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FORM DV-100 INSTRUCTIONS

REQUEST FOR ORDER (DV-100)


At the top of page 3, 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).
   


What orders do you want? In this part, numbers 9 through 22, check all of the boxes as to orders that you want the judge to apply to your case.


9.    No Guns or Other Firearms:

Check the box which is true in your case. Yes – you know that the Restrained Person has or owns any guns or ammunition. No – you know that the Restrained Person does not have or own any guns or ammunition. You don’t know.

NOTE: The law says that no one is allowed to own or have any guns, other firearms or ammunition if he or she is restrained by a court order because of domestic violence. This means that if the judge approves this Request for a Domestic Violence Prevention Order, the Restrained Person will have to sell or turn in any guns, firearms or ammunition that he or she has, owns or controls.


10.    Record Unlawful Communications:

Check this box if you want to be allowed to record any conversations, in person or by telephone, with the person to be restrained that violates the Restraining Order.

 
11.    Animals: Possession and Stay-Away Order

Check this box if you want the judge to order that you are the only one who can own, care for, and control the animal(s) you list.

Write the number of yards that you would like the person to be restrained to be ordered to stay away from the animal(s). (Usually people write 100 yards. 100 yards is the length of a football field. This is 91.44 meters.)

You are asking that the person to be restrained cannot take, sell, transfer, encumber, conceal, molest, attack, strike, threaten, harm, or deal in any other way with the animal(s) you list. Write the name of the animal, with a short description. For example: “Tom, pet Persian cat,” or “Suzy, pet poodle.”

If you ask for the animal possession and stay-away order, you must explain to the judge why you should have the animals with you. For example:

  • You have a legal right to the animal(s): you own it (them) and have owned it (them) for a long time.
  • The person to be restrained has abused, or threatened to abuse, the animal(s).
  • You or a person under your care will be emotionally harmed if the person to be restrained takes the animal(s) away.


12.     Child Custody and Visitation:

  1. Check this box if you and the person to be restrained are the parents together of one or more children under the age of 18 years and you want the judge to include decisions regarding child custody and visitation in this restraining order.
  2. Check this box if you already have a child custody or visitation order and you want to change it.

If you check either one of these boxes, you must then fill out a Request for Child Custody and Visitation Orders (Form DV-105) and attach it to this form.

NOTE:  If you and the other parent want the court to say that you are the legal parents of the children, you can do this now.  Fill out an Agreement and Judgment of Parentage (Form DV-180) and attach it to this form.


13.     Child Support:

  1. Check this box if you and the person to be restrained are the parents together of one or more children under the age of 18 years and you want the judge to include decisions regarding child support in this restraining order.
  2. Check this box if you already have a child support order and you want to change it.
  3. Check this box if you have asked for -- or are now getting -- TANF, Welfare, CalWORKS, or Medi-Cal.
    If you are asking for child support, you must then fill out an Income and Expense Declaration (Form FL-150) or a Financial Statement (Simplified) (Form FL-155) and attach it to this form. (Use Form DV-570 to help you figure out which of theese 2 forms is right for you.  The court's Family Law Facilitator in your county can help you fill out these forms.  For help finding the Family Law Facilitator in your county, click here.)


14.    Property Control:

Check this box if you want the judge to order that you are the only one who can use, possess and control property that you both own or are in the process of buying. This includes personal property, cars, appliances, real property or other things that you shared or bought together.

NOTE: This part of a restraining order is only temporary. It does not guarantee that you can keep the property.
 

15.    Debt Payment:

Check this box if you want the judge to order the person to be restrained to pay certain bills while the Restraining Order is in effect. This might include rent, a mortgage, credit card bills or other items.

Check this box if you need to list more than 1 payment you want the restrained person to make. You can use a separate blank sheet of paper. At the top of it write: “DV-100 - Debt Payment.”  Then line by line write who should get paid ("Pay to:"), what the payment is for ("For:"), the amount of money to be paid ("Amount: $____ "), and the date the payment is due ("Due date:") for each bill that you want the person to be restrained to pay.
 

16.    Property Restraint:

Check this box only if you and the person to be restrained are married to each other, or are registered domestic partners, now.  This order stops the person to be restrained from transferring, borrowing against, selling, hiding or getting rid of or destroying any property except to pay for necessary living expenses. This order also requires the person to be restrained to notify you of any new or big expenses and to explain these expenses to the judge.



At the top of page 4, 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).

 

 


17.    Spousal Support

Check this box if you are married, or are in a registered domestic partnership, now, and you want the judge to order that the person to be restrained pay you spousal support. If you check this box, you must then fill out an Income and Expense Declaration (Form FL-150).  You have to file the completed form at the courthouse and serve a copy of the form on the person to be restrained before the court hearing date.

The court's Family Law Facilitator in your county can help you fill out these forms.  For help finding the Family Law Facilitator in your county, click here.)

 
18.    Lawyer’s Fees and Costs:

Check this box if you want the judge to order the person to be restrained to pay some or all of your lawyer’s fees and court costs. You can check this box if you do not have a lawyer yet, but are planning to get one for the hearing.

If you check this box, you must also fill out and file an Income and Expense Declaration (Form FL-150 ). You have to file the completed form at the courthouse and serve a copy of the form on the person to be restrained before the court hearing date.


19.    Payments for Costs and Services:

Check this box if you want the judge to order the person to be restrained to pay you back for money that you lost (such as from missed work) or things you had to pay for (such as damaged property, medical bills, counseling, or temporary housing) because of the violence or other scary behavior of the person to be restrained.

Write in who the money is owed to, what it is owed for, and how much is due.  If the money is owed to you because you already paid for the expenses, write your name, what it was for and how much. (You must bring receipts, bills, written estimates for repairs or letters from an employer to the hearing to prove your payments or days you missed from work.)


20.    Batterer Intervention Program:

Check this box if you want the judge to make the person to be restrained go to a “Batterer Intervention Program” for a year. A batterer’s intervention program is different than an anger management class. There are classes every week for 1 year. (If ordered, the restrained person will have to show proof that he or she went to this program for the year.)


21.    Other Orders:

Check this box if you want the judge to include extra protections or orders. Write exactly what other things you want included in the court order.

If you need more space to write down all of the orders you are asking for you can use a separate blank sheet of paper. At the top of the page write: “DV-100 - Other Orders.”  Then write down what you want the judge to order.


22.    Time for Service (Notice):

Check this box if you want to serve this form on the person to be restrained less than 5 days before the court hearing. (Usually you have to serve the court form 5 days before the court hearing.)  Write on the blank lines why you want such a short time between when the person to be restrained is given notice of the court hearing and the day of the court hearing itself.  (For example, you may think the person to be restrained may get angry when they find out about the court hearing and try to hurt you.)

NOTE:  To learn how to notify the Restrained Person (called service) and how to let the court know that you have notified the Person (called proof of service), read an information sheet called What is “Proof of Service”? (Form DV-200-INFO).


23.    No Fee to Serve (Notify) Restrained Person:

You may have the sheriff or marshal serve (give a copy of your court papers to) the person to be restrained for you for free. If you qualify for a fee waiver, the sheriff or marshal will do this for free.  If you want to do this, ask the court clerk how. 


24.  Court Hearing

When you file this form (DV-100), the court will automatically set a date for a judge to hear your case.  While you are waiting for this court date, a judge may make "temporary restraining orders" in an attempt to keep you safe while you wait.  However, the judge may not give you the protections you asked for - or, at least, not all of them.  He or she will give the reasons for not granting what you asked on the Notice of Court Hearing, Form DV-109. 

If the judge denies your requests for temporary orders and it makes you want to cancel the case and not go forward with the court hearing, you can cancel the hearing by filling out another form: Waiver of Hearing on Denied Request for Temporary Restraining Order, Form DV-112.

NOTE:  Even if the judge did not make all the temporary orders you asked for, you can still go to the court hearing and ask for those orders.  The judge may grant them at the court hearing, even if he or she did not grant them as temporary orders before the hearing. 

But if all or part of your request was denied, you can cancel the court hearing the judge wrote on your Form DV-109 and, basically, drop your restraining order case for now.  You can refile your request at a later date.




At the top of page 5, 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).

 

 

25.    Describe the Most Recent Abuse:

NOTE: The information you put here is very important. The judge will use this information to decide if he or she will grant the restraining order.  Answer every question that applies to you.

  1. Write the DATE of the last time you were abused.
  2. List anyone who was there and saw or heard the abuse.
  3. Write what the person to be restrained did or said the last time he or she hurt you or your children, or made you afraid. Be sure that you give enough information for the judge to understand what happened.

    Check the box if you need more space to describe the most recent abuse. Use a separate sheet of paper.  On the top of this paper write “DV-100 – Recent Abuse,” then write the additional information you feel the judge needs to know about the abuse.
  4. Write what happened if the person to be restrained used, or said he or she would use, a gun or something else to hurt you (such as a knife or another object).
  5. If you got hurt, tell how you were hurt the last time the person to be restrained abused you. For example, you might tell about bruises, cuts, a broken bone or some other injury.
  6. Check  either the “Yes” or “No” box to tell whether the police came.

    If the police did come out, Check either the “Yes”, “No,” or “I don’t know” box to tell the judge if they gave you an Emergency Protective Order (Form EPO-001). If you know that you did get this kind of order, attach a copy of the order to this form.
  7. Check this box if there have been other times the person to be restrained hurt you or made you afraid.  Be sure that you give enough information for the judge to really understand everything that happened. Use a Description of Abuse (Form DV-101), or a separate sheet of paper to describe any previous abuse. At the top of either piece of paper write: “DV-100 – Recent Abuse.”


26.  Other Persons to Be Protected

If, on Item 3, you asked restraining orders for other people in your family or household, write why they should be protected from the Person to be Restrained.


27.  Number of pages attached to this form, if any: _____

If you used sheets of paper or forms to give the court all of the information it asked for, count the total number of pages you are attaching to this Request for Domestic Violence Restraining Order.

  • For example, if for item 4, if you and the person to be restrained have more than 3 children together who are under the age of 18 you were told to attach a sheet of paper titled "DV-100, Children Under 18" and list all of your children. That's one page that is attached to this form.
  • If for item 13 you asked for child support orders, you were told to fill out and attach Form FL-150, Income and Expense Declaration.  FL-150 is 4 pages long, so with the 1 page attachment for item 4 you have a total of 5 pages. 


Penalty of Perjury:

The last sentence of the form requires that you date and sign the form. Write the date, then print, and sign your name. You are promising under penalty of perjury that everything you have written on this form is true and correct.

If you have a lawyer, your lawyer should also date and sign the form.