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Document Sample
1Petitioner (Employer) a. Name:
Lawyer for Petitioner (if any, for this case):
Name: |
State Bar No.: |
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Firm Name: |
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b. Your Address (If you have a lawyer, give your lawyer’s information.):
Address:
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State: |
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Zip: |
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Telephone:Fax:
2Employee (Protected Person)
Full Name:
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California, County of
Court fills in case number when form is filed.
3 Respondent (Restrained Person) |
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Case Number: |
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Full Name: |
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Description: |
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Sex: |
M |
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F Height: |
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Weight: |
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Date of Birth: |
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Hair Color: |
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Eye Color: |
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Age: |
Race: |
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Home Address (if known): |
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City: |
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State: |
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Zip: |
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Relationship to Employee: |
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4
Additional Protected Persons
In addition to the employee, the following family or household members or other employees are protected by the temporary orders indicated below:
Full Name |
Sex Age Household Member? |
Relation to Employee |
Yes 
No
Yes 
No
Yes 
No
Additional protected persons are listed at the end of this Order on Attachment 4.
5Expiration Date
This Order expires at the end of the hearing scheduled for the date and time below:
Date: |
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Time: |
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a.m. |
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p.m. |
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This is a Court Order.
Judicial Council of California, www.courts.ca.gov Revised January 1, 2017, Mandatory Form Code of Civil Procedure, §§ 527.8 and 527.9 Approved by DOJ
Temporary Restraining Order |
(Workplace Violence Prevention)
Case Number:
To the Respondent:
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.
6Personal Conduct Orders
Not Requested |
Denied Until the Hearing |
Granted as Follows:
a. You are ordered not do the following things to the employee and to the other protected persons listed in 4 :
(1) |
Harass, molest, strike, assault (sexually or otherwise), batter, abuse, destroy personal property of, or |
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disturb the peace of the person. |
(2) |
Commit acts of violence or make threats of violence against the person. |
(3) |
Follow or stalk the person during work hours or to or from the place of work. |
(4) |
Contact the person, either directly or indirectly, in any way, including, but not limited to, in person, by |
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telephone, in writing, by public or private mail, by |
(5)
Enter the workplace of the person.
(6)
Take any action to obtain the person’s address or locations. If this item is not checked, the court has found good cause not to make this order.
(7)
Other (specify):
Other personal conduct orders are attached at the end of this Order on Attachment 6a(7).
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 petitioner.
7
Not Requested
Denied Until the Hearing |
Granted as Follows: |
a. You must stay at least |
yards away from |
(check all that apply): |
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(1) |
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(7) |
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The employee |
The employee’s children’s place of child care |
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(2) |
Each other protected person listed in 4 (8) |
The employee’s vehicle |
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(3) |
The employee’s workplace |
(9) |
Other (specify): |
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(4)
The employee’s home
(5)
The employee’s school
(6)
The employee’s children’s school
b. This
This is a Court Order.
Revised January 1, 2017
Temporary Restraining Order
(Workplace Violence Prevention)
Case Number:
8No Guns or Other Firearms and Ammunition
a.You cannot own, possess, have, buy or try to buy, receive or try to receive, or in any other way get guns, other firearms, or ammunition.
b.You must:
(1)Sell to or store with a licensed gun dealer or turn in to a law enforcement agency any guns or other firearms 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 guns or firearms have been turned in, sold, or stored. (You may use form
c.
The court has received information that you own or possess a firearm.
9 Other Orders |
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Not Requested |
Denied Until the Hearing |
Granted as Follows (specify): |
Additional orders are attached at the end of this Order on Attachment 9.
To the Petitioner:
10Mandatory 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. 
b.
The clerk will enter this Order and its
The clerk will transmit this Order and its
c.
By the close of business on the date that this Order is made, the employer or the employer’s lawyer should deliver a copy of the Order and its
Name of Law Enforcement Agency |
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Address (City, State, Zip) |
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Additional law enforcement agencies are listed at the end of this Order on Attachment 10.
11 No Fee to Serve (Notify) Restrained Person |
Ordered |
Not Ordered |
The sheriff or marshal will serve this Order without charge because:
a.
The Order is based on a credible threat of violence or stalking.
b.
The petitioner is entitled to a fee waiver.
This is a Court Order.
Revised January 1, 2017
Temporary Restraining Order
(Workplace Violence Prevention)
Case Number:
12Number of pages attached to this Order, if any: Date:
Judicial Officer
Warnings and Notices to the Restrained Person in 2
You Cannot Have Guns or Firearms
You cannot own, have, possess, buy or try to buy, receive or try to receive, or otherwise get guns, other firearms, or ammunition 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 guns or other firearms that you have or control as stated in item 8 above. 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
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.
After You Have Been Served With a Restraining Order
•Obey all the orders. Any intentional violation of this Order is a misdemeanor punishable by a fine or by imprisonment in a county jail, or by both fine and imprisonment. (Pen. Code, § 273.6.)
•Read form
•If you want to respond, fill out form
•You must have form
•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
•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 three years. Tell the judge why you disagree with the orders requested.
This is a Court Order.
Revised January 1, 2017
Temporary Restraining Order
(Workplace Violence Prevention)
Case Number:
Instructions for Law Enforcement
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 Orders System (CARPOS). Agencies are encouraged to enter violation messages into 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 item 5 on page 1.
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
If more than one restraining order has been issued, the orders must be enforced according to the following priorities: (See Pen. Code, § 136.2, Fam. Code, §§ 6383(h)(2), 6405(b).)
1.EPO: If one of the orders is an Emergency Protective Order (form
2.No Contact Order: If there is no EPO, a
3.Criminal Order: If none of the orders includes a no contact order, a domestic violence protective order issued in a criminal case takes precedence in enforcement over any conflicting civil court order. Any nonconflicting terms of the civil restraining order remain in effect and enforceable.
4.Family, Juvenile, or Civil Order: If more than one family, juvenile, or other civil restraining or protective order has been issued, the one that was issued last must be enforced.
Clerk’s Certificate [seal]
(Clerk will fill out this part.)
I certify that this Temporary Restraining Order is a true and correct copy of the original on file in the court.
Date: |
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Clerk, by |
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, Deputy |
This is a Court Order.
Revised January 1, 2017
Temporary Restraining Order
(Workplace Violence Prevention)
Document Information
| Fact Name | Details |
|---|---|
| Form Title | WV-110 Temporary Restraining Order |
| Governing Law | California Code of Civil Procedure, §§ 527.8 and 527.9 |
| Petitioner | Typically the employer seeking protection for an employee. |
| Respondent | The individual who is being restrained by the order. |
| Protected Persons | Includes the employee and potentially other family or household members. |
| Expiration | The order expires at the end of the scheduled hearing. |
| Firearm Restrictions | The respondent cannot own or possess firearms while the order is in effect. |
| Stay-Away Requirements | The respondent must maintain a specified distance from the employee and other protected persons. |
| Service Fees | The sheriff or marshal serves the order without charge under specific conditions. |
Fake Restraining Order - Usage Guidelines
Completing the Fake Restraining Order form requires careful attention to detail. Each section of the form asks for specific information that is essential for the court to process the request. After filling out the form, it will need to be filed with the appropriate court, and you may need to prepare for a subsequent hearing. Here are the steps to fill out the form correctly:
- Petitioner Information: In the first section, provide your name as the petitioner (employer). If you have a lawyer, include their name, state bar number, and firm name. If you do not have a lawyer, fill in your own address, city, state, zip, telephone, fax, and email address.
- Employee Information: Enter the full name of the employee who is the protected person. Leave space for the court to stamp the date when the form is filed.
- Court Information: Fill in the name of the court and its street address. The court will assign a case number when you file the form.
- Respondent Information: Provide the full name of the respondent (restrained person). Fill in their sex, height, weight, date of birth, hair color, eye color, age, race, and home address if known. Also, describe the relationship between the employee and the respondent.
- Additional Protected Persons: List any additional family or household members or other employees who are also protected. Include their full names, sex, age, and indicate if they are household members and their relation to the employee.
- Expiration Date: Specify the date and time when the order will expire, indicating whether it is a.m. or p.m.
- Personal Conduct Orders: Check the boxes for any personal conduct orders that you are requesting against the respondent. If you want to specify other conduct, write it in the space provided.
- Stay-Away Order: Indicate the distance the respondent must stay away from the employee and any other specified locations by checking the appropriate boxes.
- No Guns or Other Firearms: Confirm the respondent's inability to possess firearms and list any requirements regarding firearms possession.
- Other Orders: If you have additional orders to request, specify them in this section.
- Entry of Order: Indicate how the order will be entered into the California Restraining and Protective Order System (CARPOS).
- Service Fee: Check whether a fee waiver for serving the restrained person is requested.
- Attachments: Note the number of pages attached to the order, if any.
- Date and Signature: Finally, leave space for the judicial officer's signature and date.
Once you have completed the form, it is crucial to file it with the court and be prepared for any follow-up actions, including a possible hearing. Make sure to keep a copy for your records and follow all instructions provided by the court regarding the next steps.
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Dos and Don'ts
When filling out a Fake Restraining Order form, it is crucial to approach the process with care and consideration. Here are some important dos and don’ts to keep in mind:
- Do provide accurate information for all required fields, including names and addresses.
- Do ensure that the details about the protected person and restrained person are complete and truthful.
- Do follow the instructions carefully as outlined in the form.
- Do keep a copy of the completed form for your records.
- Do submit the form to the appropriate court as soon as possible.
- Don’t include false information or exaggerate any claims made in the form.
- Don’t submit the form without reviewing it for errors or omissions.
- Don’t forget to check the specific requirements of your local court, as they may vary.
- Don’t ignore deadlines for submitting the form or for attending court hearings related to the restraining order.
Being thorough and honest during this process is essential for ensuring that the restraining order is handled appropriately. Each step taken can have significant implications for all parties involved.
Common mistakes
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Incomplete Petitioner Information: Failing to provide all required details about the petitioner, such as name, address, and contact information, can lead to delays in processing the restraining order.
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Incorrect Respondent Details: Not accurately filling out the respondent's full name, physical description, or relationship to the employee may cause confusion and hinder enforcement of the order.
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Omitting Additional Protected Persons: Forgetting to list family members or other employees who need protection can leave them vulnerable. It’s important to ensure that all relevant individuals are included.
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Missing Expiration Date: Leaving the expiration date blank can lead to legal complications. Always specify when the order should end, which is crucial for clarity.
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Failing to Check Required Boxes: Not marking the appropriate boxes for personal conduct orders or stay-away orders can result in incomplete protections being granted.
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Ignoring Firearm Restrictions: Neglecting to complete the section regarding firearms can have serious implications. Ensure that all firearm restrictions are clearly stated and understood.
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Not Providing Law Enforcement Information: If applicable, failing to list law enforcement agencies for the entry of the order into CARPOS can delay enforcement and create additional risks.
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Overlooking Service Fee Waiver: If a service fee waiver is applicable, not checking this box can lead to unnecessary costs. Ensure that this detail is addressed if relevant.
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Forgetting to Sign and Date: Omitting the signature and date can render the form invalid. Always double-check that the form is properly signed and dated before submission.
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Neglecting to Attach Required Documents: Failing to include necessary attachments, such as proof of service or additional orders, can result in delays or rejection of the application.