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FORM DV-100 INSTRUCTIONS

REQUEST FOR ORDER (DV-100)





NOTE:
You will need a copy of the English-language Judicial Council form DV-100 to follow these instructions. Also:

 



Filling out the Caption on your form

Leave Blank. The clerk will stamp this area when the form is filed.
SUPERIOR COURT OF CALIFORNIA, COUNTY OF” – write the name of the County where you are filing your case. Click here for location of courts.
Case Number:  Leave blank. A court clerk will fill in your case number.

 



Filling out the rest of your form

Request for Order

This form tells the court what kind of protection you want for the next several months or years. Judges are willing to consider restricting (stopping) people from doing certain things for a period of time when it seems this will help each person to stay safe as they handle responsibilities for their children and other parts of their lives that they shared.


1.    Write the name and age of the person who wants to get a protection order from the court (this can only be one person.)  This person is called the “Protected Person.”  If the Protected Person has an attorney, write that attorney's name, State Bar number, and the name of the law firm where he or she works.  Write the attorney's address, telephone number, fax number and email address.

If the Protected Person does not have an attorney, write the P.O. box or mailing address where court papers can be delivered.  Do not give the Protected Person's telephone number, fax number or email address if you don't want to.

IMPORTANT:  Your restraining order paperwork will go to the restrained person in your case and he or she will get a chance to see everything you write.  If you are staying somewhere you do not want the restrained person to know about and you want to keep the address confidential, do NOT write it on these papers.  You can use a program called "Safe at Home" that give you a secure address to use for your court papers (or for banking and other things) where you can still get your court papers without having to reveal your confidential address.  To learn about the Safe at Home program, click here.


2. 
   Write the name of the person who you want the court to restrain (stop from doing something). Check the box next to M if the person to be restrained is a man (male), or check the box next to F if this person is a woman (female). Write how tall the person is on the line next to “Height”. Write how much the person weighs on the line next to “Weight”.  Write the color of the person's hair and eyes, his or her race, age, and the date when he or she was born, on the blank lines.  Also write his or her address, if you know it.


3.
    Write the names and ages of any other people who live with you who also need to be protected from the person to be restrained. Write how each person is related to you (for example, they might be your child, relative, or roommate). They should be ready to not see or talk to the person to be restrained while the Restraining Order is in effect. These people are sometimes called “Other Protected Persons.” Only list names of people who live with you all the time.

Check this box if you need to list more than 3 other people who need protection. You can either use an Additional Page (Form MC-020) (to be attached to any form) or a separate blank sheet of paper. On either one, at the top write: “DV-100, Protected People.”  Then list the rest of the people who need protection, their sex, their ages, whether or not they live with you, and how they are related to you.

NOTE: If the judge grants (approves) this court order, all people listed here should be given a copy of the final court order.


4.    Relationship Between the Parties:

Check all of the boxes that describe your relationship with the Restrained Person.

  1. Check this box if you and the person to be restrained are married to each other now or if you and your partner are currently in a Registered Domestic Partnership.
  2. Check this box if you and the person to be restrained were married to each other in the past or if you and the person to be restrained used to be in a Registered Domestic Partnership.
  3. Check this box also if you and the person to be restrained live together now (but more than just roommates).
  4. Check this box if you and the person to be restrained lived together in the past.
  5. Check this box if you and the person to be restrained are relatives. Describe the relationship between you and the person to be restrained on the line provided.


    NOTE: 
    The Domestic Violence Prevention Act (Family Code Sections 6200-6219) includes people related to you by blood, marriage, or adoption “to the 2nd degree.” People related to you by blood, marriage or adoption in the first degree are your parents and children; and also stepparents or stepchildren. People related to you in the second degree are your brothers, sisters, grandparents, grandchildren and also half relatives of this type, for example, a half-sister; plus in-laws.

  6. Check this box if you and the person to be restrained are dating each other now, or used to date in the past. (It does not have to be an intimate or sexual relationship), OR if you and the person to be restrained are engaged to be married to each other or were engaged to be married to each other in the past.
  7. Check this box if you and the person to be restrained are the parents together of any children under the age of 18. Write each child’s name and the date that he or she was born.

    If you and the person to be restrained have more than 3 children together under the age of 18, check the box. Use an Additional Page (to be attached to any form) (Form MC-020) or, use a separate blank sheet to add your other children. On either one, at the top write: “DV-100, Children Under 18.” Then write the names and dates of birth of your other children.
  8. Check this box if you and the person to be restrained have filled out a Voluntary Declaration of Paternity (Form CS 909). (Attach a copy of the completed form to this Request for a Restraining Order, if you have it.)


At the top of page 2, DV-100

  Fill out the caption boxes as follows:

Case Number:  Leave this blank for now, but when the clerk gives you a case number make sure it's on every page (the same number as on page 1).

   


5.    Other Court Cases:

  1. Check this box next to “No” or “Yes” to tell the judge if you or any other person listed in item 3 have ever been involved in another court case with the person to be restrained.

    If you checked the box next to “Yes”, write the name of the county and state where the court case happened. Write the case number or numbers if you know them.
    Check this box or boxes that show what kind of court case or cases these were. 
    If the type of case that you and the person to be restrained were involved in is not listed, check the box next to “Other” and write in the kind of case that you had. 
    If you need more space, check that box and attach a sheet of paper and write at the top"DV-100, Other Court Cases."  Then write the additional types of case, places were they were filed, the years they were filed, and the case numbers - if you know them.
  2. Check this box next to “No” or “Yes” to tell the judge if there are any restraining or protective orders that affect you or the person to be restrained. Attach a copy of any protection or restraining order you have.

What orders do you want? In this part, numbers 6 through 22, check all of the boxes that describe orders you want the judge to apply to your case.


6.    Personal Conduct Orders:

Check this box to tell the judge what actions you want the court to limit.

  1. Check this box if you want the judge to order the person to be restrained not to: harass, attack, strike, threaten, assault, hit, follow, stalk, molest, destroy personal property, disturb the peace of, keep under surveillance or block you (or your movements) or do these actions to the other persons you listed in 3 (Other Protected Persons).
  2. Check this box if you want the judge to order the person to be restrained not to contact you or the other protected persons (directly or indirectly) by telephone, mail, or e-mail, or by any other means.


7.   Stay-Away Order:

  1. Check this box if you want the judge to order the person to be restrained to stay away from you, your children, or other people who live with you. Write the number of yards that you would like the person to be restrained to be ordered to stay away from you and any people you listed in 3.  (Usually people write 100 yards. 100 yards is the length of a football field.  It is 91.44 meters.)

    Me  Check this box if you want the judge to order the person to be restrained to stay the certain distance away from you that you just wrote in the line above.

    My home  Check this box if you want the judge to order the person to be restrained to stay away from your home.

    My job  Check this box if you want the judge to order the person to be restrained to stay away from your job or workplace.

    My school  Check this box if you want the judge to order the person to be restrained to stay away from your school.

    My vehicle  Check this box if you want the judge to order the person to be restrained to stay away from your car.

    The children's shcool or child care  Check this box if you want the judge to order the person to be restrained to stay the certain distance away from your children’s school or place of child care.

    Each person listed in 3  Check this box if you want the judge to order the person to be restrained to stay away from the Other Protected Persons listed in 3.

    Other  Check this box if you want the judge to order the person to be restrained to stay away from any other places. (For example, your church, synagogue or mosque, a place where you play sports, or any other place you go regularly.)

  2.  Check the "Yes" box if the person to be restrained is ordered to stay away from all the places you checked and will still be able to get to his or her home, school, job, workplace, school, or vehicle.  If he or she will not be able to get to his or her home, school, job, workplace, school, or vehicle, check the "No" box -- and on the line be low, write out why you still want the judge to make that order.

(Be aware that the judge may or may not order the distance you requested.  The judge may order a greater or lesser distance depending on your circumstances.)


8.     Move-Out Order:

Check this box if you want the person to be restrained to be ordered to move out of the home you share. If you check this box, write the address of the shared home and answer the second part of this question.

If you ask for the move-out order, you must explain to the judge why you have the right to live at the home you share with the person to be restrained. 
For example:

  • You have a legal right to the home, you own the home, or have lived there for a long time.
  • You or a person under your care will be physically or emotionally harmed if the person to be restrained does not move out.

NOTE: If the judge orders the person to be restrained to move out of the shared home, he or she will be allowed to take their personal clothing and belongings, but cannot move back into your home unless the judge allows it at a later date.
 

DV-100 continued on Page 2