INFORMATION

Physical description of person:  Male  Female Age DOB Height Weight

Race Unique Characteristics

Nicknames/Aliases

List any known previous arrests:

Are there any weapons on the premises?

Where are they kept?

Is the person known to carry a weapon? If so, what type?

Description of vehicle driven by person to be served (model, color, license #, etc.):

Other information (ex. alcoholic, drug addict, martial arts expert, etc.):

The Sheriff’s Department DOES NOT guarantee service.

The Sheriff’s Department is entitled to its fees whether the service is completed or not. (California Government Code 26738)

X Signature Date

Name of Attorney (Or Party Without Attorney) Requesting Service

Address Email Address

City State Zip Code Phone Number

DO NOT

WRITE ON THE FOLLOWING BLANK FORMS!

THESE BLANK FORMS

MUST

BE SERVED ON THE

OTHER PARTY,

SO THAT THE OTHER PARTY MAY

RESPOND TO THIS ACTION.

ALONG WITH THE BLANK FORMS YOU MUST

ALSO INCLUDE A COPY OF THE FORMS

THAT YOU PREPARED AND FILED

ES NECESARIO

DEJAR LOS SIGUIENTES DOCUMENTOS

EN BLANCO.

ESTOS DOCUMENTOS TIENEN QUE

SER ENTREGADOS A LA OTRA PERSONA,

PARA QUE PUEDA RESPONDER A ESTA ACCION.

INCLUYA CON ESTOS DOCUMENTOS UNA COPIA DE

LOS DOCUMENTOS QUE USTED LLENO Y ARCHIVO.

How Can I Respond to a Request for

Civil Harassment Restraining Orders?

What is a civil harassment restraining

order?

What does the order do?

Not contact the person who asked for the order

Stay away from that person and the person’s home

and workplace

Not have any guns as long as the order is in effect

Who can ask for a civil harassment

restraining order?

Stalked

Harassed

Assaulted, including sexually, or

What if I don't obey the order?

Do I have to serve the other person with a

copy of my response?

Should I go to the court hearing?

Yes. You should go to court on the date listed on Form

CH-109, Notice of Court Hearing. If you do not go to

the hearing, the judge can make orders against you

without hearing from you.

How Can I Respond to a Request for Civil

Harassment Restraining Orders

(Civil Harassment Prevention)

CH-120-INFO, Page 1 of 2

Judicial Council of California, www.courts.ca.gov

Revised July 1, 2014, Optional Form

Code of Civil Procedure, § 527.6

•

What if I don't agree with what the order

says?

You still must obey the order until the hearing. If you

disagree with the orders the person is asking for, fill out

Form CH-120, Response to Request for Civil

Harassment Restraining Orders, before your hearing

date and file it with the court. If you need to include

attachments, you can use Form MC-025. You can get

the forms from legal publishers or on the Internet at

www.courts.ca.gov. You also may be able to find them

at your local courthouse or county law library.

Yes. Have someone age 18 or older—not you—mail a

copy of completed Form CH-120 to the person who

asked for the order (or that person’s lawyer). (This is

called “service by mail.”)

The person who serves the form by mail must fill out

Form CH-250, Proof of Service of Response by Mail.

Have the person who did the mailing sign the original.

Take the completed form back to the court clerk or bring

it with you to the hearing.

Threatened with violence

CH-120-INFO

It is a court order that prohibits you from doing certain

things and going to certain places.

A person who is worried about safety because he or she

has been or is being:

The court can order you to:

The police can arrest you. You can go to jail and pay a

fine.

I've been served with a request for civil

harassment restraining orders. What do I

do now?

Read the papers served on you very carefully. The

Notice of Court Hearing tells you when to appear in

court. There may also be a Temporary Restraining

Order forbidding you from doing certain things. You

must obey the order until the hearing.

Will I see the person who asked for the

order at the court hearing?

Can I bring a witness to the court hearing?

What if I don't speak English?

When you file your papers, ask the clerk if a court

interpreter is available. You may have to pay a fee for

the interpreter. If an interpreter is not available for your

court date, bring someone to interpret for you. You

should ask someone age 18 or older to interpret for you.

Do I need a lawyer?

Having a lawyer is always a good idea, but it is not

required, and you are not entitled to a free court-

appointed attorney. Ask the court clerk about free and

low-cost legal services and self-help centers in your

county.

What if I have a gun?

If a restraining order is issued, you cannot own, possess,

or have a gun, other firearm, or ammunition while the

order is in effect. If you have a gun or other firearm in

your immediate possession or control, you must sell it to

or store it with a licensed gun dealer, or turn it in to a

law enforcement agency.

Can I agree with the protected person to

cancel the order?

Yes. Assume that the person who is asking for the order

will attend the hearing. Do not talk to him or her unless

the judge or that person’s attorney says that you can.

Yes. You can bring witnesses or documents that support

your case to the hearing. But if possible, you should also

bring the witnesses’ written statements of what they saw

or heard. Their statements must be made under penalty

of perjury. You can use Form MC-030 for this.

If the court issued a temporary restraining order before

the hearing, it will last until your hearing date. At that

time, the court will decide to continue or cancel the

order. Any order issued at the hearing can last for up to

five years.

How long does the order last?

For help in your area, contact:

[Local information may be inserted.]

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 court

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.)

No. Once the order is issued, only the judge can change

or cancel it. You or the protected person would have to

file a request with the court to cancel the order.

How Can I Respond to a Request for

Civil Harassment Restraining Orders?

CH-120-INFO

How Can I Respond to a Request for Civil

Harassment Restraining Orders

(Civil Harassment Prevention)

CH-120-INFO, Page 2 of 2

Revised July 1, 2014

Present your response and any opposition at the

hearing. Write your hearing date, time, and place

from form CH-109 item here:

If you were served with a Temporary

Restraining Order, you must obey it until the

hearing. At the hearing, the court may make

orders against you that last for up to five years.



Hearing

Date

Date:

Time:

Dept.: Room:

CH-120

Response to Request for Civil

Harassment Restraining Orders

CH-120, Page 1 of 4

Response to Request for Civil Harassment

Restraining Orders

(Civil Harassment Prevention)

Judicial Council of California, www.courts.ca.gov

Revised January 1, 2018, Mandatory Form

Code of Civil Procedure, §§ 527.6 and 527.9

Use this form to respond to the Request (form CH-100)

Read How Can I Respond to a Request for Civil Harassment

Restraining Orders? (form CH-120-INFO) to protect your rights.

Fill out this form and take it to the court clerk.

Have someone age 18 or older—not you—serve the person in or

his or her lawyer by mail with a copy of this form and any attached

pages. (Use form CH-250, Proof of Service of Response by Mail.)

•

Your Lawyer (if you have one for this case)

Person Seeking Protection

Person From Whom Protection Is Sought

Your Address (If you have a lawyer, give your lawyer’s information.

If you do not have a lawyer and want to keep your home address

private, you may give a different mailing address instead. You do not

have to give telephone, fax, or e-mail.)

I agree that the persons listed in item of form CH-100 may be protected by the order requested.

I do not agree that the persons listed in item of form CH-100 may be protected by the order requested.

Full name of person seeking protection (see form CH-100, item ):

Your Name:

Name: State Bar No.:

Firm Name:

Address:

City:

State:

Zip:

Telephone: Fax:

E-mail Address:

I do not agree to the orders requested.

(Specify why you disagree in item on page 3.)

I agree to the orders requested.

I agree to the following orders (Specify below or in item on page 3.)

I do not agree to the orders requested. (Specify why you disagree in item on page 3.)

I agree to the orders requested.

Stay-Away Orders

I agree to the following orders (specify below or in item on page 3):

Clerk stamps date here when form is filed.

Fill in court name and street address:

Superior Court of California, County of

Orange

Court fills in case number when form is filed.

Case Number:

Additional Protected Persons

Personal Conduct Orders

700 Civic Center Drive

Santa Ana, CA 92701

Central Justice Center

A copy of the receipt

I have turned in my guns and firearms to the police or sold them to or stored them with a licensed gun dealer.

is attached.

has already been filed with the court.

I agree to the orders requested.

I do not agree to the orders requested. (Specify why you disagree in item on page 3.)

I agree to the following orders (specify below or in item on page 3):

Possession and Protection of Animals

I did not do anything described in item of form CH-100. (Skip to .)

Denial

Guns or Other Firearms and Ammunition

If you were served with form CH-110, Temporary Restraining Order, you cannot own or possess any guns,

other firearms, or ammunition. (See item of form CH-110.) You must sell to or store with a licensed gun

dealer, or turn in to a law enforcement agency, any guns or other firearms in your immediate possession or

control within 24 hours of being served with form CH-110. You must file a receipt with the court. You may

use form CH-800, Proof of Firearms Turned In, Sold or Stored, for the receipt.

Case Number:

a. I do not own or control any guns or firearms.

I do not agree to the orders requested. (Specify why you disagree in item on page 3.)

I agree to the orders requested.

I agree to the following orders (specify below or in item on page 3):

Other Orders

Check here if there is not enough space below for your answer. Put your complete answer on an attached

sheet of paper and write “Attachment 6b—Firearms Surrender Exemption” as a title. You may use form

MC-025, Attachment.

I ask for an exemption from the firearms prohibition under Code of Civil Procedure section 527.9(f) because

carrying a firearm is a condition of my employment, and my employer is unable to reassign me to another

position where a firearm is unnecessary. (Explain):

CH-120, Page 2 of 4

Response to Request for Civil Harassment

Restraining Orders

(Civil Harassment Prevention)

Revised January 1, 2018

Case Number:

If I did some or all of the things that the person in has accused me of, my actions were justified or excused for

the following reasons (explain):

Justification or Excuse

Check here if there is not enough space below for your answer. Put your complete answer on an attached sheet

of paper and write “Attachment 10—Justification or Excuse” as a title. You may use form MC-025, Attachment.

Explain your answers to each order requested that you do not agree with.

Reasons I Do Not Agree to the Orders Requested

Check here if there is not enough space below for your answer. Put your complete answer on an attached sheet

of paper and write “Attachment 11—Reasons I Disagree” as a title. You may use form MC-025, Attachment.

CH-120, Page 3 of 4

Response to Request for Civil Harassment

Restraining Orders

(Civil Harassment Prevention)

Revised January 1, 2018

CH-120, Page 4 of 4

Response to Request for Civil Harassment

Restraining Orders

(Civil Harassment Prevention)

Revised January 1, 2018

Case Number:

Date:

Lawyer’s name (if any)

Lawyer’s signature



Sign your name



I declare under penalty of perjury under the laws of the State of California that the information above and on all

attachments is true and correct.

Date:

Type or print your name

Number of pages attached to this form, if any:

I request that I not be required to pay the filing fee because the person in claims in form CH-100

item to be entitled to free filing.

I request that I not be required to pay the filing fee because I am eligible for a fee waiver. (Form FW-001,

Request to Waive Court Fees, must be filed separately.)

The amounts requested are:

I ask the court to order payment of my

Lawyer’s fees

Court costs.

$ $

Check here if there are more items. Put the items and amounts on the attached sheet of paper and write

“Attachment 13—Lawyer’s Fees and Costs” for a title. You may use or form MC-025, Attachment.

Item Amount Item Amount

No Fee for Filing

Lawyer's Fees and Costs

b. I ask the court to deny the request of the person asking for protection that I pay his or her lawyer’s fees

and costs.

CH-250, Page 1 of 1

Proof of Service of Response by Mail

(Civil Harassment Prevention)

CH-250

Proof of Service of Response by

Mail

Judicial Council of California, www.courts.ca.gov

Rev. January 1, 2012, Optional Form

Code of Civil Procedure, § 527.6

The server must:

Be 18 years of age or older.

Mail a copy of all documents

checked in to the person in .

Complete and sign this form and give

it to the person in .

•

Notice to Server

I am 18 years of age or older and not a party to this proceeding. I live or am employed in the county where the

mailing took place. I mailed the person in a copy of all documents checked below:

a. Form CH-120, Response to Request for Civil Harassment Restraining Orders

I declare under penalty of perjury under the laws of the State of California that the information above is true and

correct.

b. Other (specify):

Clerk stamps date here when form is filed.

•

PROOF OF SERVICE BY MAIL

Fill in court name and street address:

Superior Court of California, County of

Orange

Case Number:

Fill in case number:

Server’s Information

Name:

Address:

Zip:

State:City:

Telephone:

(If you are a registered process server):

Registration number:

County of registration:

Date:

Type or print server’s name

Server to sign here

Live or be employed in the county

where the mailing took place.

Name:

Person From Whom Protection Is Sought

Your Name:

Person Seeking Protection

•

I placed copies of the documents checked above in a sealed envelope and mailed them as described below:

Zip:

State:

City:

Mailed to (name):

On (date): Mailed from:

City:

State:

Not be listed in items or of Form

CH-100.

To this address:

•

700 Civic Center Drive

Santa Ana, CA 92701

Central Justice Center

CH-800-INFO, Page 1 of 1

Judicial Council of California, www.courts.ca.gov

Rev. July 1, 2014, Optional Form

How Do I Turn In, Sell, or Store My Firearms?

(Civil Harassment Prevention)

What is a firearm?

• Rifle

• Shotgun

• Assault weapon

• Handgun

A firearm is a:

If you own or have a firearm you must:

• Sell it to a licensed firearms dealer, or

• Store it with a licensed firearms dealer

How do I sell or store my firearm?

Look under “Firearms Dealers” in your local Yellow Pages or on the Internet. Make sure the dealer is licensed.

Find a California licensed firearms dealer in your area.

If I turn my firearm in to law enforcement, how long will they keep it?

Ask the law enforcement agency.

After I give my firearm to law enforcement, can I

change my mind?

Yes. You are allowed to make one sale through a licensed gun

dealer. To do this, a licensed gun dealer must present a bill of

sale to your local law enforcement agency. The law

enforcement agency will give the licensed gun dealer the

firearm you are selling.

Do I have to pay the law enforcement agency to

keep my firearm?

You may have to pay the agency for keeping your firearm.

Contact your local law enforcement agency and ask if a fee is

charged. The agency will tell you how much you need to pay.

Call your local law enforcement agency:

(Insert local information here.)

Questions?

How do I take my firearm to law enforcement?

Call your local law enforcement agency to ask about their procedures. Take a copy of the restraining order with you.

Go directly to the law enforcement agency. Do not go anywhere else with firearms in your vehicle!

CH-800-INFO

How Do I Turn In, Sell, or Store My Firearms?

• Turn it in to local law enforcement

Signature of law enforcement agent

If the court has ordered you to turn in, sell, or store your firearms, you may use this form to prove to the court that

you have obeyed its orders. When you deliver your unloaded weapons, ask the law enforcement officer or the

licensed gun dealer to complete item or and item . After the form is signed, file it with the court clerk.

Keep a copy for yourself. For help, read Form CH-800-INFO, How Do I Turn in, Sell, or Store My Firearms?

To Law Enforcement

Fill out items and of this form. Keep a

copy and give the original to the person who sold

you the firearms or stored them with you.

Fill out items and of this form. Keep a

copy and give the original to the person who

turned in the firearms.

The firearms listed in were

The firearms listed in were turned in on:

To:

I declare under penalty of perjury under the laws

of the State of California that the information

above is true and correct.

I declare under penalty of perjury under the laws

of the State of California that the information

above is true and correct.

CH-800, Page 1 of 2

Proof of Firearms Turned In, Sold, or Stored

(Civil Harassment Prevention)

Judicial Council of California, www.courts.ca.gov

Revised July 1, 2014, Optional Form

Code of Civil Procedure, § 527.9,

Penal Code § 29830

4 5

CH-800

Proof of Firearms Turned In, Sold,

or Stored

4 6

Protected Person

Restrained Person

To the Restrained Person:

Your Lawyer (if you have one for this case):

Your Address (If you have a lawyer, give your lawyer’s information.

If you do not have a lawyer and want to keep your home address

private, you may give a different mailing address instead. You do not

have to give telephone, fax, or e-mail.):

Name and title of law enforcement agent

Name:

Your Name

Name: State Bar No.:

Clerk stamps date here when form is filed.

Fill in court name and street address:

Superior Court of California, County of

Orange

Court fills in case number when form is filed.

Case Number:

Firm Name:

Address:

City: State: Zip:

Telephone:

Fax:

Date: at:

a.m.

p.m.

Date: at:

a.m. p.m.

Name of law enforcement agency

Address

Name of licensed gun dealer

License number

Telephone

E-Mail Address:

To Licensed Gun Dealer

Address

Signature of gun dealer

sold to me transferred to me for storage on:

700 Civic Center Drive

Santa Ana, CA 92701

Central Justice Center

I filed a Proof of Firearms Turned In, Sold, or Stored for those firearms with the court on (date):

I am filing the proof for those firearms along with this proof.

I have not yet filed the proof for the other firearms. (Explain why not):

Revised July 1, 2014

CH-800, Page 2 of 2

Firearms

Do you have, own, possess, or control any other firearms besides the firearms listed in ?

If you answered yes, have you turned in, sold, or stored those other firearms?

If yes, check one of the boxes below:

I declare under penalty of perjury under the laws of the State of California that the information above is true and

correct.

Serial NumberModel

Make

Check here if you turned in, sold, or stored more firearms. Attach a sheet of paper and write “CH-800,

Item 6—Firearms Turned In, Sold, or Stored” for a title. Include make, model, and serial number of each

firearm. You may use Form MC-025, Attachment.

Yes

Check here if there is not enough space below for your answer. Put your complete answer on

the attached sheet of paper or Form MC-025 and write “Attachment 7c” for a title.

Case Number:

Date:

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Proof of Firearms Turned In, Sold, or Stored

(Civil Harassment Prevention)

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SUPERIOR COURT OF CALIFORNIA OF ORANGE COUNTY SELF-HELP (The Superior Court of California - County of Orange)

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Completed 4 January 2021

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