California > Judicial Council > Domestic Violence Prevention
Description Of Abuse DV-101 - California
| Description Of Abuse Form. This is a California form and can be used in Domestic Violence Prevention Judicial Council . |
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DV-101 Description of Abuse Case Number: This form is attached to DV-100, Request for Domestic Violence Restraining Order. 1 2 3 Name of person asking for protection: Name of person you want protection from: Describe the 2nd most recent abuse. a. Date of 2nd most recent abuse: b. Who was there? c. Describe how the person in 2 abused you or your children: d. Describe any use or threatened use of guns or other weapons: e. Describe any injuries: f. Did the police or other law enforcement come? No Yes Yes No I don't know If yes, did they give you or the person in 2 an Emergency Protective Order? The person in 2 The Emergency Protective Order protects You Attach a copy of the Emergency Protective Order if you have one. Judicial Council of California, www.courts.ca.gov Rev. January 1, 2012, Optional Form Family Code, ยง 6200 et seq. Description of Abuse (Domestic Violence Prevention) DV-101, Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Case Number: 4 Describe other recent abuse. a. Date of other recent abuse: b. Who was there? c. Describe how the person in 2 abused you or your children: d. Describe any use or threatened use of guns or other weapons: e. Describe any injuries: f. Did the police or other law enforcement come? No Yes Yes No I don't know If yes, did they give you or the person in 2 an Emergency Protective Order? The person in 2 The Emergency Protective Order protects You Attach a copy of the Emergency Protective Order if you have one. 5 Describe other abuse against 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. Rev. January 1, 2012 Description of Abuse (Domestic Violence Prevention) DV-101, Page 2 of 2
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