Court Hearing Judicial Council Form

Cal. Form PKT-009

California Superior Local Rules

PKT-009 (Rev. 7/26) SUPERIOR COURT OF CALIFORNIA COUNTY OF SAN DIEGO ELDER AND DEPENDENT ADULT ABUSE PACKET FORMS INCLUDED IN THIS PACKET Can a Restraining Order to Prevent Elder or Dependent Adult Abuse Help Me?

Judicial Council Form #EA-100-INFO Request for Elder or Dependent Adult Abuse Restraining Order Judicial Council Form #EA-100 Declaration Judicial Council Form #MC-030 Temporary Restraining Order Judicial Council Form #EA-110 Notice of Court Hearing Judicial Council Form #EA-109 Confidential Information for Law Enforcement Judicial Council Form #CLETS-001 Order for Removal from Residence (Domestic Violence – Elder/Dependent Abuse) SDSC Form #D-072 Civil Case Cover Sheet Judicial Council Form #CM-010 Instructions for Requesting to Continue Hearing on Restraining Order SDSC Form #CIV-385 How to Ask for a New Hearing Date Judicial Council Form #EA-115-INFO Request to Continue Court Hearing Judicial Council Form #EA-115 Order on Request to Continue Hearing Judicial Council Form #EA-116 Request for Sheriff to Serve Court Papers Judicial Council Form #SER-001

Judicial Council of California, Rev. January 1, 2025, Optional Form Welfare and Institutions Code, § 15657.03 Can a Restraining Order to Prevent Elder or Dependent Adult Abuse Help Me? (Elder or Dependent Adult Abuse Prevention) www.courts.ca.gov EA-100-INFOCan a Restraining Order to Prevent Elder or Dependent Adult Abuse Help Me? These instructions cannot cover all of the questions that may arise in a particular case. If you do not know what to do to protect your rights, you should see a lawyer. What is a restraining order? It is a court order that helps protect people from being abused.

Can I get a restraining order? If you are a person 65 years or older or a dependent adult, you can ask for a restraining order if you have been or are being: Physically abused Financially abused Mentally or emotionally abused Neglected Abandoned or abducted Isolated, or Deprived by a caregiver of goods or services you needed to avoid harm or suffering How will the order help me? The court can order a person to: Not physically abuse, harass, hit, or threaten you Not contact or go near you, and Not have any firearms (guns), firearm parts, ammunition, or body armor.

This includes firearm receivers and frames, and any item that may be used as or easily turned into a receiver or frame (see Penal Code

section 16531). For more information about the items a restrained person cannot have, please seeselfhelp.courts.ca.gov/ restraining-orders/prohibited-items. You can also ask for protection for people who live with you and family members. Who can apply for an elder or dependent adult abuse restraining order?

In addition to the elder or dependent adult, the following persons may apply for a restraining order on behalf of the elder or dependent adult: A conservator or trustee of the elder or dependent adult An attorney-in-fact of an elder or dependent adult who acts within the authority of the power of attorney A person appointed as a guardian ad litem for the elder or dependent adult Any other person legally authorized to seek such relief. How much does it cost? There is no fee for filing a request for a restraining order. You do not need to pay a fee for service of the order.

A sheriff or marshal will serve the order for free. Or you may arrange for service by a registered process server or a private party and pay any fee that is charged. The court can make the person who loses the case pay all the court fees and the lawyer’s fees for the other party. What forms do I need to get the order? You must fill out all of form , Request for Elder or Dependent Adult Abuse Restraining Orders, and form , Confidential CLETS Information. If you need attachments, you may use form , Attachment.

You must also fill out items 1 and 2 on form , Notice of Court Hearing, and items 1, 2, and 3 on form , Temporary Restraining Order. EA-100 CLETS-001 MC-025 EA-109 EA-110 Where can I get these forms? You can get the forms from legal publishers or from the California Courts website at You also may be able to find them at your local courthouse or county law library. www.courts.ca.gov/forms. What do I need to do to get the order? You must go to the superior court in the county where the abuse took place or the person to be restrained lives.

At the court, ask where you should file your request for a restraining order. (A self-help center or legal aid association may be able to assist you in filing your request.) At the court, give your forms to the clerk of the court. The clerk will give you a hearing date on the Notice of Court Hearing form, and if your request for immediate orders is granted, a copy of the Temporary Restraining Order signed by a judicial officer. How soon can I get the order? If you ask for a temporary restraining order, the court will decide within 24 hours whether or not to make the order. Sometimes the court decides sooner.

Ask whether you should wait or come back later to get the signed Notice of Court Hearing and Temporary Restraining Order. EA-100-INFO, Page 1 of 3

Rev. January 1, 2025 Can a Restraining Order to Prevent Elder or Dependent Adult Abuse Help Me? (Elder or Dependent Adult Abuse Prevention) EA-100-INFOCan a Restraining Order to Prevent Elder or Dependent Adult Abuse Help Me? How long does the order last? If the court makes a temporary order, it will last until your hearing date. At that time, the court will decide to continue or cancel the order. The order could last for up to five years. How will the person to be restrained know about the order?

Someone age 18 or older—not you or anyone else to be protected by the order—must “serve” (give) the person to be restrained a copy of the order. The server must then fill out form , Proof of Personal Service, and give it to you to file with the court. For help with service, ask the court clerk for form What Is “Proof of Personal Service”? EA-200 EA-200-INFO, What if the restrained person does not obey the order? Call the police. The restrained person can be arrested and charged with a crime. Do I have to go to court? Yes. Go to court on the date the clerk gives you.

Do I need to bring a witness to the court hearing? Witnesses are not required, but it helps to have more proof of the abuse than just your word. You can bring: Witnesses Written statements from witnesses made under oath Photos Medical or police reports Damaged property Threatening letters, emails, or telephone messages The court may or may not let witnesses speak at the hearing. So, if possible, you should bring their written statements under oath to the hearing. (You can use form for this.)MC-030 Do I need a lawyer?

Having a lawyer is always a good idea, but it is not required and you are not entitled to a free, court-appointed attorney. Ask the court clerk about free and low-cost legal services and self-help centers in your county. Will I see the restrained person at the court hearing? If the person comes to the hearing, yes. But that person does not have the right to speak to you. If you are afraid, tell the court officer. Can I bring someone with me to court? Yes. You can bring someone to sit with you during the hearing. But that person cannot speak for you in court.

Only you or your lawyer (if you have one) can speak for you. What if I don't speak English? When you file your papers, ask the clerk if a court interpreter is available. You can also use form , Request for Interpreter (Civil) or a local court form or website to request an interpreter. For more information about court interpreters, go to INT-300 selfhelp.courts.ca.gov/ request-interpreter. EA-100-INFO, Page 2 of 3

Rev. January 1, 2025 Can a Restraining Order to Prevent Elder or Dependent Adult Abuse Help Me? (Elder or Dependent Adult Abuse Prevention) EA-100-INFO Can a Restraining Order to Prevent Elder or Dependent Adult Abuse Help Me? Information about the process is also available online. See selfhelp.courts.ca.gov/EA-restraining-order. What if the restrained person's abuse caused me to owe money or debts?

If the restrained person’s financial abuse caused you to have certain debts or bills (such as using your name to open a credit card and make purchases that you didn’t agree to), you can ask the judge to make a special decision or finding that the restrained person caused you to have the debts or bills. This special finding may be helpful if you are sued for the debts or bills. For help in your area, contact: [Local information may be inserted.] Can I agree with the restrained person to cancel the order? No. Once the order is issued, only the judge can change or cancel it.

You or the restrained person would have to file a request with the court to cancel the order. What if I have a disability? If you have a disability and need an accommodation while you are at court, you can use form Disability Accommodation Request, to make your request. You can also ask the ADA Coordinator in your court for help. For more information, see form , How to Request a Disability Accommodation for Court. MC-410, MC-410-INFO EA-100-INFO, Page 3 of 3

Judicial Council of California, courts.ca.gov Rev. January 1, 2026, Mandatory Form Code Civ. Proc., § 527.9; Welf. & Inst. Code, § 15657.03 Request for Elder or Dependent Adult Abuse Restraining Orders (Elder or Dependent Adult Abuse Prevention) EA-100 Request for Elder or Dependent Adult Abuse Restraining Orders Clerk stamps date here when form is filed. Fill in court name and street address: Superior Court of California, County of San Diego Court fills in case number when form is filed.

Case Number: Read Can a Restraining Order to Prevent Elder or Dependent Adult Abuse Help Me? (form EA-100-INFO) before completing this form. Also fill out Confidential CLETS Information (form CLETS-001) with as much information as you know. 1 Elder or Dependent Adult in Need of Protection Full Name: Gender: M F Age:Nonbinary 2 Person From Whom Protection Is Sought Full Name: Address (if known): City: State: Zip: 3 Person Requesting Order Who is asking the court for protection? (Check a, b, or c): a. The elder or dependent adult named in 1 . b.

Name: conservator of the person estate person and estate of the person named in 1 , appointed by (name of court): Case No.: c. Other (name) (Show this person’s legal authority to make this request on an attached sheet of paper. Write “Attachment 3c— Information About Person Requesting Protective Order” for a title. You may use form MC-025, Attachment.) 4 Contact Information Contact information for the person asking the court for protection a. Your Lawyer (if you have one for this case) Name: State Bar No.: Firm Name: b. Your Address (If you have a lawyer, give your lawyer’s information.

If you do not have a lawyer and want to keep your home address private, you may give a different mailing address instead. The person in 1 does not have to give telephone, fax, or email.) Address: City: State: Zip: Telephone: Fax: Email Address: This is not a Court Order. EA-100, Page 1 of 10 CENTRAL DIVISION, HALL OF JUSTICE, 330 W. BROADWAY, SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910

Rev. January 1, 2026 Request for Elder or Dependent Adult Abuse Restraining Orders (Elder or Dependent Adult Abuse Prevention) Case Number: 5 Description of Protected Person The person named in (check a or b):1 a. Is age 65 or older and a resident of California. b. Is a resident of California and an adult under age 65. This person has physical or mental limitations that restrict their ability to carry out normal activities or protect their rights. (Briefly describe limitations on an attached sheet of paper or form MC-025.

Write “Attachment 5b—Description of Protected Person” for a title.) 6 Additional Protected Persons a. Are you asking for protection for any other family or household members or for the conservator of the elder or dependent adult listed in 1 ? Yes No (If yes, list them): Full Name Gender Age Relation to person in 1 ? Lives with person in 1 ? Yes No Yes No Yes No Yes No Check here if there are more persons. Attach a sheet of paper and write “Attachment 6a—Additional Protected Persons” for a title. You may use form MC-025, Attachment. b.

Why do these people need protection? (Explain below): Check here if there is not enough space for your answer. Put your complete answer on an attached sheet of paper or form MC-025 and write “Attachment 6b—Why Others Need Protection” for a title. 7 Relationship of Parties How does the person in 1 know the person in 2 ? (Explain below): Check here if there is not enough space for your answer. Put your complete answer on an attached sheet of paper or form MC-025 and write “Attachment 7—Relationship of Parties” for a title. This is not a Court Order. EA-100, Page 2 of 10

Rev. January 1, 2026 Request for Elder or Dependent Adult Abuse Restraining Orders (Elder or Dependent Adult Abuse Prevention) Case Number: 8 Description of Abuse a. Abuse means either:

(1) Physical abuse, neglect, financial abuse, abandonment, isolation, abduction, or other treatment with resulting physical harm or pain or mental suffering; or

(2) The withholding by a caretaker of goods or services that are necessary to avoid physical harm or mental suffering. b. Tell the court about the last time the person in 2 abused the person in 1 .

(1) When did it happen? (Provide date or estimated date):

(2) Who else was there?

(3) Describe what happened below. Check here if there is not enough space for your answer. Put your complete answer on an attached sheet of paper or form MC-025 and write “Attachment 8b(3)—Describe Abuse” for a title.

(4) Was the abuse solely financial abuse unaccompanied by force, threat, harassment, intimidation, or any other form of abuse? Yes, only financial abuse. No, the abuse included other forms of abuse described above.

(5) Did the person in 2 use or threaten to use a gun or any other weapon? (If yes, explain below):Yes No Check here if there is not enough space for your answer. Put your complete answer on an attached sheet of paper or form MC-025 and write “Attachment 8b(5)—Use of Weapons” for a title. Was the person in 1 harmed or injured as a result of the acts of abuse described above?

(6) Yes No (If yes, explain below): Check here if there is not enough space for your answer. Put your complete answer on an attached sheet of paper or form MC-025 and write “Attachment 8b(6)—Harm or Injury” for a title.

(7) Did the police come? Yes No If yes, did they give the person in 1 or the person in 2 an Emergency Protective Order? Yes No If yes, the order protects (check all that apply): the person in 1 the person in 2 the persons in 6 . (Attach a copy of the order if you have one.) This is not a Court Order. EA-100, Page 3 of 10

Rev. January 1, 2026 Request for Elder or Dependent Adult Abuse Restraining Orders (Elder or Dependent Adult Abuse Prevention) Case Number: 8 c. Is the person in 2 a care custodian who deprived the person in 1 of (kept from the person, did not allow the person to have or receive, or did not provide the person with) goods or services that the person needed to avoid physical harm or mental suffering? (If yes, describe below what the person was deprived of and how that affected the person): Yes No Check here if there is not enough space for your answer.

Put your complete answer on an attached sheet of paper or form MC-025 and write “Attachment 8c—Deprivation by Care Custodian” for a title. d. Has the person in 2 abused the person in 1 at other times? (If yes, describe prior incidents and provide dates below):Yes No Check here if there is not enough space for your answer. Put your complete answer on an attached sheet of paper or form MC-025 and write “Attachment 8d—Previous Abuse” for a title. 9 Venue Why are you filing in this county? (Check all that apply): a. The person in 2 lives in this county. b.

The person in 1 was abused by the person in 2 in this county. c. Other (specify): 10 Other Court Cases a. Has the person in 1 or any of the persons named in 6 been involved in another court case with the person in 2 ? (If yes, specify the kind of each case and indicate where and when each was filed):No Yes Kind of Case Filed in (County/State) Year Filed Case Number (if known)

(1) Elder or Dependent Adult Abuse

(2) Civil Harassment

(3) Domestic Violence

(4) Divorce, Nullity, Legal Separation

(5) Paternity, Parentage, Child Custody

(6) Eviction

(7) Guardianship

(8) Workplace Violence

(9) Small Claims

(10) Criminal

(11) Other (specify): b. Are there now any protective or restraining orders in effect relating to the person in 1 or any of the persons named in 6 and the person in 2 ? No Yes (If yes, attach a copy if you have one.) This is not a Court Order. EA-100, Page 4 of 10

Rev. January 1, 2026 Request for Elder or Dependent Adult Abuse Restraining Orders (Elder or Dependent Adult Abuse Prevention) Case Number: Check the orders you want.  11 Personal Conduct Orders I ask the court to order the person in 2 not to do any of the following things to the person in 1 or to any person to be protected listed in 6 : a. Physically abuse, financially abuse, intimidate, molest, attack, strike, stalk, threaten, assault (sexually or otherwise), hit, harass, destroy the personal property of, or disturb the peace of the person. b.

Contact the person, either directly or indirectly, in any way, including, but not limited to, in person, by telephone, in writing, by public or private mail, by interoffice mail, by email, by text message, by fax, or by other electronic means. c. Other (specify): Check here if there is not enough space for your answer. Put your complete answer on an attached sheet of paper or form MC-025 and write “Attachment 11c—Other Personal Conduct Orders” for a title.

The person in 2 will be ordered not to take any action to get the addresses or locations of any protected person unless the court finds good cause not to make the order. 12 Stay-Away Orders a. I ask the court to order the person in 2 to stay at least yards away from (check all that apply):

(1) The elder or dependent adult in 1 .

(2) The persons in 6 .

(3) The home of the elder or dependent adult.

(4) The job or workplace of the elder or dependent adult.

(5) The vehicle of the elder or dependent adult.

(6) Other (specify): b. If the court orders the person in 2 to stay away from all the places listed above, will they still be able to get to their home, school, or job? (If no, explain below):Yes No Check here if there is not enough space for your answer. Put your complete answer on an attached sheet of paper or form MC-025 and write “Attachment 12b—Stay-Away Orders” for a title. This is not a Court Order. EA-100, Page 5 of 10

Rev. January 1, 2026 Request for Elder or Dependent Adult Abuse Restraining Orders (Elder or Dependent Adult Abuse Prevention) Case Number: 13 Move-Out Order I ask the court to order the person in 2 to move out from and not return to the residence at (address): The person in 1 will suffer physical or emotional harm if the person in 2 does not leave the residence. The person in 2 is not named in the title or lease of the residence, either alone or with others beside the person in 1 . I ask for this move-out order right away to last until the hearing, because: a.

The person in 2 assaulted or threatened the person in 1 ; and b. The person in 1 has the right to live at the above residence. (Explain below): Check here if there is not enough space for your answer. Put your complete answer on an attached sheet of paper or form MC-025 and write “Attachment 13b—My Right to Residence” for a title. 14 Order for Counseling or Anger Management Courses This item is only available in instances of alleged physical abuse or deprivation of care, not in cases with only alleged financial abuse. a.

I request the person in 2 be ordered by the court to attend clinical counseling or anger management courses provided by a professional (a counselor, psychologist, psychiatrist, therapist, clinical social worker, or mental or behavioral health professional licensed in the State of California to provide counseling or anger management courses). b. Explain why you are requesting an order that the person in 2 attend clinical counseling or anger management courses. Check here if there is not enough space for your answer.

Put your complete answer on an attached sheet of paper or form MC-025 and write “Attachment 14b— Counseling or Anger Management” for a title. This is not a Court Order. EA-100, Page 6 of 10

Rev. January 1, 2026 Request for Elder or Dependent Adult Abuse Restraining Orders (Elder or Dependent Adult Abuse Prevention) Case Number: This is not a Court Order. EA-100, Page 7 of 10 16 Temporary Restraining Order I request that a Temporary Restraining Order (TRO) be issued against the person in 2 to last until the hearing. I am presenting form EA-110, Temporary Restraining Order, for the court’s signature together with this Request.

Has the person in 2 been told that you were going to go to court to seek a TRO against them? (If you answered no, explain why below):Yes No Check here if there is not enough space for your answer. Put your complete answer on an attached sheet of paper or form MC-025 and write “Attachment 16—Temporary Restraining Order” for a title. Unless the abuse is only financial, if the judge grants a protective order, the person in 2 will be prohibited from owning, possessing, purchasing, receiving, or attempting to purchase or receive firearms (guns), firearm parts, and ammunition while the protective order is in effect.

The person in 2 will also be ordered to turn in to law enforcement, or sell to or store with a gun dealer, any firearms (guns), firearm parts, and ammunition within the respondent's immediate possession or control. If an order is granted, the person in 2 will also be prohibited from owning, possessing, or buying body armor and would have to relinquish any they have. a. I don’t know b. No c. Yes (If you have information, complete the

section below.) Describe Firearms (Guns), Firearm Parts, or Ammunition Number or Amount Location, if known (1) (2) (3) (4) (5) (6) 15 Firearms (Guns), Firearm Parts, and Ammunition Does the person in 2 have firearms (guns), firearm parts, or ammunition? (This includes firearm receivers and frames, and any item that may be used as or easily turned into a receiver or frame (see Penal Code

section 16531).)

Rev. January 1, 2026 Request for Elder or Dependent Adult Abuse Restraining Orders (Elder or Dependent Adult Abuse Prevention) Case Number: This is not a Court Order. EA-100, Page 8 of 10 18 Debts Caused by Financial Abuse You can ask the judge to decide at the hearing that certain debts or bills you have were caused by the person in (2)’s financial abuse. This may help you defend against the debt if you are sued in another case. Money Owed To For Amount (1) $ (2) $ (3) $ a.

If you want the judge to make this special finding, list the debts or bills you have that were caused by the person in (2 ’s financial abuse. Check here if you want to list additional debts or bills that were caused by financial abuse. You can attach form MC-025 and write “Attachment 18a—Additional Debts” for a title. b. Describe what the person in 2 did to cause the debts and bills that you listed above. Provide as much detail as you can about the person in 2 ’s financial abuse. Check here if there is not enough space for your answer.

Put your complete answer on an attached sheet of paper or form MC-025 and write “Attachment 18b—How Debt Was Incurred” for a title. 17 If you want there to be less than five days between service and the hearing, explain why: Request to Give Less Than Five Days' Notice of Hearing You must have your papers personally served on the person in 2 at least five days before the hearing, unless the court orders a shorter time for service. (Read form EA-200-INFO, What Is “Proof of Personal Service”?, to learn about serving legal papers.

Form EA-200, Proof of Personal Service, may be used to show the court that the papers have been served.) Check here if there is not enough space for your answer. Put your complete answer on an attached sheet of paper or form MC-025 and write “Attachment 17—Request to Give Less Than Five Days’ Notice” for a title.

Rev. January 1, 2026 Request for Elder or Dependent Adult Abuse Restraining Orders (Elder or Dependent Adult Abuse Prevention) Case Number: 19 Lawyer's Fees and Costs I ask the court to order payment of my lawyer’s fees court costs. The amounts requested are: Item Amount Item Amount $ $ $ $ $ $ Check here if there are more items. Put the items and amounts on an attached sheet of paper or form MC-025 and write “Attachment 19—Lawyer’s Fees and Costs” for a title. b.

That the person in 2 must stay at least yards away from, and not take, sell, transfer, encumber, conceal, molest, attack, strike, threaten, harm, or otherwise dispose of, the animals listed above. 20 Possession and Protection of Animals I ask the court to order the following: a. I request sole possession of the animals because (specify good cause for granting order): Check here if there is not enough space for your answer. Put your complete answer on an attached sheet of paper or form MC-025 and write “Attachment 20a—Possession of Animals” for a title.

That the person in 1 be given the sole possession, care, and control of the animals listed below, which they own, possess, lease, keep, or hold, or which reside in their household. (Identify animals by, e.g., type, breed, name, color, sex.) 21 No Fee to Serve Orders If you want the sheriff or marshal to serve (notify) the person in 2 about the orders for free, ask the court clerk what you need to do. This is not a Court Order. EA-100, Page 9 of 10

Rev. January 1, 2026 Request for Elder or Dependent Adult Abuse Restraining Orders (Elder or Dependent Adult Abuse Prevention) Case Number: 22 I ask the court to make the following additional orders (specify): Additional Orders Requested Check here if there is not enough space for your answer.

Put your complete answer on an attached sheet of paper or form MC-025 and write “Attachment 22—Additional Orders Requested” for a title. 23 Number of pages attached to this form, if any: Date: Lawyer’s name (if any) Lawyer’s signature I declare under penalty of perjury under the laws of the State of California that the information above and on all attachments is true and correct. Date: Type or print your name Signature of person making this request This is not a Court Order. EA-100, Page 10 of 10

Form Approved for Optional Use Judicial Council of California MC-030 [Rev. January 1, 2006] DECLARATION Plaintiff Other (Specify): DefendantAttorney for Date: (SIGNATURE OF DECLARANT)(TYPE OR PRINT NAME) I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

MC-030 FOR COURT USE ONLYATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FAX NO. (Optional):TELEPHONE NO.: EMAIL ADDRESS: ATTORNEY FOR (Name): PLAINTIFF/PETITIONER: DEFENDANT/RESPONDENT: DECLARATION CASE NUMBER: Petitioner Respondent Page 1 of 1 SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, HALL OF JUSTICE, 330 W BROADWAY, SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E. MAIN, EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910

Judicial Council of California, courts.ca.gov Rev. January 1, 2026, Mandatory Form Code Civ. Proc., §§ 527.9, 527.11; Welf. & Inst. Code, § 15657.03 Approved by DOJ Temporary Restraining Order (CLETS-TEA or TEF) (Elder or Dependent Adult Abuse Prevention) EA-110 Temporary Restraining Order Clerk stamps date here when form is filed. Fill in court name and street address: Superior Court of California, County of San Diego Court fills in case number when form is filed. Case Number: Person in 1 must complete 1 , 2 , and 3 only. 1 Protected Elder or Dependent Adult a.

Full Name: Person requesting protection for the elder or dependent adult, if different (person named in item 3 of form EA-100): Full Name: Lawyer for person named above (if any, for this case): Name: State Bar No.: Firm Name: b. Your Address (If you have a lawyer, give your lawyer’s information. If you do not have a lawyer and want to keep your home address private, you may give a different mailing address instead. You do not have to give telephone, fax, or email.): Address: City: State: Zip: Telephone: Fax: Email Address: 2 Restrained Person (Give all the information you know.

Information with a star (*) is required to add this order to the California police database. If age is unknown, give an estimate.) *Full Name: *Age: Date of Birth: *Race: Height: Weight: Hair Color: Eye Color: *Gender: M F Nonbinary Home Address: City: State: Zip: Relationship to Protected Person: 3 Additional Protected Persons In addition to the elder or dependent adult named in 1 , the following family or household members or conservator of that person are protected by the temporary orders indicated below: Full Name Gender Age Household Member?

Relation to Protected Person Yes No Yes No Check here if there are additional protected persons. List them on an attached sheet of paper and write “Attachment 3—Additional Protected Persons” as a title. You may use form MC-025, Attachment. 4 Expiration Date This order expires at the end of the hearing scheduled for the date and time below: Date: Time: a.m. p.m. This is a Court Order. EA-110, Page 1 of 7 MC-025 CENTRAL DIVISION, HALL OF JUSTICE, 330 W. BROADWAY, SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S.

MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910

Rev. January 1, 2026 Temporary Restraining Order (CLETS-TEA or TEF) (Elder or Dependent Adult Abuse Prevention) Case Number: To the Person in 2 :2 The court has issued the temporary orders checked as granted below. If you do not obey these orders, you can be arrested and charged with a crime. You may have to go to jail for up to one year, pay a fine of up to $1,000, or both. 5 Personal Conduct Orders Not Requested Denied Until the Hearing Granted as Follows: a. You must not do the following things to the elder or dependent adult named in 1 and to the other protected persons listed in 3 :

(1) Physically abuse, financially abuse, intimidate, molest, attack, strike, stalk, threaten, assault (sexually or otherwise), hit, harass, destroy personal property of, or disturb the peace of the person.

(2) Contact the person, either directly or indirectly, in any way, including, but not limited to, in person, by telephone, in writing, by public or private mail, by interoffice mail, by email, by text messages, by fax, or by other electronic means.

(3) Take any action to obtain the person’s address or location. If this item (3) is not checked, the court has found good cause not to make this order.

(4) Other (specify): Other personal conduct orders are attached at the end of this order on Attachment 5a(4). b. Peaceful written contact through a lawyer or a process server or other person for service of legal papers related to a court case is allowed and does not violate this order. However, you may have your papers served by mail on the person in 1 . 6 Stay-Away Orders Not Requested Denied Until the Hearing Granted as Follows: a. You must stay at least yards away from (check all that apply):

(1) The elder or dependent adult in 1

(2) Each person in 3

(3) The home of the elder or dependent adult

(4) The job or workplace of the elder or dependent adult

(5) The vehicle of the person in 1

(6) Other (specify): b. This stay-away order does not prevent you from going to or from your home or place of employment. 7 Move-Out Order Not Requested Denied Until the Hearing Granted as Follows: You must immediately move out from and not return to (address): This is a Court Order. EA-110, Page 2 of 7

Rev. January 1, 2026 Temporary Restraining Order (CLETS-TEA or TEF) (Elder or Dependent Adult Abuse Prevention) Case Number: 8 No Firearms (Guns), Firearm Parts, or Ammunition Not Issued (financial abuse only) Granted as Follows: This order must be granted unless only financial abuse is alleged. a. You cannot own, possess, have, buy or try to buy, receive or try to receive, or in any other way get any prohibited items listed in b below. b. Prohibited items are:

(1) Firearms (guns);

(2) Firearm parts, meaning receivers, frames, or any item that may be used as or easily turned into a receiver or frame (see Penal Code

section 16531); and

(3) Ammunition. c. You must:

(1) Sell to or store with a licensed gun dealer, or turn in to a law enforcement agency, any firearms (guns), firearm parts, and ammunition in your immediate possession or control. This must be done within 24 hours of being served with this order.

(2) File a receipt with the court within 48 hours of receiving this order that proves that your firearms (guns), firearm parts, and ammunition have been turned in, sold, or stored. (You may use form EA-800, Receipt for Firearms, Firearm Parts, and Ammunition, for the receipt.) d. The court has received information that you own or possess a firearm (gun), firearm parts, or ammunition. 9 Restrained Person Has Prohibited Items The court finds that you have the following prohibited items: a.

Firearms and/or firearm parts Description (include serial number, if known) Location, if known Proof of compliance received by the court (1) (date): (2) (date): (3) (date): (4) (date): b. Ammunition Description Amount, if known Location, if known Proof of compliance received by the court (1) (date): (2) (date): (3) (date): (4) (date): Check here to list additional items.

List them on a separate piece of paper, write “EA-110, Restrained Person Has Prohibited Items” at the top, and attach it to this form. 10 No Body Armor If the order in 8 is granted, you cannot own, possess, or buy body armor (defined in Penal Code

section 16288). You must relinquish any body armor you have in your possession. This is a Court Order. EA-110, Page 3 of 7

Rev. January 1, 2026 Temporary Restraining Order (CLETS-TEA or TEF) (Elder or Dependent Adult Abuse Prevention) Case Number: 11 Court Hearing to Review Firearms (Guns), Firearm Parts, and Ammunition Compliance In addition to the hearing listed on form EA-109, you must attend the court hearing listed below to prove that you have properly turned in, sold, or stored all prohibited items (described in 8

b) you still have or own, including any items listed in 9 . If you do not attend the court hearing listed below, a judge may find that you have violated the restraining order and notify law enforcement and a prosecuting attorney of the violation. Date: Dept.: Time: Room: Name and address of court, if different than court address listed on page 1: 12 involve solely financial abuse unaccompanied by force, threat, harassment, intimidation, or any other form of abuse. Financial Abuse This case does not does 13 Possession and Protection of Animals Not Requested Denied Until the Hearing Granted as Follows (specify): a.

The person in 1 is given the sole possession, care, and control of the animals listed below, which are owned, possessed, leased, kept, or held by them, or reside in their household. (Identify animals by, e.g., type, breed, name, color, sex.) b. The person in 2 must stay at least yards away from, and not take, sell, transfer, encumber, conceal, molest, attack, strike, threaten, harm, or otherwise dispose of, the animals listed above. 14 Other Orders Not Requested Denied Until the Hearing Granted as Follows (specify): Additional orders are attached at the end of this order on Attachment 14. This is a Court Order.

EA-110, Page 4 of 7

Rev. January 1, 2026 Temporary Restraining Order (CLETS-TEA or TEF) (Elder or Dependent Adult Abuse Prevention) Case Number: To the Person in :1 15 Mandatory Entry of Order Into CARPOS Through CLETS This order must be entered into the California Restraining and Protective Order System (CARPOS) through the California Law Enforcement Telecommunications System (CLETS). (Check one): a. The clerk will enter this order and its proof of service form into CARPOS. b. The clerk will transmit this order and its proof of service form to a law enforcement agency to be entered into CARPOS. c.

By the close of business on the date that this order is made, the petitioner or the petitioner’s lawyer should deliver a copy of the order and its proof of service form to the law enforcement agencies listed below to enter into CARPOS: Name of Law Enforcement Agency Address (City, State, Zip) Additional law enforcement agencies are listed at the end of this order on Attachment 15. 16 No Fee to Serve (Notify) Restrained Person If the sheriff or marshal serves this order, the sheriff or marshal will do so for free. 17 Number of pages attached to this order, if any: Date: Judicial Officer Warnings and Notices to the Restrained Person in 2 You Cannot Have Firearms (Guns), Firearm Parts, or Ammunition If the court grants the orders in 8 , you cannot own, have, possess, buy or try to buy, receive or try to receive, or otherwise get any prohibited items listed in 8 b on page 3 while this order is in effect.

If you do, you can go to jail and pay a $1,000 fine. You must sell to or store with a licensed gun dealer, or turn in to a law enforcement agency, any firearms (guns), firearm parts, and ammunition that you have or control as stated in 8 . The court will require you to prove that you did so.

Notice Regarding Nonappearance at Hearing and Service of Order If you have been personally served with this Temporary Restraining Order and form EA-109, Notice of Court Hearing, but you do not appear at the hearing either in person or by a lawyer, and a restraining order that does not differ from this order except for the expiration date is issued at the hearing, a copy of the order will be served on you by mail at the address in 2 .

If this address is not correct or you wish to verify that the temporary restraining order was converted into a restraining order at the hearing without substantive change, or to find out the duration of the order, contact the clerk of the court. This is a Court Order. EA-110, Page 5 of 7

Rev. January 1, 2026 Temporary Restraining Order (CLETS-TEA or TEF) (Elder or Dependent Adult Abuse Prevention) Case Number: After You Have Been Served With a Restraining Order Obey all the orders. Read form EA-120-INFO, How Can I Respond to a Request for Elder or Dependent Adult Abuse Restraining Orders?, to learn how to respond to this order. If you want to respond, fill out form EA-120, Response to Request for Elder or Dependent Adult Abuse Restraining Orders, and file it with the court clerk. You do not have to pay any fee to file your response.

You must have form EA-120 served on the person in 1 (the person asking the court for protection of the elder or dependent adult or the elder or dependent adult if no other person is named in that item), or that person’s attorney, by mail. You cannot do this yourself. The person who does the mailing should complete and sign form EA-250, Proof of Service of Response by Mail. File the completed proof of service with the court clerk before the hearing date or bring it with you to the hearing.

In addition to the response, you may file and have declarations served signed by you and other persons who have personal knowledge of the facts. You may use form MC-030, Declaration, for this purpose. It is available from the clerk’s office at the court shown on page 1 of this form or at courts.ca.gov/rules-forms/find-your-court-forms. If you do not know how to prepare a declaration, you should see a lawyer. Whether or not you file a response, you should attend the hearing. If you have any witnesses, they must also go to the hearing.

At the hearing, the judge can make restraining orders against you that last for up to five years. Tell the judge why you disagree with the orders requested. Enforcing the Restraining Order This order is enforceable by any law enforcement agency that has received the order, is shown a copy of the order, or has verified its existence on the California Restraining and Protective Order System (CARPOS). If the law enforcement agency has not received proof of service on the restrained person, the agency must advise the restrained person of the terms of the order and then must enforce it.

Violations of this order are subject to criminal penalties. Start Date and End Date of Orders This order starts on the date next to the judge’s signature on page 4. The order ends on the expiration date in on page 1. 4 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. Agencies are encouraged to enter violation messages into CARPOS. Notice/Proof of Service The law enforcement agency must first determine if the restrained person had notice of the order. Consider the restrained person “served” (given notice) if (Pen. Code, § 836(c)(2)): 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 informed of the order by an officer. An officer can obtain information about the contents of the order and proof of service in CARPOS.

If proof of service on the restrained person cannot be verified, the agency must advise the restrained person of the terms of the order and then enforce it. Instructions for Law Enforcement This is a Court Order. EA-110, Page 6 of 7

Rev. January 1, 2026 Temporary Restraining Order (CLETS-TEA or TEF) (Elder or Dependent Adult Abuse Prevention) Case Number: If the Protected Person Contacts the Restrained Person Even if the protected person invites or consents to contact with the restrained person, this order remains in effect and must be enforced. The protected person cannot be arrested for inviting or consenting to contact with the restrained person. The order can be changed only by another court order. (Pen.

Code, § 13710(b).) Conflicting Orders—Priorities for Enforcement If more than one restraining order has been issued protecting the protected person from the restrained person, the orders must be enforced in the following priority (see Pen. Code, § 136.2; Fam. Code, §§ 6383(h)(2), 6405(b); Code Civ. Proc., § 527.12(d)(2)): 1. Emergency Protective Order (EPO): If one of the orders is an Emergency Protective Order (form EPO-001), provisions (e.g., stay-away order) that are more restrictive than in the other restraining/protective orders must be enforced.

Provisions of another order that do not conflict with the EPO must also be enforced. 2. No-Contact Order: If a restraining/protective order includes a no-contact order, the no-contact order must be enforced. 5 a(2) is an example of a no-contact order. 3. Criminal Protective Order (CPO): If none of the orders includes an EPO or a no-contact order, the most recent CPO must be enforced. (Fam. Code, §§ 6383(h)(2), 6405(b); Code Civ.

Proc., § 527.12(d)(2).) Additionally, a CPO issued in a criminal case involving charges of domestic violence, Penal Code sections 261, 261.5, or former 262, or charges requiring sex offender registration must be enforced over any civil court order. (Pen. Code, § 136.2(e)(2).) All provisions in the civil court order that do not conflict with the CPO must also be enforced. 4. Civil Restraining Orders: If there is more than one civil restraining order (e.g., domestic violence, juvenile, elder abuse, civil harassment), then the order that was issued last must be enforced.

Provisions that do not conflict with the most recent civil restraining order must also be enforced. —Clerk's Certificate— I certify that this Temporary Restraining Order is a true and correct copy of the original on file in the court. Clerk’s Certificate [seal] Clerk, by , Deputy (Clerk will fill out this part.) Date: This is a Court Order. EA-110, Page 7 of 7

Judicial Council of California, courts.ca.gov Rev. January 1, 2026, Mandatory Form Code Civ. Proc., § 527.9; Welf. & Inst. Code, § 15657.03 Approved by DOJ Notice of Court Hearing (Elder or Dependent Adult Abuse Prevention) EA-109 Notice of Court Hearing Clerk stamps date here when form is filed. Fill in court name and street address: Superior Court of California, County of San Diego Court fills in case number when form is filed. Case Number: 1 Elder or Dependent Adult in Need of Protection a.

Full Name: Person requesting protection for the elder or dependent adult, if different (person named in item 3 of form EA-100): Full Name: Lawyer for person named above (if any for this case): Name: State Bar No.: Firm Name: b. Address for person named above (If you have a lawyer, give your lawyer’s information. If you do not have a lawyer, give information for the person requesting the order. If you want to keep your home address private, you may give a different mailing address instead.

You do not have to give telephone, fax, or email.): Address: City: State: Zip: Telephone: Fax: Email Address: 2 Person You Want Protection From Full Name: The court will complete the rest of this form. 3 Notice of Hearing A court hearing is scheduled on the request for restraining orders against the person in 2 : Name and address of court if different from above: Hearing Date Date: Time: Dept.: Room: If you attend the hearing (in person, by phone, or by videoconference) and the judge grants a restraining order against you, the order will be effective immediately, and you could be arrested if you violate the order.

If you do not attend the hearing, the judge may still grant the restraining order that could last up to five years. After you receive a copy of the order, you could be arrested if you violate the order. To the person in 2 : 4 Temporary Restraining Orders (Any orders granted are on form EA-110, served with this notice.) a. Temporary restraining orders for personal conduct and stay-away orders as requested in form EA-100, Request for Elder or Dependent Adult Abuse Restraining Orders,a r e (check only one box below):

(1) All GRANTED until the court hearing.

(2) All DENIED until the court hearing. (Specify reasons for denial in b, below.)

(3) Partly GRANTED and partly DENIED until the court hearing. (Specify reasons for denial in 4 b, below.) EA-109, Page 1 of 3 CENTRAL DIVISION, HALL OF JUSTICE, 330 W. BROADWAY, SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910

Rev. January 1, 2026 Notice of Court Hearing (Elder or Dependent Adult Abuse Prevention) Case Number: 4 Temporary Restraining Orders (Continued) b. Reasons for denial of some or all of those personal conduct and stay-away orders as requested in form EA-100, Request for Elder or Dependent Adult Abuse Restraining Orders, are:

(1) The facts as stated in form EA-100 do not sufficiently show reasonable proof of a past act or acts of abuse of the elder or dependent adult by the person in 2 .

(2) Other (specify): As stated on Attachment 4b. 5 Service of Documents by the Person in 1 At least days before the hearing, someone age 18 or older—not you or anyone to be protected—must personally give (serve) a court file-stamped copy of this form EA-109, Notice of Court Hearing, to the person in 2 along with a copy of all the forms indicated below: five a. EA-100, Request for Elder or Dependent Adult Abuse Restraining Orders (file-stamped) b. EA-110, Temporary Restraining Order (file-stamped) IF GRANTED c. EA-120, Response to Request for Elder or Dependent Adult Abuse Restraining Orders (blank form) d. e.

EA-120-INFO, How Can I Respond to a Request for Elder or Dependent Adult Abuse Restraining Orders? Other(specify): Date: Judicial Officer To the Person in 1 :1 The court cannot make the restraining orders after the court hearing unless the person in 2 has been personally given (served) a copy of your request and any temporary orders. To show that the person in 2 has been served, the person who served the forms must fill out a proof of service form. Form EA-200, Proof of Personal Service, may be used. For information about service, read form EA-200-INFO, What Is “Proof of Personal Service”?

You may ask to reschedule the hearing if you are unable to find the person in 2 and need more time to serve the documents, or for other good reasons. Read form EA-115-INFO, How to Ask for a New Hearing Date. You must attend the hearing if you want the judge to make any of the orders you requested on form EA-100, Request for Elder or Dependent Adult Abuse Restraining Orders. Bring any evidence or witnesses you have. For more information, read form EA-100-INFO, Can a Restraining Order to Prevent Elder or Dependent Adult Abuse Help Me? EA-109, Page 2 of 3

Rev. January 1, 2026 Notice of Court Hearing (Elder or Dependent Adult Abuse Prevention) Case Number: To the Person in 2 :2 If you want to respond to the request for orders in writing, file form EA-120, Response to Request for Elder or Dependent Adult Abuse Restraining Orders, and have someone age 18 or older—not you or anyone to be protected— mail it to the person in 1 . The person who mailed the form must fill out a proof of service form. Form EA-250, Proof of Service of Response by Mail, may be used. File the completed form with the court before the hearing and bring a copy with you to the court hearing.

Whether or not you respond in writing, go to the hearing if you want the judge to hear from you before making an order. You may tell the judge why you agree or disagree with the orders requested. You may bring witnesses and other evidence. At the hearing, the judge may make restraining orders against you that could last up to five years and may order you to sell or turn in any firearms (guns), firearm parts, and ammunition that you own or possess. This includes firearm receivers and frames, and any item that may be used as or easily turned into a receiver or frame (see Penal Code

section 16531). If an order is granted, you will also be prohibited from owning, possessing, or buying body armor and will have to relinquish any body armor you have. If you are unable to attend your court hearing or need more time to prepare your case, you may ask to reschedule your court date. Read form EA-115-INFO, How to Ask for a New Hearing Date. Request 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 hearing.

Contact the clerk’s office or go to courts.ca.gov/rules-forms/find-your-court-forms for Disability Accommodation Request (form MC-410). (Civ. Code, § 54.8.) (Clerk will fill out this part.) —Clerk's Certificate— I certify that this Notice of Court Hearing is a true and correct copy of the original on file in the court. Clerk’s Certificate [seal] Date: Clerk, by , Deputy EA-109, Page 3 of 3

Confidential Information for Law Enforcement Judicial Council of California, courts.ca.gov Rev. January 1, 2026, Mandatory Form Cal. Rules of Court, rule 1.51 CLETS-001, Page 1 of 2 CLETS-001 Confidential Information for Law Enforcement Instructions: • If you are asking for a restraining order, you must complete this form and give it to the court clerk, along with the other court forms required in your case.

For juvenile orders, list the primary protected person’s information in 2 and 3 . • If the judge grants the restraining order, information you give on this form will be entered into a California database (called CLETS) to help law enforcement enforce the order. • If information changes later, you may complete this form again and turn it in to the court. To Court Clerk: Do not file this form. The information on this form must be entered into the protective order registry in CLETS. Court fills in case number when form is received.

Case Number: Date received by court: Information that has a star (*) next to it is required. All other information is helpful. 1 Person You Want a Restraining Order Against *Name: Other names used: Marks, scars, or tattoos: SSN:Driver’s license (number and state): Vehicle type: Model: Year: Plate number: Name of employer and address: Does the person speak English? Yes I don’t know No (list language): Does the person have any firearms (guns), firearm parts, ammunition, or body armor?

No I don’t know Yes (Give any information you have below, like the type, amount, or location of any items, if known.) Telephone: This is not a Court Order—Do not place in court file.

Confidential Information for Law EnforcementRev. January 1, 2026 CLETS-001, Page 2 of 2 (Skip and if you are asking for a gun violence (form GV-100) or retail crime (form RT-100) restraining order.)3 4 3 Your Information *Age: Date of Birth (month, day, year): (If the judge grants your restraining order, your information will be entered into California’s law enforcement database. If you give your date of birth, it will also be entered into the federal law enforcement database.

If your information is not in the federal law enforcement database, your restraining order may be more difficult to enforce outside of California.) 4 Other People You Want Protected *Name: *Gender: Race: Date of Birth: *Name: *Gender: Race: Date of Birth: *Name: *Gender: Race: Date of Birth: *Name: *Gender: Race: Date of Birth: Check here if you have more people to list. Write them on a separate piece of paper, write “Item 4” at the top, and attach it to this form. Telephone: No (list language): Do you speak English? Yes This is not a Court Order—Do not place in court file.

X (nonbinary)*Gender: M F Race: Case Number: 2 *Your Name:

SDSC D-072 (Rev. 9/21) ORDER FOR REMOVAL FROM RESIDENCE (DOMESTIC VIOLENCE – ELDER/DEPENDENT ABUSE) ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): TELEPHONE NO.: FAX NO. (Optional): EMAIL ADDRESS (Optional): ATTORNEY FOR (Name): FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, CENTRAL COURTHOUSE, 1100 UNION ST., SAN DIEGO, CA 92101 CENTRAL DIVISION, HALL OF JUSTICE, 330 W. BROADWAY, SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910 PETITIONER(

S) RESPONDENT(

S) JUDGE/DEPT ORDER FOR REMOVAL FROM RESIDENCE (DOMESTIC VIOLENCE – ELDER/DEPENDENT ABUSE) CASE NUMBER TO: SAN DIEGO COUNTY SHERIFF Pursuant to the following TRO/RO issued on : Temporary Restraining Order (CLETS-TRO) (Domestic Violence Prevention) (JC Form #DV-110) Temporary Restraining Order (CLETS-TEA or TEF) (Elder or Dependent Adult Abuse Prevention) (JC Form #EA-110) Restraining Order After Hearing (CLETS-OAH) (Order of Protection) (Domestic Violence Prevention) (JC Form #DV-130) Elder or Dependent Adult Abuse Restraining Order After Hearing (CLETS-EAR or EAF) (Elder or Dependent Adult Abuse Prevention) (JC Form #EA-130) YOU ARE ORDERED to remove (name of party to be removed): from the residence located at: Street California City State Zip Code YOU ARE FURTHER ORDERED to remain on the premises of said residence for a reasonable period in order to provide an opportunity for the removed party to take personal effects from those premises.

Date: Judge/Commissioner of the Superior Court CLERK'S CERTIFICATE The foregoing document, consisting of _____ page(s), is a full, true, and correct copy of the original copy on file in this office. Clerk of the Superior Court Date: by , Deputy

Judicial Council of California, courts.ca.gov Rev. July 1, 2026, Mandatory Form Cal. Rules of Court, rules 2.30, 3.220, 3.400–3.403, 3.740 Cal. Stds. Jud. Admin., std. 3.10 Civil Case Cover Sheet CM-010 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FAX NO. (Optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, HALL OF JUSTICE, 330 W. BROADWAY, SAN DIEGO, CA 92101 CENTRAL DIVISION, JUVENILE COURT, 2851 MEADOW LARK DR., SAN DIEGO, CA 92123 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S.

MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910 CASE NAME: CIVIL CASE COVER SHEET Unlimited (Amount demanded exceeds $35,000) Limited (Amount demanded is $35,000 or less) Complex Case Designation Counter Joinder Filed with first appearance by defendant (Cal. Rules of Court, rule 3.402) FOR COURT USE ONLY CASE NUMBER: JUDGE: DEPT.: Items 1–6 below must be completed (see instructions on page 2 and examples on page 3). 1. Check one box below for the case type that best describes this case: Auto Tort Auto

(22) Uninsured motorist

(46) Asbestos Asbestos

(04) Other PI/PD/WD (Personal Injury/Property Damage/Wrongful Death) Tort Product liability

(24) Medical malpractice

(45) Other PI/PD/WD

(23) Non-PI/PD/WD (Other) Tort Business tort/Unfair business practice

(07) Civil rights

(08) Defamation

(13) Fraud

(16) Intellectual property

(19) Professional negligence

(25) Other non-PI/PD/WD tort

(35) Employment Wrongful termination

(36) Other employment

(15) Contract Breach of contract/warranty

(06) Rule 3.740 collections

(09) Other collections

(09) Insurance coverage

(18) Other contract

(37) Song-Beverly Act: Motor Vehicle Lemon Law

(49) Real Property Eminent domain/Inverse condemnation

(14) Wrongful eviction

(33) Other real property

(26) Unlawful Detainer Commercial

(31) Residential

(32) Drugs

(38) Judicial Review Asset forfeiture

(05) Petition re arbitration award

(11) Writ of mandate

(02) Other judicial review

(39) Employment Development Department (EDD) EDD decision review

(48) Provisionally Complex Civil Litigation (Cal. Rules of Court, rules 3.400–3.404) Antitrust/Trade regulation

(03) Construction defect

(10) Mass tort

(40) Securities litigation

(28) Environmental/Toxic tort

(30) Comprehensive groundwater adjudication

(47) Insurance coverage claims arising from the above listed provisionally complex case types

(41) Enforcement of Judgment Enforcement of judgment

(20) Miscellaneous Civil Complaint RICO

(27) Other complaint (not specified above)

(42) Miscellaneous Civil Petition Partnership and corporate governance

(21) Other petition (not specified above)

(43) CM-010, Page 1 of 3 TELEPHONE NO.: EMAIL ADDRESS: ATTORNEY FOR (Name):

Rev. July 1, 2026 Civil Case Cover Sheet CM-010 2. Yes NoIs this case complex under rule 3.400 of the California Rules of Court? If the case is complex, mark the factors requiring exceptional judicial management: a. Large number of separately represented parties b. Extensive motion practice raising difficult or novel issues that will be time-consuming to resolve c. Substantial amount of documentary evidence d. Large number of witnesses e. Coordination with related actions pending in one or more courts in other counties, states, or countries, or in a federal court f.

Substantial postjudgment judicial supervision 3. Remedies sought (check all that apply): a. monetary b. nonmonetary; declaratory or injunctive relief c. punitive 4. Number of causes of action (specify): 5. Is this case a class action suit? Yes No 6.

If there are any known related cases, file and serve a notice of related case. (You may use form CM-015.) Date: Type or print name Signature of party or attorney for party Plaintiff must file this cover sheet with the first paper filed in the action or proceeding (except small claims cases or cases filed under the Probate Code, Family Code, or Welfare and Institutions Code). (Cal. Rules of Court, rule 3.220.) Failure to file may result in sanctions. File this cover sheet in addition to any cover sheet required by local court rule.

If this case is complex under rule 3.400 et seq. of the California Rules of Court, or a collections case under rule 3.740, you must serve a copy of this cover sheet on all other parties to the action or proceeding. (Cal. Rules of Court, rule 3.220.) Unless this is a collections case under rule 3.740 or a complex case, this cover sheet will be used for statistical purposes only. NOTICE INSTRUCTIONS ON HOW TO COMPLETE THE COVER SHEET To Plaintiffs and Others Filing First Papers.

If you are filing a first paper (for example, a complaint) in a civil case, you must complete and file, along with your first paper, the Civil Case Cover Sheet contained on pages 1 and 2. This information will be used to compile statistics about the types and numbers of cases filed. You must complete items 1 through 6 on the sheet. In item 1, you must check one box for the case type that best describes the case. If the case fits both a general and a more specific type of case listed in item 1, check the more specific one.

If the case has multiple causes of action, check the box that best indicates the primary cause of action. To assist you in completing the sheet, examples of the cases that belong under each case type in item 1 are provided on page 3 of this form. A cover sheet must be filed only with your initial paper. Failure to file a cover sheet with the first paper filed in a civil case may subject a party, its counsel, or both to sanctions under rules 2.30 and 3.220 of the California Rules of Court. To Parties in Rule 3.740 Collections Cases.

A "collections case" under rule 3.740 of the California Rules of Court is defined as an action for recovery of money owed in a sum stated to be certain that is not more than $35,000, exclusive of interest and attorney's fees, arising from a transaction in which property, services, or money was acquired on credit. A collections case does not include an action seeking the following: (1) tort damages, (2) punitive damages, (3) recovery of real property, (4) recovery of personal property, or (5) a prejudgment writ of attachment.

The identification of a case as a rule 3.740 collections case on this form means that it will be exempt from the general time-for-service requirements and case management rules, unless a defendant files a responsive pleading. A rule 3.740 collections case will be subject to the requirements for service and obtaining a judgment in rule 3.740. To Parties in Complex Cases. In complex cases only, parties must also use the Civil Case Cover Sheet to designate whether the case is complex.

If a plaintiff believes the case is complex under rule 3.400 of the California Rules of Court, this must be indicated by completing the appropriate boxes in items 1 and 2. If a plaintiff designates a case as complex, the cover sheet must be served with the complaint on all parties to the action. A defendant may file and serve no later than the time of its first appearance a joinder in the plaintiff's designation, a counter-designation that the case is not complex, or, if the plaintiff has made no designation, a designation that the case is complex. SEE PAGE 3 FOR INFORMATION PURPOSES ONLY. CM-010, Page 2 of 3

Rev. July 1, 2026 Civil Case Cover Sheet CM-010 CASE TYPES AND EXAMPLES Auto Tort Auto (22)–Personal Injury/Property Damage/ Wrongful Death Uninsured Motorist (if the case involves an uninsured motorist claim subject to arbitration, check this item instead of Auto)

(46) Asbestos Asbestos

(04) Asbestos Property Damage Asbestos Personal Injury/Wrongful Death Other PI/PD/WD (Personal Injury/ Property Damage/Wrongful Death) Tort Product Liability (not asbestos or environmental/toxic tort)

(24) Medical Malpractice

(45) Medical Malpractice–Physicians & Surgeons Other Professional Health Care Malpractice Other PI/PD/WD

(23) Premises Liability (e.g., slip and fall) Intentional Bodily Injury/PD/WD (e.g., assault, vandalism) Intentional Infliction of Emotional Distress Negligent Infliction of Emotional Distress Other PI/PD/WD Non-PI/PD/WD (Other) Tort Business Tort/Unfair Business Practice

(07) Civil Rights (e.g., discrimination, false arrest) (not civil harassment)

(08) Defamation (e.g., slander, libel)

(13) Fraud (other than contract)

(16) Intellectual Property

(19) Professional Negligence

(25) Legal Malpractice Other Professional Malpractice (not medical) Other Non-PI/PD/WD Tort

(35) Employment Wrongful Termination

(36) Other Employment

(15) Contract Breach of Contract/Warranty

(06) Breach of Rental/Lease Contract (not unlawful detainer or wrongful eviction) Contract/Warranty Breach–Seller Plaintiff (not fraud) Negligent Breach of Contract/Warranty Other Breach of Contract/Warranty Song-Beverly Act: Motor Vehicle Lemon Law (check this item if the case involves a Song- Beverly Act claim regarding a motor vehicle)

(49) Rule 3.740 Collections (as defined in Cal. Rules of Court, rule 3.740(a))

(09) Other Collections (e.g., money owed, open book accounts, promissory note)

(09) Insurance Coverage (not provisionally complex)

(18) Auto Subrogation Other Coverage Other Contract

(37) Contractual Fraud Other Contract Dispute Real Property Eminent Domain/Inverse Condemnation

(14) Wrongful Eviction

(33) Other Real Property (e.g., quiet title)

(26) Writ of Possession of Real Property Mortgage Foreclosure Quiet Title Other Real Property (not unlawful detainer) Unlawful Detainer Commercial

(31) Residential

(32) Drugs (if the case involves illegal drugs, check this item; otherwise, choose Commercial or Residential)

(38) Judicial Review Asset Forfeiture

(05) Petition re Arbitration Award

(11) Writ of Mandate

(02) Writ–Administrative Mandamus Writ–Mandamus on Limited Court Case Matter Writ–Other Limited Court Case Review Other Judicial Review

(39) Review of Health Officer Order Notice of Appeal–Labor Commissioner Appeals Employment Development Department (EDD) EDD Decision Review (if the case involves an Employment Development Department decision, check this item instead of wrongful termination or other employment)

(48) Provisionally Complex Civil Litigation (Cal. Rules of Court, rules 3.400–3.404) Antitrust/Trade Regulation

(03) Construction Defect

(10) Mass Tort

(40) Securities Litigation

(28) Environmental/Toxic Tort

(30) Comprehensive Groundwater Adjudication

(47) Insurance Coverage Claims (arising from provisionally complex case type listed above)

(41) Enforcement of Judgment Enforcement of Judgment

(20) Abstract of Judgment (Out of County) Confession of Judgment (non-domestic relations) Sister-State Judgment Administrative Agency Award Petition/Certification of Entry of Judgment on Unpaid Taxes Other Enforcement of Judgment Case Miscellaneous Civil Complaint RICO

(27) Other Complaint (not specified above)

(42) Declaratory Relief Only Injunctive Relief Only (non-harassment) Mechanic's Lien Other Commercial Complaint Case (non-tort/non-complex) Other Civil Complaint (non-tort/ non-complex) Miscellaneous Civil Petition Partnership and Corporate Governance

(21) Other Petition (not specified above)

(43) Civil Harassment Workplace Violence Elder/Dependent Adult Abuse Election Contest Petition for Name Change Petition for Relief From Government Claim Requirement Other Civil Petition The list below provides explanations and examples for the case type checkboxes listed in item 1 on this form. The lists of examples below are not meant to be exhaustive, and some case types may have causes of action not listed here. CM-010, Page 3 of 3

SDSC CIV-385 (Rev. 1/26) INSTRUCTIONS FOR REQUSTING TO CONTINUE Informational Form HEARING ON RESTRAINING ORDER SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO INSTRUCTIONS FOR REQUESTING TO CONTINUE HEARING ON RESTRAINING ORDER Protected or restrained persons may request to continue the hearing on restraining order by following the process for the location where the hearing is scheduled as indicated below.

The following forms are required: Civil Harassment • Request to Continue Hearing (JC Form #CH-115) • Order on Request to Continue Hearing (JC Form #CH-116) Elder or Dependent Adult Abuse • Request to Continue Hearing (JC Form #EA-115) • Order on Request to Continue Hearing (JC Form #EA-116) Gun Violence • Request to Continue Court Hearing for Gun Violence Restraining Order (JC Form #GV-115) • Order on Request to Continue Hearing (JC Form #GV-116) Postsecondary School Violence • Request to Continue Hearing (JC Form #SV-115) • Order on Request to Continue Hearing (JC Form #SV-116) Workplace Violence • Request to Continue Hearing (JC Form #WV-115) • Order on Request to Continue Hearing (JC Form #WV-116) Parties may request to continue the hearing by either appearing on the day of the hearing or appearing ex parte prior to the scheduled hearing date.

Instructions for Appearing Ex Parte Central Division An ex parte hearing may be scheduled by calling (619) 450-7275 and requesting to be transferred to Department 61. Notice of the ex parte hearing must be provided by a third party to the opposing party/ attorney no later than 10:00 a.m. the court day prior to the ex parte appearance. In addition to the required forms listed above, the requesting party must also complete and submit an Ex Parte Application (SDSC Form #ADM-252) to the courtroom clerk upon checking-in. East County Division An ex parte hearing may be heard on a walk -in basis.

The required forms listed above must be submitted in the Business Office prior to 3:00 p.m. North County Division An ex parte hearing may be heard on a walk -in basis. The required forms listed above must be submitted in the Business Office prior to 3:00 p.m. South County Division An ex parte hearing may be scheduled at the counter in the Business Office or by calling (619) 746-6200 the day before the requested hearing date. Notice of the ex parte hearing must be provided by a third party to the opposing party/attorney no later than 10:00 a.m. the court day prior to the ex parte appearance.

In addition to the required forms listed above, the requesting party must also complete and submit an Ex Parte Application (SDSC Form #ADM-252) and a declaration of notice and drop them off in the Ex Parte Box no later than 12:00 p.m. the day before the scheduled ex parte hearing.

EA-115-INFO How to Ask for a New Hearing Date You may need to ask for a new court date if: What does form EA-115 do? Use Request to Continue Hearing (form EA-115) to ask the court to reschedule your court date. If your court date is rescheduled and a Temporary Restraining Order (TRO; form EA-110) was granted, the TRO will be extended until the end of your new court date unless the court decides to modify or terminate it. “Extend” means to keep any temporary orders in effect until the new hearing date. Follow these steps: • Fill out all of form EA-115. • • The judge will need to review your papers.

In some courts, you must give your papers to the clerk. Ask the court clerk for information on how you ask the judge to review your papers. • After you turn in your forms as required by your local court, check with the clerk’s office to see if the judge approved (granted) your request to reschedule your court date. • If the judge signed form EA-116 , you will have a new court date. If the judge did NOT sign the form, you should go to court at the date, time, and location on form EA-109. • Next, file both forms EA-115 and EA-116 with the clerk. The clerk will make up to three file-stamped copies for you.

Keep at least one copy to bring to your court date. • on form EA-116. • Ask the person who serves the papers to complete a proof of service form and give it to you. If service was in person, use Proof of Personal Service (form EA-200). If service was by mail, use Proof of Service—Civil (form POS-040). Make two copies of the completed forms. • If the court reschedules your court date and extends the TRO to the new court date, the clerk will send the TRO to law enforcement. It will be entered into a statewide computer system that lets police know about the order so that it can be enforced. Need help?

Ask the court clerk about free or low-cost legal help that may be available in your county.

How to Ask for a New Hearing Date (Elder or Dependent Adult Abuse Prevention) EA-115-INFO, Page 1 of 1 Go to your court date You are the person seeking protection and are unable to have Notice of Court Hearing (form EA-109) and other papers served in time before your court date. • File the completed and signed proof of service form with the clerk’s office before your court date.• If you are the person seeking protection and you do not go to your court date, your TRO will expire on the date and time of your court date. • • Take at least two copies of your documents and filed forms to your court date.

Include a filed proof of service form. “Documents” may include exhibits, declarations, and financial statements, and the court may enter into them evidence at its discretion. Judicial Council of California, www.courts.ca.gov Revised January 1, 2020, Optional Form Welfare and Institutions Code, § 15657.03(

n) You are the person to be restrained and making your first request to reschedule your court date. You have a good reason for needing a new court date. (The court may grant your request to reschedule on a showing of good cause.) • • If you are the person to be restrained and you do not go to the hearing, the court can still make orders against you that can last for up to five years. • 1 2 3 4 5 Fill out items 1 2 on Order on Request to Continue Hearing (form EA-116).and The other party must be served a copy of the court papers as described in item 6

Judicial Council of California, www.courts.ca.gov Revised January 1, 2020, Mandatory Form Welfare and Institutions Code, § 15657.03(

n) Request to Continue Court Hearing (Temporary Restraining Order) (Elder or Dependent Adult Abuse Prevention) This is not a Court Order. EA-115, Page 1 of 2 Clerk stamps date here when form is filed. Fill in court name and street address: Superior Court of California, County of San Diego Fill in case number: Case Number: EA-115 Request to Continue Court Hearing Instructions: Use this form to ask the court to reschedule the court date listed on form EA-109, Notice of Court Hearing. Read EA-115-INFO, How to Ask for a New Hearing Date, for more information.

I have a court date currently scheduled for (date): 2 Information About My Case (full name):The other party in this case isa. b. 1 Parties Information a. Protected party Restrained party (give your contact information below). I am the (check one of the boxes below): This address will be used by the court and other party to notify you in this case. If you want to keep your home address private, you can use another address like a post office box or another person's address if you have their permission. If you have a lawyer, give your lawyer's address and contact information.

Lawyer's information (skip if you do not have one): Name: State Bar No.: Firm Name: Address: Telephone: State: Zip: E-Mail Address: City: b. My contact information (optional): Fax: My name is: Address where I can receive mail: (3) (2) (name of elder or dependent adult): (1) (skip to ).2 (skip to ).2 Person asking for protection for the protected party CENTRAL DIVISION, HALL OF JUSTICE, 330 W. BROADWAY, SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910

Judicial Council of California, www.courts.ca.gov Revised January 1, 2020, Mandatory Form Welfare and Institutions Code, § 15657.03(

n) Request to Continue Court Hearing (Temporary Restraining Order) (Elder or Dependent Adult Abuse Prevention) This is not a Court Order. Case Number: EA-115, Page 2 of 2 I declare under penalty of perjury under the laws of the State of California that the information above is true and correct. Date: Type or print name of Sign your name Lawyer Party Without Lawyer 4 Why Does the Court Date Need to be Rescheduled? c. I am the restrained party and this is my first request to reschedule the court date.b. a. I need more time to have the restrained party personally served. Date the order was made, if known:Yes.

Notice: If the court date is rescheduled, the Temporary Restraining Order (form EA-110) will remain in effect until the end of the new court date unless otherwise ordered by the court. Is There a Temporary Restraining Order in Effect?3 No. Please attach a copy of the order if you have one. Other reason: I don t know.’

This is a Court Order. Order on Request to Continue Hearing (Temporary Restraining Order) (CLETS-TEA or TEF) (Elder or Dependent Adult Abuse Prevention)

(1) Any Temporary Restraining Order (form EA-110) already granted stays in full force and effect until the next court date. Next Court Date b. Clerk stamps date here when form is filed. Fill in court name and street address: Superior Court of California, County of San Diego Fill in case number: Case Number: 4 Order on Request to Continue HearingEA-116 Date: Time: Room:Dept.: New Court Date  Name and address of court, if different from above: EA-116, Page 1 of 3 3 The request to reschedule the court date is denied.a.

Warning and Notice to the Restrained Party: If 4 b is checked, an elder or dependent abuse restraining order has been issued against you. You must follow the orders until they expire. Your court date is: A TRO was not previously granted by the court. Temporary Restraining Order a. There is no Temporary Restraining Order (TRO) in this case until the next court date because:

(1) A Temporary Restraining Order (TRO) is still in full force and effect because:b. c. (specify):Other The court will complete the rest of the this form (2) (1)

(2) The court changes the TRO previously granted and signs a new TRO (form EA-110 ). (date) It now expires on (date): The court extends the TRO previously granted on : (If no date is listed, the TRO expires at the end of the court date listed in 3b.) 1 2 Protected Party: Restrained Party: The court terminates (cancels) the previously granted TRO because:

(2) Your court date is not rescheduled because: Judicial Council of California, www.courts.ca.gov Revised January 1, 2020, Mandatory Form Welfare and Institutions Code, § 15657.03(

n) Complete items 1 2 only.and The request to reschedule the court date is granted. Your court date is rescheduled for the day and time listed below. See 4 – 8 for more information. CENTRAL DIVISION, HALL OF JUSTICE, 330 W. BROADWAY, SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910

This is a Court Order. Order on Request to Continue Hearing (Temporary Restraining Order) (CLETS-TEA or TEF) (Elder or Dependent Adult Abuse Prevention) You must have the protected party served with a copy of this order. This can be done by mail. You must serve by You must have the restrained party served with a copy of this order. This can be done by mail. You must serve by Case Number: EA-116, Page 2 of 3 You do not have to serve the restrained party because they or their lawyer were at the court date or agreed to reschedule the court date. Serving (Giving) Order to Other Party6

(1) You must have the protected party personally served with a copy of this order by (2) (date): (date): Protected party Restrained partyb. Courtc. Further notice is not required. (1)

(2) You do not have to serve the protected party because they or their lawyer were at the court date or agreed to reschedule the court date. (1) (3) (4) (date): (3) (date): The request to reschedule was made by the: a.

(2) The court will mail a copy of this order to all parties by (date):

(3) Reason Court Date Is Rescheduled (2)

(1) This is the first time that the restrained party has asked for more time to prepare. 5 There is good cause to reschedule the court date (check one): b. c. The court reschedules the court date on its own motion. a. Other: Revised January 1, 2020

(4) Other: Other: Other: The protected party has not served the restrained party. You must have the restrained party personally served with a copy of this order and a copy of all documents listed on form EA-109 , item 5 , by

This is a Court Order. Order on Request to Continue Hearing (Temporary Restraining Order) (CLETS-TEA or TEF) (Elder or Dependent Adult Abuse Prevention) Request 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 hearing. Contact the clerk’s office or go to www.courts.ca.gov/forms.htm for Request for Accommodations by Persons With Disabilities and Response (form MC-410). (Civ.

Code, § 54.8.) —Clerk's Certificate— I certify that this Order on Request to Continue Hearing (Temporary Restraining Order) (CLETS-TEA or TEF) (form EA-116) is a true and correct copy of the original on file in the court. Clerk’s Certificate [seal] Clerk, by: , DeputyDate: Date: Judicial Officer EA-116, Page 3 of 3 Instructions to Clerk If the hearing is rescheduled and the court extended, modified or terminated a temporary restraining order, then the court must enter this order into CLETS or send this order to law enforcement to enter into CLETS.

This must be done within one business day from the day the order is made. Other Orders8 Case Number: No Fee to Serve7 The sheriff or marshal will serve this order for free. Bring a copy of all the papers that need to be served to the sheriff or marshal. Revised January 1, 2020

Judicial Council of California, courts.ca.gov Rev. January 1, 2026, Mandatory Form Gov. Code, §§ 7927.430, 26666, 26666.5, 26666.10 Request for Sheriff to Serve Court Papers SER-001, Page 1 of 5 SER-001 Request for Sheriff to Serve Court Papers CONFIDENTIAL To Court Clerk: Do not file this form. Sheriff File Number (for sheriff to complete, if needed): Fill in case number: Court Case Number: Instructions: Each county in California has a sheriff (and sometimes a marshal’s office) that can serve different types of court papers, including restraining orders.

Note that the sheriff cannot guarantee that they will be successful in finding the person you need served, but they will try to serve based on the information you put on this form. Complete this form for each set of papers you need served. You must complete a separate form for each person you need served. Find out where the person you need served is located. Give your papers to the sheriff or marshal’s office in that county. You may have to pay for service of some court papers. For more information, see page 5 of this form, or go to selfhelp.courts.ca.gov/sheriff-serves.

Do not use this form if you are asking the sheriff to enforce a wage garnishment order on an employer. Instead, use forms WG-001, Application for Earnings Withholding Order, and WG-035, Confidential Statement of Judgment Debtor’s Social Security Number. If you want the sheriff to enforce a writ or levy, complete this form and form SER-001A, Special Instructions for Writs and Levies—Attachment. All information is required unless it is listed as optional or does not apply to your case. 1 To the Sheriff or Marshal of (name of county): 2 Your Information a. Your name (party requesting service): b.

Your lawyer’s information (if you have one) Name: Firm name: c. Court case name: (example: Garcia v. Smith) d. Contact information for the sheriff or marshal to reach you (Give an address where you can receive mail regularly, like a post office box, a Safe at Home address, or another safe address. If you have a lawyer, give the lawyer’s information.) Address to receive mail: City: State: Zip: Telephone number (optional): Email address (optional): CONFIDENTIAL This is not a court form. Do not file with the court.

Rev. January 1, 2026 Request for Sheriff to Serve Court Papers Court Case Number: 3 Information About Person or Entity You Want Served (Check a or

b) a. I ask the sheriff to serve a person (complete

section below)

(1) Name of person: Nicknames or aliases (optional):

(2) Telephone number (optional):

(3) Can you describe the person? No, I do not have any information about the person’s description. Yes (complete the

section below with any information you have): Gender: Male Female Nonbinary Height: Weight: Hair color: Eye color: Date of birth or age (give estimate, if unknown): Race/Ethnicity: Special marks or features (tattoos, scars, etc.): Vehicle (type, model, year, color, plate number): Check here if you are including a picture of the person.

(4) Do you know of any safety or accessibility issues? No Yes (complete the

section below with any information you have): The person (check all that apply): Has a gun or other weapon. Is on probation or parole. Has a history of violence or abuse. Has an aggressive animal. Has special training (examples: military, first responder). Has mental health issues. Is deaf or hard of hearing. Does not speak English (list language): Add any other information about safety or accessibility that you know about: b. I ask the sheriff to serve an entity (examples: business or government agency)

(1) Name and type of entity: Telephone number (optional):

(2) If there is a specific person who should be served, give name:

(3) If there is an agent for service of process, give name:

(4) List any safety or accessibility issues (examples: weapons, aggressive animals, language barrier): CONFIDENTIAL This is not a court form. Do not file with the court. SER-001, Page 2 of 5

Rev. January 1, 2026 Request for Sheriff to Serve Court Papers Court Case Number: 4 Address Where Person or Entity Should Be Served (The sheriff typically serves during normal business hours. Check with the sheriff’s office for the exact times.) Address: Home Business City: State: Zip: Gate code or special instructions: Best time to serve at this address (example: 8 a.m.–noon): Check here if the person is in jail or prison (give name of facility): Alternate address (optional) (If the person cannot be found at the address listed above, some sheriffs may try a second address if it’s in the same county. If you have a second address for the person you want served, complete the

section below.) Address: Home Business City: State: Zip: Gate code or special instructions: Best time to serve at this address (example: 8 a.m.–noon): 5 Information About Your Request a. What type of court papers are you giving the sheriff to serve (examples: summons, restraining order, eviction, small claims, bank levy, or writ of attachment)? b. List all forms or court papers you want served on the person in 3 a. (optional). (Note: You can list each form by its form number (example: FL-100, SC-100). If there is no form number, give the title of the document.

The court may have ordered you to serve certain papers. Look at the court’s order and list all forms required. If you do not know which papers you need to serve, ask a lawyer, or contact your local self-help center for free information.) c. Is there a court hearing (court date)? I don’t know No Yes (if yes, give date of hearing): CONFIDENTIAL This is not a court form. Do not file with the court. SER-001, Page 3 of 5

Rev. January 1, 2026 Request for Sheriff to Serve Court Papers Court Case Number: 5 d. Is there a deadline for service? I don’t know No Yes (if yes, give deadline): e. Has the court allowed you to serve your court papers in another way besides personal service (example: substituted service)? I don’t know No Yes (if yes, include a copy of the order allowing another type of service) f. Is there any other information you want or need to give to the sheriff to serve your court papers?

No Yes (if yes, give information below): 6 Enforcement of Writ or Levy If you want the sheriff to enforce a writ or levy, you must complete form SER-001A, Special Instructions for Writs and Levies—Attachment, and turn it in with this form. (Only complete this

section if you want the sheriff to enforce a writ or levy.) Do you want the sheriff to both serve your court papers and act as levying officer? Yes No. I only want the sheriff to act as levying officer. A registered process server has or will serve my papers. Your Signature (party asking for service, or their lawyer) Date: Type or print your name Sign your name (may be electronic) CONFIDENTIAL This is not a court form. Do not file with the court. SER-001, Page 4 of 5

Rev. January 1, 2026 Request for Sheriff to Serve Court Papers SER-001, Page 5 of 5 Court Case Number: Your Next Steps Find out if you need to pay a fee for service by asking the court’s self-help center, a lawyer, or the sheriff’s office. Here are some situations where you do not need to pay for service: If you have a fee waiver in your case (fee waiver granted by a judge on form FW-003 or FW-005). If you are serving a domestic violence, elder abuse, or gun violence restraining order.

If you have a civil harassment, workplace violence, or school violence restraining order based on a credible threat of violence or stalking. Give this form and a copy of all the court papers you need served to the sheriff or marshal, including a copy of a fee waiver (if you have one). You can turn in your papers in person or send them electronically. You should get a form back from the sheriff. If the sheriff was able to serve your court papers, you should receive a form (called a proof of service). Make sure you get a copy from the sheriff and file it with the court.

Note that if there is a court stamp at the top right corner of the first page, it has already been filed and you do not need to file it with the court. If the sheriff was unable to serve your court papers, you should receive a form (sometimes called declaration of due diligence) that tells you that service was unsuccessful and will give details about when the sheriff tried to serve the person. If the sheriff was unable to serve your papers, you can ask a lawyer or court’s self-help center about your next steps. To find your local court self-help center, go to selfhelp.courts.ca.gov/.

Self-help center staff will not act as your lawyer but may be able to give you information to help you decide what to do in your case. Services are free. To Sheriff or Marshal This form is confidential and must not be made public. Any papers submitted with this form should be served and listed on the applicable proof of service form. Note that 5 b is optional and may help to identify documents that should have been submitted but were not received by your office. Under Government Code

section 26666.2, once you’ve received a completed copy of this form and forms for service, you must attempt service unless: Any order submitted does not have a judge’s signature or other representation of a judge’s signature; clerk’s endorsement; or court stamp, seal, or other court endorsement; or A court case number is not listed on the order, summons, or other notice. CONFIDENTIAL This is not a court form. Do not file with the court.

Document details

Collection	California Superior Local Rules
Citation	Cal. Form PKT-009
Type	court_rule
Language	en
Format	pdf
Source	CA_LOCAL
Identifier	7f9258de392c1f01f7b59b65ea22ac3fbc478c7a

Source file is stored in the law ingest library (pdf).