Domestic Violence Temporary Restraining Order and Notice of Hearing Sample Legal Form.pdf

Loading ...
Global Do...
News & Politics
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):
Zip:
State:
City:  
Telephone number:  
(
l)
Protected person’s lawyer (if any):  (Name, address, telephone number, 
and State Bar number):
Restrained person’s name:
M       F   Height:
Description of that person: Sex:   
Hair Color:
Weight: 
Race:  
Date of Birth: 
Eye Color: 
Age: 
List the full names of all family or household members protected by this order:
This is a Court Order.
DV-110, Page 1 of 5
Judicial Council of California, www.courtinfo.ca.gov
Revised July 1, 2007, Mandatory Form
Family Code, § 6200 et seq.  Approved by DOJ
Temporary Restraining Order 
and Notice of Hearing (CLETS—TRO) 
1
 (Domestic Violence Prevention)
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California, County of
Case Number:
Fill in case number:
DV-110
Temporary Restraining 
Order and Notice of Hearing
1
2
4
3
Clerk will fill out section below.
Name and address of court if different from above:
Date:
Time:
Dept.:
Rm.:
3
Hearing 
Date
Î
Court Hearing Date (Fecha de la Audiencia)
To the person in       :  At the hearing, the judge can make restraining orders that last for up to 5 years. The judge 
can also make other orders about your children, child support, spousal support, money, and property. File an answer 
on Form DV-120 before the hearing. At the hearing, you can tell the judge that you do not want the orders against 
you. Even if you do not attend the hearing, you must obey the orders.
Temporary Orders (Ordenes Temporales) 
Read this form carefully. All checked boxes        and items 10 and 11 are court orders.
Todas las órdenes hechas en esta formulario terminarán en la fecha y hora de la audiencia en      , al menos que 
un juez las extienda. Lea este formulario con cuidado. Todas las casillas marcadas       y los articulos 10 y 11 son 
órdenes de la corte.
Any orders made in this form end at the time of the court hearing in      , unless a judge extends them.
5
Para la persona nombrada en       :  En esta audiencia el juez puede hacer que la orden de restricción sea válida 
hasta un máximo de 5 años. El juez puede también hacer otras órdenes acerca de  niños, manutención, dinero y 
propiedad. Presente una respuesta en el formulario DV-120 antes de la audiencia. Si Usted se opone a estas 
órdenes, vaya a la audiencia y dígaselo al juez. Aunque no vaya a la audiencia, tiene que obedecer estas órdenes.
To the person in      :  At the hearing, the judge will consider whether denial of any orders will jeopardize your 
safety and the safety of children for whom you are requesting custody, visitation, and child support. Safety 
concerns related to the financial needs of you and your children will also be considered.
1
4
2
2
4
Personal Conduct Orders
The person in       must not do the following things to the protected people listed in
and      :
Harass, attack, strike, threaten, assault (sexually or otherwise), hit, follow, stalk, molest, destroy personal
a.  
property, disturb the peace, keep under surveillance, or block movements
Contact (either directly or indirectly), or telephone, or send messages or mail or e-mail
b.  
Except for brief and peaceful contact as required for court-ordered visitation of children unless a
criminal protective order says otherwise
Stay-Away Order
yards away from:
 must stay at 
The person in
The children’s school or child care
The person listed in
a.
d.
The people listed in
b.
e.
Other (specify):
Home        
Vehicle of person in
Job   
c.
Move-Out Order
The person in
must take only personal clothing and belongings needed until the hearing and move out
immediately from (address):
Child Custody and Visitation Order
You and the other parent must make an appointment for court mediation (address and phone number):
a.
Follow the orders listed in Form DV-140, which is attached.
b.
No Guns or Other Firearms or Ammunition
The person in       cannot own, possess, have, buy or try to buy, receive or try to receive, or in any other way get  
guns, firearms, or ammunition.
Turn in or sell guns or firearms.
The person in      :
Must sell to a licensed gun dealer or turn in to police any guns or firearms that he or she has or controls.  This 
must be done within 24 hours of being served with this order.
Must bring a receipt to the court within 48 hours of being served with this order, to prove that guns and firearms 
have been turned in or sold.
Property Control
Until the hearing, only the person in
can use, control, and possess the following property and things:
Revised July 1, 2007
DV-110,  Page 2 of 5
6
9
Temporary Restraining Order 
and Notice of Hearing (CLETS—TRO) 
 (Domestic Violence Prevention)
6
6
Case Number:
Your name:
7
8
9
10
11
12
2
1
1
2
2
1
•
•
2
1
3
This is a Court Order.
3
Peaceful written contact through a lawyer or through a process server or another person in order to serve legal 
papers is allowed and does not violate this order.
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.)
c.
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       .)
26
16
 least
2
Property Restraint
Unlawful communications may be recorded.
No Fee to Notify (Serve) Restrained Person 
If the sheriff serves this order, he or she will do it for free.
Other Orders (specify):
If the judge makes a restraining order at the hearing, which has the same orders as in this form, the person in       
will get a copy of that order by mail at his or her last known address. (Write restrained person’s address here):
Time for Service
Revised July 1, 2007
DV-110,  Page 3 of 5
6
Temporary Restraining Order 
and Notice of Hearing (CLETS—TRO) 
 (Domestic Violence Prevention)
6
Case Number:
Your name:
13
14
15
16
17
18
2
This is a Court Order.
If the people in       and       are married to each other or are registered domestic partners, 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       cannot contact the person in       if the court has made a “no contact” order.)
The person in       can record communications made by the person in        that violate the judge’s orders.
1
2
If this address is not correct, or to know if the orders were made permanent, contact the court.
To:  Person Served With Order
To:  Person Asking for Order
If you want to respond in writing, someone 18 or 
over—not you—must “serve” Form DV-120 on the 
person in      , then file it with the court at least 
________ days before the hearing.
For help with Service or answering, read Form DV-210-INFO or DV-540-INFO.
A
B
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 
________ days before the hearing.
Certificate of Compliance With VAWA
This temporary protective order meets all Full Faith and Credit requirements of the Violence Against Women 
Act, 18 U.S.C. § 2265 (1994) (VAWA) upon notice of the restrained person. This court has jurisdiction over 
the parties and the subject matter; the restrained person has been or will be afforded notice and a timely 
opportunity to be heard as provided by the laws of this jurisdiction. This order is valid and entitled to 
enforcement in each jurisdiction throughout the 50 United States, the District of Columbia, all tribal 
lands, and all U.S. territories, commonwealths, and possessions and shall be enforced as if it were an 
order of that jurisdiction.
1
2
Date:
Judge (or Judicial Officer)
1
2
1
If you do not obey this order, you can be arrested and charged with a crime.
Revised July 1, 2007
DV-110,  Page 4 of 5
6
Temporary Restraining Order 
and Notice of Hearing (CLETS—TRO) 
 (Domestic Violence Prevention)
Case Number:
Your name:
19
This is a Court Order.
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 prison and/or pay a fine.
It is a felony to take or hide a child in violation of this order.  You can go to prison and/or pay a fine.
•
•
•
You cannot have guns, firearms, and/or ammunition.
620
You cannot own, have, possess, buy or try to buy, receive or try to receive, or 
otherwise get guns, firearms, and/or ammunition while the order is in effect. If 
you do, you can go to jail and pay a $1,000 fine. 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
621
Obey all the orders.
If you want to respond, fill out Form DV-120. Take it to the court clerk with the forms listed in item       . 
At the hearing, tell the judge if you agree or disagree with the orders requested.
Even if you do not attend the hearing, the judge can make the restraining orders last for 5 years.
File DV-120 and have all papers served on the protected person by the date listed in item       of this form.
•
•
•
•
•
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.
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 (Form FL-155) or an Income and 
Expense Declaration (Form FL-150) so the judge will have information about your finances. Otherwise, the 
court may make support orders without hearing your side.
•
•
Spousal Support:  File and serve a Financial Statement (Form FL-155) or an Income and Expense Declaration
(Form FL-150) so the judge will have information about your finances. Otherwise, the court may make support 
orders without hearing your side.
•
Warnings and Notices to the Restrained Person in 2
22
18
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.)
622
623
I certify that this Temporary Restraining Order is a true and correct copy of the 
original on file in the court.
Start Date and End Date of Orders
Revised July 1, 2007
DV-110,  Page 5 of 5
6
9
Temporary Restraining Order 
and Notice of Hearing (CLETS—TRO) 
 (Domestic Violence Prevention)
Case Number:
Your name:
24
25
26
27
28
29
30
This is a Court Order.
Instructions for Law Enforcement
Arrest Required If Order Is Violated
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 fails to 
obey the orders, the officer must enforce them. (Family 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. (Fam. 
Code, § 6383; Pen. Code, § 836(c)(2).) An officer can obtain information about the contents of the order in
the Domestic Violence Restraining Orders System (DVROS). (Fam. Code, § 6381(b)(c).)
If the Protected Person Contacts the Restrained Person 
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 
Conflicting Orders 
Clerk’s Certificate
Date:
[seal]
Clerk, by
, Deputy
The start date is the date next to the judge’s signature on page 3. The orders end on the hearing date on page 1 or 
the hearing date on Form DV-125, if attached.
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. (Penal Code, §§ 836(c)(1), 13701(b).) A violation of the order 
may be a violation of Penal Code section 166 or 273.6.
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, § 13710(b).)
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.
A protective order issued in a criminal case on Form CR-160 takes precedence in enforcement over any conflicting 
civil court order. (Pen. Code, § 136.2(e)(2).) Any nonconflicting terms of the civil restraining order remain in full 
force. An emergency protective order (Form EPO-001) that is in effect between the same parties and is more 
restrictive than other restraining orders takes precedence over all other restraining orders.
•
•
•
•
3
4