M F Ht.:
City:
Telephone number:
Hair Color:
Eye Color:
Date of Birth:
Date: Time:
Dept.:
DV-110 Temporary Restraining Order
and Notice of Hearing Clerk stamps below when form is filed.
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):
State: Zip
:
Protected person’s lawyer (if any): (Name, address, telephone number,
and State Bar number): Court name and street address:
Superior Court of California, County of
Restrained person's name:
Description of that person: Sex: Case Number:
Wt.
: Race:
Age
:
List the full names of all family or household members protected by this order:
Court Hearing Date (Fecha de la Audiencia)
Court will fill in box below.
Name and address of court if different from above:
Rm
.
At the hearing, the judge can make restraining orders that last for up to 3 years. The judgeTo the person in
can also make other orders about children, child support, money, and property. At the hearing, you can tell the
judge if you do not want the orders against you. Even if you do not attend the hearing, you must obey the orders.
Para la persona nombrada en esta audiencia e1juez puede hacer que la orden de restricci6n sea v6lida hasta un
m6ximo de 3 aiios. Eljuez pitede tambi6n hacer otras 6rdenes acerca de nfflos, manutenci6n, dinero y propiedad. Si Usted
se opone a estas 6rdenes, vaya a la audiencia y digaselo a1juez. Aunque no vaya a la audiencia, tiene que obedecer estas
6rdenes.
Temporary Orders (Ordenes Temporales)
Any orders made in this form end on the date and time of the court hearing in
Read this form carefully. All checked boxes and item 10 are court orders. unless a judge extends them.
Todas las ordenes hechas en esta formulario terminar6n en la fecha y hora de la audiencia en
This is a Court Order.
J u d i c i a l C o u n c i l o f C a l i f o r n i a ,
Revised July 1, 2007 andatory Form
Family Code, §§ 6200 et seq. Approved by D0J Temporary Restraining Order (CLETS)
(Domestic Violence Prevention) DV-110, Page 1 of 5Hearing
Date
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L a w P u b l i s h e r s al menos que un juez las
extienda. Lea este formulario con cuidado. Todas las casillas marcadas articulo 10 son ordenes de la cotte.1
452
3
c. Take any action, directly or through others, to get the addresses or locations of any protected persons or of their family members,
caretakers, or guardians. (If item c is not checked, the court has found good cause not to make this order.)
Peaceful written contact through a lawyer or a process server or another person to serve legal papers is allowed and does not
violate this order.
A criminal protective order on Form CR-160 is in effect. Case Number: County (if known):
Expiration Date: (If more orders, list them in item 16 .)
Protected person's name:
Personal Conduct Orders
Harass, attack, strike, threaten, assault (sexually or otherwise), hit, follow, stalk, molest, destroy
Contact (either directly or indirectly), or telephone, or send messages or mail or e-mail
Move-Out Order
immediately from (address):
Child Custody and Visitation Order
You and the other parent must make an appointment for court mediation (address and phone #):
Follow the orders listed in Form DV- 140, which is attached.
Turn In or Sell Guns or Firearms
Property Control
Stay-Away Order
The person listed in
Other (specify):The children's school or child careThe person in must stay at least Except for brief and peaceful contact as required for court-ordered visitation of children unless a
Home Job Vehicle of person in The people listed in C a s e N u m b e r :
The person in must not do the following things to the protected people listed in and
a .
personal property, disturb the peace, keep under surveillance, or block movements
b.
criminal protective order says otherwise
yards away from:
a. d.
b. e.
c.
The person in must take only personal clothing and belongings needed until the hearing and move out
a.
b.
No Guns or Other Firearms
The person in cannot own, possess, have, buy or try to buy, receive or try to receive, or in any other way
get a gun or firearm.
The person in
• Must sell to a licensed gun dealer or turn in to police any guns or firearms that lie or she has or controls.
This must be done within 48 hours of receiving this order. But if the person in was at a hearing on this
order, it must be done within 24 hours of the hearing.
• Must bring a receipt to the court within 72 hours of receiving this order, to prove that guns have been
turned in or sold.
Until the hearing, only the person in
can use, control, and possess the following property and things:
This is a Court Order.
Revised July 1, 2007
Temporary Restraining Order (CLETS)
(Domestic Violence Prevention) DV-110, Page 2 of 5121110 986
7
Protected person's name:
Property Restraint
Unlawful Communications may be recorded
Other Orders (specify):
Time for Service
Date: Case Number:
If the people in
and are married to each other, they must not transfer, borrow against, sell, hide, or get
rid of or destroy any property, except in the usual course of business or for necessities of life. In addition,
each person must notify the other of any new or big expenses and explain them to the court.
The person in can record communications made by the person in
that violate the judge's orders.
No Fee to Notify Restrained Person
If the sheriff or marshal serves this order, he or she will do it for free -
If the judge makes a restraining order at the hearing, which has the same orders as in this form, the person ill
will get a copy of that order by mail at his or her last known address. (Write restrained person's address here):
If this address is not correct, or to know if the orders were made permanent, contact the court.
To: Person Asking for Order To: Person Served With Order
Someone 18 or over - not you or the other
protected people - must personally ''serve'' a copy
of this order to the restrained person at least If you want to respond in writing, someone 18 or
over - not you - must ''serve'' Form DV- 120 on the
person in
days before the hearing. then file it with the court at least
days before the hearing.
For help with Service or Answering, read Form DV-210 or DV-540.
Judge (or Judicial Officer)
Certi f icate of Com p liance Wit h VAWA
This temporary protective order meets all F ul l Faith and C r edit requirements of the Violence Ag a i nst
Women 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 restrai n e d pe rs on . T his c o ur t h as
j ur i s d icti o n o v er th e parties an d the subj e c t m a tter; the restrained per s on h as bee n or will be afforde d notice
and a tim e ly o p p o rt u ni t y to be he ar d as p ro v i d ed by the laws of t his jur i sdiction. T h is or d er is vali d a n d
en t itled t o enforcement in all j u r i s dictions throughout th e 50 Unite d Sta tes, the D i s t r i c t of Col u m b ia,
a l l tri b al lands, and all U.S. territori e s , commonwealths, and pos s essions and sha l l be enforc e d a s if it
we r e an order of tha t jurisdiction.
This is a Court Order.
Revised July 1, 2007
Temporary Restraining Order (CLETS)
(Domestic Violence Prevention) DV-110, Page 3 of 5A B181716151413
C a s e N u m b e r :
Protected person's name -
Warnings and Notices to the Restrained Person in 2
If you do not obey this order, you can be arrested and charged with a crime.
• It is a felony to take or hide a child in violation of this order. You can go to prii son and/or pay a fine.
• If you travel to another state or to tribal lands, or make the protected person do so, with the intention of
disobeying this order, you can be charged with a federal crime.
• If you do not obey this order, you can go to prii son and/or pay a fine.
You Cannot Have Guns or Firearms
You cannot own, have, possess, buy or try to buy, receive or try to receive, or
otherwise get a gun while the order is in effect. If you do, you can go to jail
and pay a $1,000 fine. If item on this form is checked, you must sell to a
gun dealer or turn in to police any guns or firearms that you have or control.
The judge will ask you for proof that you did so. If you do not obey this order,
you can be charged with a crime. Federal law says you cannot have guns or
ammunition if you are subject to a restraining order made after a noticed
hearing.
After You Have Been Served With a Restraining Order
• Obey all the orders.
• File DV-120 and have all papers served on the protected person by the date listed in Item• If you want to respond, fill out Form DV-120. Take itto the court clerk with the forms listed in Itein
of this form.
• At the hearing, tell the judge if you agree to or disagree with the orders requested.
• Even if you do not attend the hearing, the judge can make the restraining orders last for 3 years.
Child Custody, Visitation, and Support
• Child Custody and Visitation: If you do not go to the hearing, the judge can make custody and visitation
orders for your children without hearing your side.
• S p o u sal S u p p ort : Fil e and serve a Fi n an c i a l St ateme nt (FL-15 5 ) or a n In c ome a n d Ex p ense De c l a rati o n
(FL-150) so th e judg e w i ll have inform a t ion about you r finances . Otherwise , t h e court m a y mak e s upport
ord e r s wit h out h e ari n g y o u r si d e.
Requests 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 proceeding. Contact the clerk's office or go to
www.courtinfo.ca.gov/forms for Request for Accommodations by Persons With Disabilities and Order (Form MC-
410). (Civil Code, § 54.8.)• Child Support: The judge can order child support based on the income of both parents. The judge can also
have that support taken directly from your paycheck. Child support can be a lot of money, and usually you
have to pay until the child is 18. File and serve a Financial Statement (FL- 155) or an Income and Expense
Declaration (FL-150) so the judge will have information about your finances. Otherwise, the court may make
support orders without hearing your side.
This is a Court Order.
Revised July 1, 2007
Temporary Restraining Order (CLETS)
(Domestic Violence Prevention) DV-110, Page 4 of 52322 212019
Date: C a s e N u m b e r :
Protected person's name-
Instructions for Law Enforcement
Start Date and End Date of Orders
The start date is the date next to the judge's signature on page 3. The orders end on the hearing date on page I or
the hearing date on Form DV-125, if attached.
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.
Notice/Proof of Service
• Law enforcement must first determine if the restrained person had notice of the orders. If notice cannot be
verified, the restrained person must be advised of the terms of the orders. If the restrained person then falls to
obey the orders, the officer must enforce them. (Fain. Code, § 6383.)
Consider the restrained person ''served'' (noticed) if
• 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
(Fain. Code, § 6383, Pen. Code, § 836 (c) (2).) A n o f fice r can o b t a i n i nf o rmatio n a b o u t t h e co n te n ts
o f t h e or de r in the Dom e stic Viol e nce Restraining Ord e r s S y stem ( D VROS). ( F am. Code, § 6381(b)
If the Protected Person Contacts the Restrained Person
Even if the protected person invites or consents to contact with the restrained person, the orders remain 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, § 13 7 1 0(b).)
Child Custody and Visitation
• Custody and visitation orders are on Form DV-140, Items and
They are sometimes also written on
additional pages or referenced in DV-140 or other orders that are not part of the restraining order.
• Forms DV-100 and DV-105 are not orders. Do not enforce them.
Enforcing the Restraining Order in California
Any law enforcement officer in California who receives, sees, or verifies the orders on a paper copy, or on the
California Law Enforcement Telecommunications System (CLETS), or in an NCIC Protection Order File must
enforce the orders.
Conflicting Orders
If a criminal restraining order (CR- 160) conflicts with a civil restraining order (DV- 110 or DV-13 0), enforce the
criminal order. Even if the criminal order is older, the officer must still enforce it over the civil order. (Pen. Code,
§ 136.2 (h).) Any nonconflicting terms of the civil restraining order remain in full force.
Clerk's Certificate
I certify that this Temporary Restraining Order is a true and correct copy of
[seal
]
the original on file in the court.
Clerk,
by I Deputy
This is a Court Order.
Revised July 1, 2007
Temporary Restraining Order (CLETS)
(Domestic Violence Prevention) DV-110, Page 5 of 53029 2827262524
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