A T TORNE Y OR P A RTY W I THOUT ATT O RN E Y ( N am e , S ta t e B a r n um b er , a n d
a d d r ess):
T E L E PH O NE N O.
( O p t io n a l ): FA X NO.
( O p t i o n a l):
E-M A IL ADDR E S S
(O pt io n al ):
A T T O RN E Y FO R
(N a me ) :
SUPERIOR COURT OF CALI F ORNIA, COUNTY
OF
S TRE E T
ADDR E S S :
MAILING
A DDR E S S :
CITY AND ZIP
CODE:
BR A NCH
NAM E :
CASE
NAME:
REST R AINING ORDER—JUVENILE
(CLETS)
T e mp o rary O r de r O r der After Hearin g
FAMI LY :
THIS TE M PORARY ORD E R WILL EXPIR E A T M I DNIGHT O N (must be within 15 day s o f t he temporar y ord e r or , u p on a
fin d ing of g oo d cause, withi n 2 0 d a ys; sp e c i f y date):
THIS ORDER AFTE R HEARING WIL L EXPIRE AT MIDNIGHT O N (n o t m o r e than thre e y e ars from dat e o f heari n g;
specify d a te):
Ex parte
o r der
Perso n to b e restraine d receive d n o tice.
Perso n to b e restraine d d i d n o t receiv e notice.
If , at th e h e aring , t he j udge make s a restra i ning order that has th e same order s as in t h i s form, th e p e rso n
to be restra i ned will receive a c o p y of th a t orde r b y mail a t h i s or he r l ast known address . (Write r e s t rained
person ' s a ddress h e r e ):
Date o f h e aring:
Jud i c i al office r
( n am e ) : T i m
e: Dept
.: Roo
m:
Persons and attorn e y s presen t (na m es):
Pers on to be restrai n ed present . No furth e r servic e
n eede d .
Person t o b e restr a ined not present.
The ju d ge ' s orders in th i s form ar e the sam e as in th e prior temporary restraini n g o r d er excep t fo r th e
e n d date. The restra i ned person can b e s e rve d by m a il.
T he jud g e's order s are differen t fr om t h os e in the prior t e mp o r a r y restr a i n ing order. S o me o ne—not th e
person o r persons to be protect e d—mus t p e rso n ally serv e a copy of t h i s o r d e r on the r e strain ed p ers o n.
THE COUR T FINDS AND
ORDERS
Thi s orde r is b a s e d o n th e f o llow i n g fin d ings of fact b y the
court: Note : If thi s address is no t c o rrect or to d etermin e wh e the r t he o r d ers were m a de perm a nent , contact t he c l erk o f this
court. C A S E
NUMB E RS:
JUV E NI L E:
1
. –––––
–––––
–––––
–––––
–––––
–––––
–––––
–––––
–––––
–––––
–––––
–––––
–––––
–––––
–––––
– – –––––
–
–––––
– –––––
–––––
–
–
–
–
–––––
–––––
–––––
––––– ––––– ––––– –––––
–––––
–––––
–
–
–
–
–––––
–––––
–––––
–––––
–––––
–––––
–––––
––––– FOR COUR T US E
ONLY JV-
2 5 0
a
.
(
1
)
(
2
)
(
3
)
b
.
c
. d
.
e
.
f
. (
1
)
(
2
)
2
.
For m A d o p t e d f o r M a n d a t o r y
Use J u dici a l Co u ncil of
Cal i f o rn i a JV- 2 5 0 [R e v. Ju l y
1 , 2006] REST R AINING ORDER—JUVENILE (CLETS—
JUV) P a g e 1 of
4
W e l f ar e a n d In s t i t u t i o n s Co d e ,
§ § 2 1 3 . 5 , 3 0 4 , 3 6 2 . 4 ,
7 26 .5 ; Fa m il y C o d e, § § 6 2 1 8 ,
6 38 9 ; P e n all
Co d e12 0 2 1 ( g) elec troni c form ã
2006
WWW.LawCA.co
m
L a w
P u b l i s h e r s
CASE NAME :
C A S E
NU M B E RS:
JUV E NIL E :F A M I L
Y :
PERSON S TO BE PROTECTE D (insert full name s o f AL L person s to be
prot e c ted):
PERSON TO B E RESTRAINE D (full
name):
F
H t .: Wt
.: Hair
c o lor: Eye
color: Rac
e: Ag
e: Date o f
birth:
RESTRAINED PERSON
a . must no t harass, attack , str i k e , t h r e at e n, as s aul t (sexu a lly or otherwise), h i t, foll o w, sta l k, m o lest ,
d estroy personal p r o perty of, distur b the pea c e of, keep un d e r surveil l ance , or bloc k movement s o f each person
named in item 3.
b . must no t c o nt a c t ( e it h er d i r e ctl y or i n direct l y ), or telep h one, o r sen d m e ss a ges or mai l or e-mai l to e ach
p ers o n n am e d i n i te m 3
exce p t for brie f a nd peaceful contact a s re q uired for court-ord e r ed visitation o f ch i ldren, as provid e d i n i te m
5e,
u n less a crimina l protect i v e ord er says otherwise.
(2 ) exce p t for peaceful writte n contac t throug h a proces s serve r or a n ot h er perso n to serv e leg a l
p apers re l at e d to a cou r t c a s e.
must mov e imm e diately fro m (ad d r e ss ) :
a nd take on l y person al cl o th i ng and
effects.
m u s t s t a y a wa y at l eas t (specify):
a r e o p ti o na l an d may b e kep t c o nf i dential):
(1 ) Protecte d perso n s named in ite m
3 yards from th e foll o wing persons and place s (th e a d dress es of thes e
pl a c e s
Protecte d perso n ’s resid e nc e (addres s
optional):
(3 ) Protecte d perso n ’s p l ace of wor k (ad d r e ss option a l):
(4 ) T he c h ildren ’ s school or place o f chi ld car e (address
optiona l ):
Protecte d perso n ’s veh i c le (d e s criptio n
o p ti o nal):
O t her (specify):
e. h as the right to vi s i t t he m i n or chil d re n n a me d i n item 3 a s
f o llows:
(1 ) N o ne
V i s i tatio n accordi n g t o th e attache d sc h edul e (for m JV-2 0 5 must b e attache d i f an y visitat i on is
ordere d )
f. mus t N OT remove the minor childr en
named i n i tem 3 from the st a te o f C a liforni a o th er
(specify):
w i th o ut order o f the c ourt o r o th e r cond i ti on
(specify):Sex :
M ––––– –––––
–––––
–––––
–––––
–––––
–––––
–––––
–––––
– – ––––– ––––– ––––– ––––– ––––– ––––– –––––
–
–
–
–
–
–––––
–––––
–––––
– –––––
–
– –––––
– –––––
– –––––
– –––––
– –––––
–––––
–––––
–––––
–––––
–
–
–
–
– – –––––
–––––
– –––––
–––––
–––––
–––––
–––––3
.
4
.
5
.
(
1
)
c
.
d
.
(
2
)
(
5
)
(
6
)
(
2
)
J V - 2 50 [R ev. Ju ly 1,
2006] RESTRAIN I NG O R DER—JUVENILE ( C LETS—
JUV) P a g e 2 of
4el ectr onic form ã
2006
WWW.LawCA.co
m
L a w
P u b l i s h e r sg. must NOT take any action to get the address or location of any person named in item 3 or the addresses or locations of the
family members, caregivers, or guardians of any persons named in item 3.
CASE NA M E:
CA S E
NUM B ER S :
JU V EN I L E :
6 . T he child is a w a r d of th e cour t o r t h e su b jec t of a petitio n un d er W e lf a r e a n d Instit u ti o ns Co d e sectio n 60 1
o r 60 2 and must n ot contact, t h reaten, stalk, o r distur b the peace o f (l i s t names):
T he juven i le
c o urt h a s h as
n o t terminated jurisdictio n ove r th e mino r childre n n a me d i n item
3 .
Ot her o r der s
(specify):––––– –––––
–––––
–
–––––
–––––
–––––
–––––
– –
–––––
–––––
–––––
–––––
Date: –––––FIREARM RESTRICTION
W it h in 24 hour s a fte r rece i v i ng th i s order , the restrai n ed person i s ord e r ed to give up an y firear m in o r subj e c t to his o r h er
i m medi a te possessio n or contro l .
A ny firearm s shoul d b e surrend e r e d t o t h e co n tro l o f l o c al l a w e nf o rceme n t o r to a l icensed gun de a ler . W it h i n 7 2 h o u r s o f
receivin g thi s or d er, t h e r estraine d p ers on mus t pr o v ide the co u r t wit h a rec e i p t o r with form DV-800/JV-25 2 (P r oof of
Firearm s Turne d In o r Sold) s h o w i ng com p l i an c e w it h th is or d er.
Any firearms should be surrendered to the control of local law enforcement or to a licensed gun dealer. Within 72 hours of
receiving this order, the restrained person must provide the court with a receipt or with form DV-800/JV-252 (Proof of
Firearms Turned In or Sold) showing compliance with this order.
A criminal protective order on form CR-160 is in effect: case number (specify): –––––
(expiration date): ––––– in (specify county, if known): –––––
Conflicting Orders If a criminal restraining order (form CR-160) conflicts with a juvenile restraining order (form JV-250), a law
enforcement agency must enforce the criminal order. Even if the criminal order is older, the officer must still enforce it over the
juvenile order. (Penal Code, § 136.2(h).) Any nonconflicting terms of the juvenile custody or visitation order remain in full force. An
emergency protective order (form EPO-001) that is in effect between the same parties and that is more restrictive than other
restraining orders takes precedence over all other restraining orders. (Pen. Code, § 136.2.)
TO THE PERSO N RESTRAINE D U NDE R A TEMPORARY ORDER
A court he a r i ng ha s b een set a t the t i me an d p l ac e i ndicated bel o w. You may atten d t h is hearin g , wit h o r without an attorney ,
t o p r o v i de an y l egal reason tha t th e orders a b ove sh o ul d not b e e x ten d ed . I f yo u d o not a p pear at t h is h e a r ing , the court ma y
ext e nd or mod i fy th e ord e rs for up t o thre e year s witho u t further notic e to you.
Date: ––––– Time: ––––– Dept: ––––– Room: ––––– FAMIL
Y :
7
.
8
.
1
0
. 9
.
JUDICIA L
OFFICER
JV- 2 5 0 [ R e v . July 1 ,
2006] RESTRAINING ORDER—JUVENILE (CLETS—
JUV) P a g e 3 of
4el ectr onic form ã
2006
WWW.LawCA.co
m
L a w
P u b l i s h e r s
CAS E NAM E :
C A S E
NU M B E RS:
JUV E NIL E :
T h is o r d e r is ef f e ctiv e w h e n m a d e . It i s e n fo r ce a bl e in a l l 5 0 sta t es , th e Dist r i c t o f Col u m b ia, a ll tri b al l a n d s, a n d all
U.S. t e rrit o r i e s a n d sh a ll b e e n force d as if i t w e re a n or d e r of th a t j u risdictio n by a n y law e n f o rc e m e n t a ge n cy t ha t
h a s r e cei v e d th e o r d e r, i s sh o wn a c o py o f t h e o r d e r , o r h a s v e rifie d its e xist e nc e o n t h e C a lifo r ni a L a w Enf o rc e m e n t
T e le c o mm u n ic a tio n s Syst e m ( CLETS). I f p r o o f o f se r vic e o n th e r e str a in e d p e r so n h a s n o t b e e n r e c e ive d a n d t he
restr a i n e d p e rs o n was n o t p r e se n t a t t h e c o urt h e arin g , t h e l a w e n force m e n t a g e n cy s h all a d vise t h e restrai n ed
p e rs on of t he te r m s o f t h e o r d e r a n d t h e n sh a ll e n fo r c e it.
Viol a t i o n s : An y p e r s on s u b je c t to a r e s t r a i n i n g o r d e r is p r o h ibite d fr o m o w ni n g, p u rc h a s in g o r a t te m pti n g
to purchase , receiving or attempting t o receive , or otherwise obtaining a fir e arm. Such conduct is subject
to a
$1,00 0 fine and imprisonment . Under federal l a w , the issuance o f a restraining orde r after hearin g will
g e n e r a ll y p r ohi b it th e r e s trai n e d p e r s o n fro m ow nin g , a c c e p ti n g, tra n s p o r tin g , or p o s s e s s ing fir e ar m s
or a mmu n itio n . A v iol a t io n of t h i s p r oh i bition is a separ a te federal crime.
Viol a t i o n of t h is r es t r a ini n g o r d e r ma y b e pu n is h e d a s a c o nte m p t o f c o u r t , a mis d em ea no r pu n is h a b l e by
one year in ja i l or a $1,00 0 fine, o r both, or a felony. Takin g o r concealing a child in v i olatio n of t h i s o r d e r
is subje c t t o s t a t e and f e d e r a l c r iminal p e n a l tie s .
Cert i ficate of Complianc e W i th VAWA for Temporary Orders
T h is t e m p o r a r y p r ot e ctiv e o r d e r mee t s all F u l l F a ith a n d Cr e d it r e q u ir e m e n t s o f th e Viol e n c e Ag a i n st W o m e n Ac t ,
1 8 U.S.C . § 2 2 6 5 ( 1 9 9 4 ) (VAWA ) u p o n n o tice o f t h e r e s t rained person. Thi s cour t ha s j u ri s d iction over the par t ies
an d the subject m a tter ; th e restrained person has bee n or will be afforded notice a n d a ti m e ly opportunity t o be
h e a r d a s p ro v ide d b y th e la w s o f this j u ris d ictio n. T h i s o r d e r is v a lid a nd e ntitled to enforcement in a l l
jur i sdic t ion s th r oughout t h e 5 0 Un i t ed States, the District of Columbi a , al l tribal lands , an d all U.S.
ter r it o r ie s , c o mmo n w ea l th s , a n d p o s s e s si o n s a n d s h all b e e n f o r c e d a s if it w e r e a n or d e r o f t h at
jur i sdiction.
Certificate of Co m pliance Wit h V A W A f o r O r d e r s Af t e r
H e a r ing
T h is p r o tec t i v e o r d e r me e ts a ll F u ll F a it h a n d C r e d it r e q u ireme n ts o f t h e Vi o len c e A g ain s t Wome n Act, 1 8 U .S.C. §
2 2 6 5 ( 1 9 9 4 ) (VAWA). T h i s co u rt h a s juris d ictio n ov e r t h e p a rties a n d t h e su b je c t matter; th e re st rained person has
b e e n a f fo r d e d r ea s on a bl e n o tic e a n d a n o p p o r tu n ity t o b e h e a r d a s p r ovi d e d b y th e law s of t h is j u ris d ictio n. T h is
o r d e r i s v a lid an d enti t led to enfo r c e m e n t in al l juri s d i c t i ons t h r o ug h o u t the 50 Uni t ed St a te s , t h e Dis tr ic t
of Columbia , al l tribal lands , an d al l U.S. te r r it o r i e s, c o mmo nw e a lt h s , a n d p o s se s s i o n s a n d s h all b e
e n f o r c ed as if it wer e an ord e r of that jurisd i c t i on.
CLE R K’S
CERT I F IC A T E
I certify t h at t he foreg o in g Restra i ning Ord e r—Juven i le (C L E T S—JUV ) is a tru e a n d
correct copy of the origin al o n fil e i n th e c o urt.
Date : Clerk, b y ,
Depu t y––––– –––––
–––––
––––– F A M I L
Y :
[SE A
L]
J V - 2 50 [R ev. Ju ly 1,
2006] RESTRAI N ING ORDER—J U VEN I LE ( CLETS—
JUV) P a ge 4 of
4el ectr onic form ã
2006
WWW.LawCA.co
m
L a w
P u b l i s h e r s
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