Fill and Sign the Order Domestic Violence Application Form

DV-125 Name of person asking for protection (protected person): ––––– Protected person's address (skip this if you have a lawyer): (If you want your address to be private, give a mailing address instead): ––––– City: ––––– State: ––––– Zip: ––––– Phone # (optional): ( ––––– ) ––––– Protected person's lawyer (if any): ( Name, address, phone #, and State Bar #): ––––– ––––– ––––– ––––– Restrained person's name: ––––– Description of that person: Sex: M F Ht.: ––––– Wt.: ––––– Race: ––––– Hair Color: ––––– Eye Color: ––––– Age: ––––– Date of Birth: ––––– I ask the judge to reissue the Temporary Restraining Order, Form DV-110. a. The last hearing date was (date): ––––– b. The order has been reissued ––––– times. I ask the judge to reissue the order because: a. I could not get the order served before the hearing date. b. The date of the hearing was changed because we were sent to mediators or other family court services. c. Other (specify): ––––– I declare under penalty of perjury under the laws of the State of California that the information above is true and correct. Date: ––––– Sign your name This is a Court Order. Clerk stamps below when form is filed. Court name and street address: Superior Court of California, County of ––––– ––––– ––––– ––––– ––––– Case Number: –––––Reissue Temporary Restraining Order ––––– Type or print your name Clerk will fill out section below. The order listed in Ž is reissued and reset for hearing in this court on the date and time below. Unless a judge extends the time, the order will end on the date and time below. Date: ––––– Dept.: ––––– Time: ––––– ––––– Rm. ––––– All other orders in the Temporary Restraining Order stay in effect unless this order changes them. Date: ––––– Judge (or . Judicial Officer) Judicial Council of California Reissue Temporary Restraining Order Rev. July 1, 2003, Mandatory Form ( Domestic Violence Prevention) Code of Civil Procedure, § 527(b). Approved by DOJ DV-125, Page 1 of 1el ectr onic form ã 2003 WWW.LawCA.co m L a w P u b l i s h e r s1 2 543