DV-101, Page 1 of 2Judicial Council of California, www.courts.ca.gov

Cal. Form DV-101

California Superior Local Rules

DV-101, Page of 2Judicial Council of California, www.courts.ca.gov Rev. January 1, 2017, Optional Form Family Code, § 6200 et seq. 3 Describe abuse to you or your children. Name of person asking for protection: Name of person you want protection from: Case Number: DV-101 Description of Abuse a. Date of abuse: d. This form is attached to DV-100, Request for Domestic Violence Restraining Order . b. Who was there? 2Describe how the person in abused you or your children: Description of Abuse (Domestic Violence Prevention) Describe any use or threatened use of guns or other weapons: e.

Did the police or other law enforcement come? If yes, did they give you or the person in an Emergency Protective Order? 2The Emergency Protective Order protects Attach a copy of the Emergency Protective Order if you have one. f. YesNo Yes No I don’t know2 You The person in Describe any injuries: Case Number: 4 Describe abuse to you or your children. a. Date of abuse: d. b. c. e. Did the police or other law enforcement come? If yes, did they give you or the person in an Emergency Protective Order? 2The Emergency Protective Order protects Attach a copy of the Emergency Protective Order if you have one. f.

YesNo Yes No I don’t know2 You The person in Has the person in abused you (or your children) other times?2 Describe abuse to you or your children. Check here if you need more space. Attach a sheet of paper and write “DV-101—Description of Abuse” for a title. DV-101, Page of 2Rev. January 1, 2017 Description of Abuse (Domestic Violence Prevention) Who was there? 2Describe how the person in abused you or your children: Describe any use or threatened use of guns or other weapons: Describe any injuries:

Document details

Collection	California Superior Local Rules
Citation	Cal. Form DV-101
Type	court_rule
Language	en
Format	pdf
Source	CA_LOCAL
Identifier	c533a94a131e0b379b687c2e734b244925872ef7

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