Fill and Sign the If the Protected Person in a Restraining Order Dies is the Order Form

MF H t.: C ity : T ele p hone n um ber: H air C olo r: E ye C olo r: D ate o f B ir th : D ate : T im e: D ep t.: D V-1 10Temporary Restraining Order and Notice of HearingClerk stamps below when form is filed.Nam e o f p ers o n a sk in g f o r p ro te ctio n ( p ro te cte d p ers o n)P ro te cte d p ers o n's a d dre ss (s k ip t h is i f y o u h ave a l a w yer): ( If y o u w ant yo ur a ddre ss t o b e p riv a te , g iv e a m aili n g a ddre ss i n ste a d):S ta te :Z ip :P ro te cte d p ers o n’s l a w yer ( if a n y): ( N am e, a d dre ss, t e le p hon e n um ber, an d S ta te B ar n u m ber):C ourt n am e a nd s tr e e t a ddre ss:S uperio r C ourt o f C alif o rn ia , C ounty o fR estr a in ed p ers o n's n am e:D esc rip tio n o f t h at p ers o n: S ex :C ase N um ber:W t.:R ace:A ge:L is t t h e f u ll n am es o f a ll f a m ily o r h ouse h old m em bers p ro te cte d b y t h is o rd er:C ou rt H ea rin g D ate ( F ech a d e l a A udie n cia ) Court w ill f ill i n b ox b elo w .Name and address of court if different from above:R m .At t h e h earin g, t h e j u dge c an m ak e r e str a in in g o rd ers t h at l a st f o r u p t o 3 y ears . T he j u dgeT o t h e p ers o n i n ca n a ls o m ak e o th er o rd ers a b out c h ild re n , c h ild s u pport, m oney , a n d p ro perty . A t t h e h earin g, y ou c an t e ll t h e judge i f y ou d o n ot w an t t h e o rd ers a g ain st y ou. E ven i f y ou d o n ot a tte n d t h e h earin g, y ou m ust o bey t h e o rd ers . Pa ra la p ers o na n om bra da e n e sta a udie ncia e 1ju ez p uede h ace r q u e la o rd en d e r e str ic ci6 n s e a v 6 lid a h asta u n m6 xim o d e 3 a iio s. E lju ez p it e de t a m bi6 n h ace r o tr a s 6 rd enes a ce rc a d e n fflo s, m anute nci6 n, d in ero y p ro pie dad. S i U ste d se o pone a e sta s 6 rd enes, v a ya a la a udie ncia y d ig ase lo a 1ju ez. A unque n o v a ya a la a udie ncia , t ie ne q ue o bedece r e sta s 6rd e nes.T em pora ry O rd ers ( O rd en es T em pora le s)A ny o rd ers m ad e i n t h is f o rm e n d o n t h e d ate a n d t im e o f t h e c o urt h earin g i n Re ad t h is f o rm c are fu lly . A ll c h eck ed b oxes a n d i te m 1 0 a re c o urt o rd ers .u nle ss a j u dge e x te n ds t h em .Todas la s o rd enes h ech as e n e sta f o rm ula rio t e rm in ar6 n e n la f e ch a y h ora d e la a udie ncia e nT his is a C ourt O rd er.J u dic ia l C ouncil o f C alif o rn ia , Revis e d J u ly 1 , 2 007 a nda to ry F orm Fa m ily C ode, § § 6 200 e t s e q. A ppro ve d b y D 0JT em pora ry R estr a in in g O rd er ( C LE TS ) (Dom estic V io le nce P re ve ntio n)DV-110, Page 1 of 5Hearing Dateele ctr o nic f o rm  2004.7 WWW.LawCA.com La w P ublis h ers a l m enos q ue u n ju ez la s extie nda. L ea e ste f o rm ula rio c o n c u id ado. T odas la s c a silla s m arc a d as artic u lo 1 0 s o n o rd enes d e la c o tte . 14523 c. T ak e a n y a ctio n, d ir e ctly o r t h ro ugh o th ers , t o g et t h e a d dre sse s o r l o catio ns o f a n y p ro te cte d p ers o ns o r o f t h eir f a m ily m em bers , ca re ta k ers , o r g uard ia n s. ( If i te m c i s n ot c h eck ed , t h e c o urt h as f o und g ood c au se n ot t o m ak e t h is o rd er.) Pe acefu l w ritte n c o nta ct t h ro ugh a l a w yer o r a p ro cess s e rv er o r a n oth er p ers o n t o s e rv e l e g al p ap ers i s a llo w ed a n d d oes n ot vi o la te t h is o rd er. A c rim in al p ro te ctiv e o rd er o n F orm C R-1 60 i s i n e ffe ct. C ase N um ber: C ounty ( if k now n): Ex pir a tio n D ate : ( If m ore o rd ers , l is t t h em i n i te m 1 6 .) P ro te cte d p ers o n's n am e: P erso n al C on duct O rd ersH ara ss, a tta ck , s tr ik e, t h re ate n , a ssa u lt ( s e x ually o r o th erw is e ), h it, f o llo w , s ta lk , m ole st, d estr o yC onta ct ( e ith er d ir e ctly o r i n dir e ctly ), o r t e le p hone, o r s e n d m essa g es o r m ail o r e -m ailM ov e-O ut O rd er im med ia te ly f ro m ( a ddre ss): C hild C usto d y a n d V is it a tio n O rd erY ou a n d t h e o th er p are n t m ust m ak e a n a p poin tm en t f o r c o urt m ed ia tio n ( a ddre ss a nd p hone # ): Follo w t h e o rd ers l is te d i n F orm D V- 1 40, w hic h i s a tta ch ed . T urn I n o r S ell G uns o r F ir ea rm s Pro p erty C on tr o l S ta y-A way O rd er T he p ers o n l is te d i n O th er ( s p ecify ):T he c h ild re n 's s c h ool o r c h ild c are T he p ers o n i n m ust s ta y a t l e ast E xce p t f o r b rie f a n d p eacefu l c o n ta ct a s r e q uir e d f o r c o urt- o rd ere d v is ita tio n o f c h ild re n u nle ss aH om e Job Veh ic le o f p ers o n i n The people listed in Case N um ber:T he p ers o n i n m ust n ot d o t h e f o llo w in g t h in gs t o t h e p ro te cte d p eo ple l is te d i n a n d a .pers o nal p ro perty , d is tu rb t h e p eace, k eep u nder s u rv eilla n ce, o r b lo ck m ovem en tsb .crim in al p ro te ctiv e o rd er s a y s o th erw is ey ard s a w ay f ro m :a.d .b.e.c .T he p ers o n i n m ust t a k e o nly p ers o nal c lo th in g a n d b elo ngin gs n eed ed u ntil t h e h earin g a n d m ove o uta.b .N o G uns o r O th er F ir ea rm s The p ers o n i n c an not o w n, p osse ss, h av e, b uy o r t r y t o b uy, r e ceiv e o r t r y t o r e ceiv e, o r i n a n y o th er w ay get a g un o r f ir e a rm .The p ers o n i n • M ust s e ll t o a l ic en se d g un d eale r o r t u rn i n t o p olic e a n y g u ns o r f ir e arm s t h at l ie o r s h e h as o r c o ntr o ls .T his m ust b e d one w ith in 4 8 h ours o f r e ceiv in g t h is o rd er. B ut i f t h e p ers o n i n w as a t a h earin g o n t h is or d er, i t m ust b e d one w ith in 2 4 h ours o f t h e h earin g.• M ust b rin g a r e ceip t t o t h e c o urt w ith in 7 2 h ours o f r e ceiv in g t h is o rd er, t o p ro ve t h at g uns h av e b een tu rn ed i n o r s o ld .U ntil t h e h earin g, o nly t h e p ers o n i n c an u se , c o ntr o l, a n d p osse ss t h e f o llo w in g p ro perty a n d t h in gs:T his is a C ourt O rd er.Revis e d J u ly 1 , 2 007T em pora ry R estr a in in g O rd er ( C LE TS ) (Dom estic V io le n ce P re ven tio n)D V-1 10, P age 2 o f 51211109867 Pro te cte d p ers o n's n am e: Property RestraintUnlawful Communications may be recordedO th er O rd er s ( s p ecify ): Time for Service D ate : C ase N um ber:If t h e p eo ple i n a n d a re m arrie d t o e ach o th er, t h ey m ust n ot t r a n sfe r, b orro w a g ain st, s e ll, h id e, o r g etrid o f o r d estr o y a n y p ro perty , e x cep t i n t h e u su al c o urs e o f b usin ess o r f o r n ecessitie s o f l if e . I n a d ditio n,each p ers o n m ust n otif y t h e o th er o f a n y n ew o r b ig e x pen se s a n d e x pla in t h em t o t h e c o urt.T he p ers o n i n c an r e co rd c o m m unic atio ns m ad e b y t h e p ers o n i n t h at v io la te t h e j u dge's o rd ers .No Fee to Notify Restrained Person If t h e s h erif f o r m ars h al s e rv es t h is o rd er, h e o r s h e w ill d o i t f o r f re e -I f t h e j u dge m ak es a r e str a in in g o rd er a t t h e h earin g, w hic h h as t h e s a m e o rd ers a s i n t h is f o rm , t h e p ers o n i ll will g et a c o py o f t h at o rd er b y m ail a t h is o r h er l a st k now n a d dre ss. ( W rite r e str a in ed p erso n's a ddre ss h ere ):I f t h is a d dre ss i s n ot c o rre ct, o r t o k now i f t h e o rd ers w ere m ad e p erm an en t, c o nta ct t h e c o urt.T o: P ers o n A sk in g f o r O rd erT o: P ers o n S erv ed W ith O rd erS om eo ne 1 8 o r o ver - n ot y ou o r t h e o th er pro te cte d p eo p le - m ust p ers o nally ''s e rv e'' a c o py of t h is o rd er t o t h e r e str a in ed p ers o n a t l e astIf y o u w an t t o r e sp ond i n w ritin g, s o m eo ne 1 8 o r over - n ot y ou - m ust ''s e rv e'' F orm D V- 1 20 o n t h e pers o n i nd ay s b efo re t h e h earin g. th en f ile i t w ith t h e c o urt a t l e ast da y s b efo re t h e h earin g. F or h elp w ith S erv ic e o r A nsw erin g, r e a d F orm D V-2 10 o r D V-5 40.Ju dge ( o r J u dic ia l O ffic er) Certif icate of Com pliance With VAWA This temporary protective order meets all F ull Faith and Cr edit requirements of th e V io le n ce A gai nst W om en Act, 1 8 U. S.C. § 2265 (1 994) (VAWA) upo n no tice o f the restrai ned perso n. T his court has j urisdictio n ov er the partie s a nd th e s ubjec t m atte r; t he r estr a in ed p ers o n h as bee n or w ill b e a ffo rd ed notic e a nd a tim ely oppo rtu nity to be h eard as prov ided b y the laws of this juri sdiction. This ord er is valid and ent itled t o enfo rce m en t i n a ll j uri sd ic tio n s t hro u gh ou t t he 50 U nit e d S ta tes, the Di strict of Colu mbia, al l tribal lan ds, a nd a ll U .S . t errit o ries , co m mon w ea lt h s, a nd p osse ssio n s a nd s hall b e e nfo rc e d a s i f i t w er e a n ord er o f t hat ju ris d ic tio n . T his is a C ourt O rd er.Revis e d J u ly 1 , 2 007T em pora ry R estr a in in g O rd er ( C LE TS ) (Dom estic V io le n ce P re ven tio n)D V-1 10, P age 3 o f 5AB181716151413 C ase N um ber:P ro te cte d p ers o n's n am e -Warnings and Notices to the Restrained Person in 2If y ou d o n ot o b ey t h is o rd er, y ou c a n b e a rreste d a n d c h arg ed w it h a c rim e. • I t i s a f e lo ny t o t a k e o r h id e a c h ild i n v io la tio n o f t h is o rd er. Y ou c an g o t o p rii s o n a n d/o r p ay a f in e.• I f y ou t r a v el t o a n oth er s ta te o r t o t r ib al l a n ds, o r m ak e t h e p ro te cte d p ers o n d o s o , w ith t h e i n te n tio n o f dis o bey in g t h is o rd er, y ou c a n b e c h arg ed w ith a f e d era l c rim e.• I f y ou d o n ot o bey t h is o rd er, y ou c an g o t o p rii s o n a n d/o r p ay a f in e.You Cannot Have Guns or FirearmsYou c an not o w n, h av e, p osse ss, b uy o r t r y t o b uy, r e ceiv e o r t r y t o r e ceiv e, o r oth erw is e g et a g un w hile t h e o rd er i s i n e ffe ct. I f y ou d o , y ou c an g o t o j a il an d p ay a $ 1,0 0 0 f in e. I f i te m o n t h is f o rm i s c h eck ed , y ou m ust s e ll t o a gu n d eale r o r t u rn i n t o p olic e a n y g uns o r f ir e arm s t h at y ou h av e o r c o ntr o l. Th e j u dg e w ill a sk y ou f o r p ro of t h at y ou d id s o . I f y ou d o n ot o bey t h is o rd er, yo u c an b e c h arg ed w ith a c rim e. F ed era l l a w s a y s y ou c an not h av e g uns o r am munitio n i f y ou a re s u bje ct t o a r e str a in in g o rd er m ad e a fte r a n otic ed hearin g.A fte r Y ou H ave B een S erv ed W it h a R estr a in in g O rd er• O bey a ll t h e o rd ers .• F ile D V-1 20 a n d h av e a ll p ap ers s e rv ed o n t h e p ro te cte d p ers o n b y t h e d ate l is te d i n I te m• I f y ou w an t t o r e sp ond, f ill o ut F orm D V-1 20. T ak e i tto t h e c o urt c le rk w ith t h e f o rm s l is te d i n I te in of t h is f o rm .• A t t h e h earin g, t e ll t h e j u dge i f y ou a g re e t o o r d is a g re e w it h t h e o rd ers r e q ueste d .• E ven i f y ou d o n ot a tte n d t h e h earin g, t h e j u dge c an m ak e t h e r e str a in in g o rd ers l a st f o r 3 y ears .C hild C usto d y, V is it a tio n , a n d S upport• C hild C usto dy a n d V is ita tio n: I f y ou d o n ot g o t o t h e h earin g, t h e j u dge c an m ak e c u sto dy a n d v is ita tio n ord ers f o r y our c h ild re n w it h out h earin g y our s id e.• S po usal S up port: Fil e a nd s erv e a Fina nci al Sta te m ent (F L -1 55) or a n I nco me a nd Expe nse D ec lar ation (F L -1 50) s o t he j udge wi ll h av e i nfo rm atio n a bout y ou r f in an ces. Oth erw is e , the court m ay m ak e su pport or d ers w itho ut h ea ring yo ur side . Req uests f o r A cco m m od atio n s Assis tiv e l is te n in g s y ste m s, c o m pute r-a ssis te d r e al- tim e c ap tio nin g, o r s ig n l a n guag e i n te rp re te r s e rv ic es a re av aila b le i f y ou a sk a t l e ast f iv e d ay s b efo re t h e p ro ceed in g. C onta ct t h e c le rk 's o ffic e o r g o t o ww w.c o urtin fo .c a.g ov/f o rm s f o r R eq uest f o r A cco m modatio ns b y P ers o ns W ith D is a b ilitie s a n d O rd er ( F orm M C- 410). ( C iv il C ode, § 5 4.8 .)• C hild S upport: T he j u dge c a n o rd er c h ild s u pport b ase d o n t h e i n co m e o f b oth p are n ts . T he j u dge c an a ls oh av e t h at s u pport t a k en d ir e ctly f ro m y our p ay ch eck . C hild s u pport c an b e a l o t o f m oney , a n d u su ally y ou hav e t o p ay u nti l t h e c h ild i s 1 8. F ile a n d s e rv e a F in an cia l S ta te m en t ( F L - 1 55) o r a n I n co m e a n d E xpen se De cla ra tio n ( F L -1 50) s o t h e j u dge w ill h av e i n fo rm atio n a b o ut y our f in an ces. O th erw is e , t h e c o urt m ay m ak e support o rd ers w ith out h earin g y our s id e.T his is a C ourt O rd er.Revis e d J u ly 1 , 2 007T em pora ry R estr a in in g O rd er ( C LE TS ) (Dom estic V io le n ce P re ven tio n)D V-1 10, P age 4 o f 52322212019 D ate : C ase N um ber:P ro te cte d p ers o n's n am e-In str u ctio ns f o r L aw E nfo rc em en tSta rt D ate a n d E nd D ate o f O rd ers Th e s ta rt d ate i s t h e d ate n ex t t o t h e j u dge's s ig natu re o n p ag e 3 . T he o rd ers e n d o n t h e h earin g d ate o n p ag e I o r the h earin g d ate o n F orm D V-1 25, i f a tta ch ed .A rrest R eq uir ed I f O rd er I s V io la te d If a n o ffic er h as p ro bab le c au se t o b elie v e t h at t h e r e str a in ed p ers o n h ad n otic e o f t h e o rd er a n d h as d is o bey ed t h e ord er, t h e o ffic e r m ust a rre st t h e r e str a in ed p ers o n. ( P en . C ode, § § 8 36 ( c ) ( 1 ), 1 3701 ( b ).) A v io la tio n o f t h e o rd er may b e a v io la ti o n o f P en al C ode s e ctio n 1 66 o r 2 73.6 .N otic e/P ro of o f S erv ic e• L aw e n fo rc em en t m ust f ir s t d ete rm in e i f t h e r e str a in ed p ers o n h ad n otic e o f t h e o rd ers . I f n otic e c an not b everif ie d , t h e r e str a in ed p ers o n m ust b e a d vis e d o f t h e t e rm s o f t h e o rd ers . I f t h e r e str a in ed p ers o n t h en f a lls t o ob ey t h e o rd ers , t h e o ffic er m ust e n fo rc e t h em . ( F ain . C ode, § 6 383.)C onsid er t h e r e str a in ed p ers o n ''s e rv ed '' ( n otic ed ) i f• T he o ffic er s e es a c o py o f t h e P ro of o f S erv ic e, o r c o nfir m s t h at t h e P ro of o f S erv ic e i s o n f ile o r• T he r e str a in ed p ers o n w as a t t h e r e str a in in g o rd er h earin g, o r w as i n fo rm ed o f t h e o rd er b y a n o ffic er (F ain . C ode, § 6 383, P en . C ode, § 8 36 ( c ) ( 2 ).) An officer can obt ain i nfo rmation about th e co nten ts of the ord er in t he D om es tic V io len ce R estr a in in g O rd er s S ys te m (DV RO S). ( Fa m. C ode, § 638 1(b )(c ).)I f t h e P ro te cte d P erso n C on ta cts t h e R estr a in ed P erso n Even i f t h e p ro te cte d p ers o n i n vite s o r c o nse n ts t o c o nta ct w ith t h e r e str a in ed p ers o n, t h e o rd ers r e m ain i n e ffe ct an d m ust b e e n fo rc ed . T he p ro te cte d p ers o n c an not b e a rre ste d f o r i n vitin g o r c o nse n tin g t o c o nta ct w ith t h e restr a in ed p ers o n. T he o rd ers c a n b e c h an ged o nly b y a n oth er c o urt o rd er. ( P en . C ode, § 1 3 7 1 0 (b ).) C hild C usto d y a n d V is it a tio n • C usto dy a n d v is ita tio n o rd ers a re o n F orm D V-1 40, I te m s a n d T hey a re s o m etim es a ls o w ritt e n o nad ditio nal p ag es o r r e fe re n ced i n D V-1 40 o r o th er o rd ers t h at a re n ot p art o f t h e r e str a in in g o rd er.• F orm s D V-1 0 0 a n d D V-1 0 5 a re n ot o rd ers. D o n ot e n fo rce t h em .Enfo rcin g t h e R estr a in in g O rd er i n C alif o rn ia An y l a w e n fo rc em en t o ffic er i n C alif o rn ia w ho r e ceiv es, s e es, o r v erif ie s t h e o rd ers o n a p ap er c o py, o r o n t h e Calif o rn ia L aw E nfo rc em en t T ele co m munic atio ns S yste m ( C LETS), o r i n a n N CIC P ro te ctio n O rd er F ile m ust en fo rc e t h e o rd ers .C on flic tin g O rd ers If a c rim in al r e str a in in g o rd er ( C R- 1 60) c o nflic ts w ith a c iv il r e str a in in g o rd er ( D V- 1 10 o r D V-1 3 0 ), e n fo rc e t h e crim in al o rd er. E ven i f t h e c rim in al o rd er i s o ld er, t h e o ffic er m ust s till e n fo rc e i t o ver t h e c iv il o rd er. ( P en . C ode, § 1 36.2 ( h ).) A ny n onco nflic tin g t e rm s o f t h e c iv il r e str a in in g o rd er r e m ain i n f u ll f o rc e.C le rk 's C ertific a teI c ertif y t h at t h is T em pora ry R estr a in in g O rd er i s a t r u e a n d c o rre ct c o py o f[se a l]t h e o rig in al o n f ile i n t h e c o urt.C le rk , b yI D ep utyT his is a C ourt O rd er.Revis e d J u ly 1 , 2 007T em pora ry R estr a in in g O rd er ( C LE TS ) (Dom estic V io le n ce P re ven tio n)D V-1 10, P age 5 o f 530292827262524e le ctr o nic f o rm  2004.5 WWW.LawCA.com La w P ublis h ers