DV-100, Request for Domestic Violence Restraining Order (Domestic Violence Prevention) Instructions

Provide further details about how the person was abusive on this specific day, including what was said, done, or sent to you, and how often it happened.

Provide additional details about how the person was abusive on this day, including what was said, done, or sent, and how often it happened.

Check this box if the first debt listed in section 'a' resulted from abuse.

Check this box if the second debt listed in section 'a' resulted from abuse.

Check this box if the third debt listed in section 'a' resulted from abuse.

Check this box if you need to list additional protected people on a separate piece of paper.

Provide a detailed explanation of why these people need protection.

Provide the total number of additional pages or forms attached to this document.

Check this box if you ask the judge to order the person listed in the form to go to a 52-week batterer intervention program.

Provide the case number for this form.

Enter the case number for this form.

Enter the case number for this document.

Enter the unique identifier assigned to this case.

Provide the case number for this form.

Enter the case number for this legal matter.

Provide the case number for this form.

Enter the unique case number assigned to this document.

Provide the unique identifying number assigned to this case.

Enter the case number for this legal document.

Enter the case number.

Provide the case number.

Check this box if you have a child with the other person and want the court to make or change a child custody or visitation order, and remember to also complete and attach form DV-105.

Check this box if you and the other person have one or more children together.

Check this box if you do not currently have a child support order and wish to obtain one from the judge.

Check this box if you currently have a child support order and wish to have the judge change it.

Check this box if you are currently receiving or have applied for TANF, Welfare, or CalWORKS benefits.

Enter a description of the property for which you are requesting temporary use, possession, and control.

Provide an explanation for why you are requesting control of the listed property.

Provide the full name and street address of the Superior Court of California, County of.

Enter the unique identifier assigned to this case by the court.

Check this box if you are involved in a criminal court case with the person in question.

Provide the city, state, or tribe where the criminal case was filed, the year it was filed, and the case number.

Check this box if the other court case with the person is a custody case.

Enter where the custody case was filed (city, state, or tribe), the year it was filed, and the case number.

Provide the date of abuse, or an estimate if the exact date is unknown.

Provide the date of the abuse, or an estimate if the exact date is not known.

Enter the date of the most recent abuse, providing an estimate if the exact date is unknown.

Enter the dates or estimates of when the abuse happened.

Check this box if you need the judge to give you more time to give notice or 'serve' the person named in field 2 of your request.

Please provide a detailed explanation of why you are requesting an extension to the deadline to serve the person.

Check this box if you do not know how the person made the debt or debts.

Check this box if you know how the person made the debt or debts and need to provide an explanation.

Provide an explanation of how the person made the debts if you answered yes to the previous question.

Provide a detailed explanation for why the person should be ordered to pay the listed debts.

Provide details about how the person was abusive on this day, including what was said, done, or sent to you, and how often something happened.

Check this box if the other court case with the person in question is a divorce case.

Enter the location where the divorce case was filed (city, state, or tribe), the year it was filed, and the case number.

Check this box if the person did not cause you any emotional or physical harm.

Check this box if the person caused you emotional or physical harm.

Provide a detailed description of any emotional or physical harm caused by the person.

Check this box if you are related to the person in (2).

Check this box if the person in (2) is your parent, stepparent, or parent-in-law.

Check this box if the person in (2) is your brother, sister, sibling, stepsibling, or sibling in-law.

Check this box if the person in (2) is your child, stepchild, or legally adopted child.

Check this box if the person in (2) is your grandparent, step-grandparent, or grandparent-in-law.

Check this box if the person in (2) is your child's spouse.

Check this box if the person in (2) is your grandchild, step-grandchild, or grandchild-in-law.

Enter the description of the fifth firearm, firearm parts, or ammunition.

Enter the number or amount of the fifth firearm, firearm parts, or ammunition.

Enter the known location of the fifth firearm, firearm parts, or ammunition.

Check this box if you do not know whether the person has firearms, firearm parts, or ammunition.

Check this box if the person does not have firearms, firearm parts, or ammunition.

Check this box if the person has firearms, firearm parts, or ammunition and you have information to complete the section below.

Enter the name or other identifying information for the first animal.

Enter the type of the first animal.

Enter the breed of the first animal, if known.

Enter the color of the first animal.

Provide the name of the entity or person to whom the first debt payment should be made.

Describe what the first debt payment is for, such as rent or mortgage.

Enter the amount of the first debt payment.

Specify the due date for the first debt payment.

Enter the name of the person or entity to whom the first expense payment should be made.

Describe the reason or purpose for the first expense payment.

Provide the total monetary amount for the first expense payment.

Provide a detailed description of the first firearm, gun, firearm part, or ammunition.

Enter the number or amount of the first firearm, gun, firearm part, or ammunition.

Provide the location where the first firearm, gun, firearm part, or ammunition is known to be.

Check this box if the first phone number to be transferred is your own.

Check this box if the first phone number to be transferred belongs to a child in your care.

Enter the first phone number to be transferred, including the area code.

Enter the full name of the first protected person.

Enter the age of the first protected person.

Enter the relationship of the first protected person to you.

Check this box if the first protected person lives with you.

Check this box if the first protected person does not live with you.

Enter the date the first restraining order was issued.

Enter the date the first restraining order expires.

Enter the name or any other identifying information for the fourth animal.

Enter the type of the fourth animal.

Enter the breed of the fourth animal, if known.

Enter the color of the fourth animal.

Provide the name of the entity or person to whom the fourth expense payment should be made.

Describe the item or service for which the fourth expense payment is being made.

Enter the total monetary amount of the fourth expense payment.

Enter a detailed description of the fourth firearm, firearm parts, or ammunition.

Enter the number or amount of the fourth described firearm, firearm parts, or ammunition.

Enter the location where the fourth described firearm, firearm parts, or ammunition can be found, if known.

Check this box if you want to transfer your own fourth phone number to your account.

Check this box if you want to transfer the fourth phone number belonging to a child in your care to your account.

Please provide the fourth phone number to be transferred, including its area code.

Enter the full legal name of the fourth protected person.

Enter the age of the fourth protected person.

Enter the relationship of the fourth protected person to you.

Check this box if the fourth protected person lives with you.

Check this box if the fourth protected person does not live with you.

Check this box if the abuse occurred only one time.

Check this box if the abuse occurred between two and five times.

Check this box if the abuse occurred on a weekly basis.

Check this box if the frequency of abuse does not fit the other options, and describe the frequency in the provided text field.

Provide the dates or estimated timeframes when the abuse occurred.

Specify how often the person abused you if it's not 'Just this once', '2-5 times', or 'Weekly'.

Provide the dates or estimated dates when the abuse happened, if known.

Check this box if the person abused you in this manner only a single time.

Check this box if the person abused you in this manner between two and five times.

Check this box if the person abused you in this manner on a weekly basis.

Check this box if the frequency of abuse was different from 'Just this once', '2-5 times', or 'Weekly', and provide details in the space provided.

Specify how often the person abused you if it does not fit the 'Just this once', '2-5 times', or 'Weekly' categories.

Check this box if the abuse described happened only once.

Check this box if the abuse described happened 2 to 5 times.

Check this box if the abuse described happened weekly.

Check this box if the frequency of abuse does not fit the 'Just this once', '2-5 times', or 'Weekly' categories.

Specify how often the person abused you if it does not fall into the given categories.

Check this box if you are involved in a Guardianship court case with the other person.

Enter the location where the guardianship case was filed (city, state, or tribe), the year it was filed, and the case number.

Check this box if the person did not cause you any emotional or physical harm during the most recent abuse.

Check this box if the person caused you emotional or physical harm during the most recent abuse.

Enter a detailed description of the emotional or physical harm caused during the most recent abuse incident.

Check this box if the person did not cause you any emotional or physical harm.

Check this box if the person caused you emotional or physical harm.

Provide a detailed description of the emotional or physical harm caused.

Check this box if you want the judge to order the other person not to make any changes to your, their, or your children's insurance or other coverage, including canceling, cashing out, borrowing against, transferring, disposing of, or changing the beneficiaries for the insurance.

Check this box if you are involved in a juvenile (child welfare or juvenile justice) court case with the person.

Provide the case number and any relevant details for the juvenile (child welfare or juvenile justice) case.

Please enter the full name of the lawyer.

Please enter the lawyer's state bar number.

Please enter the name of the lawyer's firm.

Check this box if you currently live together or used to live together with the person.

Check this box if you have lived together with the person as a family or household (more than just roommates).

Check this box if you have not lived together with the person as a family or household.

Check this box if you and the other person do not live together or live close to each other.

Check this box if you and the other person live together or live close to each other, and then select one of the specific options below.

Check this box if you and the other person currently live in the same home.

Check this box if you and the other person live in the same building but not in the same home.

Check this box if you and the other person live in the same neighborhood.

Check this box if your living situation with the other person is not described by the other options and requires further explanation.

Check this box if you need more space to describe the abuse, and you will use form DV-101 or a separate sheet of paper.

Provide the full address of the home from which the person is ordered to move out.

Check this box if the type of court case you are involved in with the person is not listed above, and you need to specify what kind of case it is.

Specify the kind of other court case you are involved in with the person.

Check this box if you are not involved in any other court case with the person.

Check this box if you are involved in another court case with the person.

Provide a description of any additional orders you want the judge to make to keep you, your children, or other people safe.

Check this box if you want the other person to pay any debts owed for property.

Check this box if you want the judge to order the other person to pay for expenses, such as damaged property, medical care, counseling, or temporary housing, that were directly caused by their actions.

Enter the petitioner's telephone number.

Enter the petitioner's fax number.

Enter the petitioner's email address.

Enter the petitioner's street address where court papers can be received.

Enter the city of the petitioner's mailing address.

Enter the state of the petitioner's mailing address.

Enter the zip code of the petitioner's mailing address.

Enter the full name of the person asking for protection.

Enter the current age of the person asking for protection.

Check this box if you do not know whether the police came.

Check this box if the police did not come.

Check this box if the police did come.

Check this box if you do not know whether the police came.

Check this box if the police did not come.

Check this box if the police came.

Check this box if you do not know whether the police came regarding the most recent abuse incident.

Check this box if the police did not come regarding the most recent abuse incident.

Check this box if the police came regarding the most recent abuse incident.

Check this box if you want the judge to order the person not to take, sell, hide, molest, attack, strike, threaten, harm, get rid of, transfer, or borrow against the animals.

Check this box if you are married or a registered domestic partner with the other person and want the judge to order them not to borrow against, sell, hide, get rid of, or destroy any possessions or property, and to notify you of new or big expenses.

Check this box if you are asking the court to protect your animals, your children's animals, or the animals of the person identified in section 2.

Check this box if you do not want the restraining order to protect your children, family, or someone you live with.

Check this box if you want the restraining order to protect your children, family, or someone you live with.

Check this box if you own the home at the given address.

Check this box if you have lived at this address for a specific duration, which needs to be specified in years and months.

Enter the number of years you have lived at this address as part of your right to live here.

Enter the number of months you have lived at this address as part of your right to live here.

Check this box if your name is listed on the lease agreement for the property.

Check this box if you contribute to paying some or all of the rent or mortgage for the property.

Check this box if you live at this address with your child or children.

Check this box if your right to live at the address is due to a reason not listed above, and you will provide an explanation.

Explain in detail your other reason for having the right to live at this address.

Continue to explain your other reason for having the right to live at this address.

Check this box if you are currently married to or are currently registered domestic partners with the other person.

Check this box if you were previously married to or were previously registered domestic partners with the other person.

Check this box if you are currently dating or previously dated the other person.

Check this box if you are currently engaged to be married or were previously engaged to be married to the other person.

Check this box if the respondent's gender is male.

Check this box if the respondent's gender is female.

Check this box if the respondent's gender is nonbinary.

Enter the full name of the person you want protection from.

Enter the age of the person you want protection from, or an estimate if the exact age is unknown.

Enter the date of birth of the person you want protection from, if known.

Enter the race of the person you want protection from.

Check this box if there are no restraining orders currently in place or that have expired in the last six months.

Check this box if there are restraining orders currently in place or that have expired in the last six months.

Enter the name or other identifying information for the second animal.

Enter the type of the second animal.

Enter the breed of the second animal, if known.

Enter the color of the second animal.

Enter the name of the person or entity to whom the second debt payment is to be made.

Provide a brief description of what the second debt payment is for, such as 'mortgage' or 'car payment'.

Enter the monetary amount of the second debt payment.

Enter the date by which the second debt payment is due.

Provide the name of the person or entity to whom the second expense payment should be made.

Describe the purpose or reason for the second expense payment.

Enter the monetary amount of the second expense payment.

Enter the first part of the description for the second firearm, firearm parts, or ammunition, including the number or amount.

Enter the second part of the description for the second firearm, firearm parts, or ammunition, including the number or amount.

Enter the known location of the second firearm, firearm parts, or ammunition.

Check this box if you want to request the transfer of your second personal phone number.

Check this box if you want to request the transfer of a second phone number belonging to a child in your care.

Enter the second phone number to be transferred, including its area code.

Enter the full name of the second protected person.

Enter the age of the second protected person.

Enter the relationship of the second protected person to you.

Check this box if the second protected person listed lives with you.

Check this box if the second protected person listed does not live with you.

Enter the date the second listed restraining order was issued.

Enter the date the second listed restraining order expires.

Check this box if you and the person do not have the same workplace or go to the same school.

Check this box if you and the person have the same workplace or go to the same school, and then select all applicable options below.

Check this box if you and the person work together at the same company.

Enter the name of the company where you and the other person work together.

Check this box if you and the person go to the same school.

Enter the name of the school you and the other person attend.

Check this box if you and the person share a workplace or school in a way not covered by the other options, and provide an explanation.

Provide an explanation for any other shared workplace or school situation not covered by the previous options.

Enter a description of the sixth firearm, firearm parts, or ammunition.

Enter the number or amount of the sixth described firearm, firearm parts, or ammunition.

Enter the known location of the sixth described firearm, firearm parts, or ammunition.

Check this box if you are asking the court to give you sole possession, care, and control of the animals.

Check this box if the reason for requesting sole possession is that the other person abuses the animals.

Check this box if the reason for requesting sole possession is that you take care of these animals.

Check this box if the reason for requesting sole possession is that you purchased these animals.

Check this box if your reason for requesting sole possession is not listed and you will provide an explanation.

Enter the first line of the explanation for requesting sole possession of animals under the 'Other' category.

Enter the second line of the explanation for requesting sole possession of animals under the 'Other' category.

Check this box if you do not want the judge to make a special decision regarding the debt.

Check this box if you want the judge to make a special decision regarding the debt.

Check this box if you are requesting the judge to order the other person to give you financial assistance (spousal support).

Check this box if you want the judge to order the person to stay away from the animals.

Check this box if you want the judge to order the person to stay at least 100 yards (300 feet) away from the animals.

Check this box if you want the judge to order the person to stay a specific other distance (number of yards) away from the animals.

Enter the specific number of yards the person must stay away from the animals, if different from 100 yards.

Check this box if you want the person to stay at least 100 yards (300 feet) away from the places specified in the Stay-Away Order.

Check this box if you want the person to stay away by a specific distance other than 100 yards, and then specify that distance in the provided field.

Enter the specific distance in yards for the person to stay away.

Check this box if you want the judge to order the person to stay away from you.

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

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

Check this box if you want the judge to order the person to stay away from each person listed in field 8 (the protected persons).

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

Check this box if you want the judge to order the person to stay away from your children's school or childcare facility.

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

Check this box if you want the judge to order the person to stay away from a location not listed, and provide details in the adjacent text field.

Provide a detailed explanation of any other specific locations not listed where the person is ordered to stay away from.

Enter the third animal's name or other identifying information.

Enter the type of the third animal.

Enter the breed of the third animal, if known.

Enter the color of the third animal.

Enter the name of the person or entity to whom the third debt payment should be made.

Enter a description of what the third debt payment is for, such as rent, mortgage, or car payment.

Enter the total monetary amount of the third debt payment.

Enter the date when the third debt payment is due.

Provide the name of the person or entity to whom the third expense payment should be made.

Provide the reason for the third expense payment.

Provide the monetary amount for the third expense payment.

Enter a detailed description of the third firearm, firearm parts, or ammunition.

Enter the quantity or amount of the third firearm, firearm parts, or ammunition.

Enter the known location of the third firearm, firearm parts, or ammunition.

Check this box if you are requesting to transfer your third phone number to your account.

Check this box if you are requesting to transfer your child's third phone number to your account.

Enter the third wireless phone number to be transferred, including its area code.

Enter the third protected person's full legal name.

Enter the age of the third protected person.

Enter the relationship of the third protected person to you.

Check this box if the third protected person lives with you.

Check this box if the third protected person does not live with you.

Check this box to ask the judge to transfer a wireless phone account (your number or your child's number) to you, making you financially responsible for the account.

Check this box if the person did not use or threaten to use a gun or other weapon.

Check this box if the person used or threatened to use a gun or other weapon.

Provide a detailed description of the gun or weapon used or threatened to be used.

Check this box if the person did not use or threaten to use a gun or other weapon during the most recent abuse.

Check this box if the person did use or threaten to use a gun or other weapon during the most recent abuse.

Provide details about the gun or other weapon used or threatened during the most recent abuse incident.

Check this box if the person did not use or threaten to use a gun or other weapon.

Check this box if the person did use or threaten to use a gun or other weapon.

Enter a description of the gun or weapon that was used or threatened.

Check this box if you do not know if anyone else heard or saw what happened on this day.

Check this box if no one else heard or saw what happened on this day.

Check this box if someone else heard or saw what happened on this day.

Provide the names of any witnesses who heard or saw what happened on the day of the abuse.

Check this box if you do not know if anyone else heard or saw what happened on the day of the abuse.

Check this box if no one else heard or saw what happened on the day of the abuse.

Check this box if someone else heard or saw what happened on the day of the abuse.

Enter the names of any other individuals who heard or saw what happened on this day.

Check this box if you do not know whether anyone else heard or saw what happened during the most recent abuse incident.

Check this box if no one else heard or saw what happened during the most recent abuse incident.

Check this box if someone else heard or saw what happened during the most recent abuse incident.

Provide the names of any witnesses who heard or saw what happened during the most recent abuse.

Enter the date of your lawyer's signature.

Enter the full name of your lawyer.

Enter the date your signature was provided.

Enter your full name as the signatory, typed or printed.