Confidential CLETS Information (Domestic Violence, Civil Harrassment, Elder Abuse)
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Confidential CLETS Information (Domestic Violence, Civil Harrassment, Elder Abuse) Form. This is a California form and can be use in Domestic Violence Prevention Judicial Council.
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Tags: Confidential CLETS Information (Domestic Violence, Civil Harrassment, Elder Abuse), DV-260 CH-102 EA-102, California Judicial Council, Domestic Violence Prevention
CONFIDENTIAL
DV-260/CH-102/EA-102
CLETS Information
California Law Enforcement Telecommunications System (CLETS)
Information Form
Important Notice: This form MUST NOT become part of the public court file. It is confidential and private. If
the court issues a restraining order, this form will provide law enforcement with information that will assist them in
enforcing a restraining order.
Person to Be Protected: Fill out this form as much as you can, and give it to the court clerk. The clerk will
provide the confidential information on this form to CLETS, a statewide system that lets police know about your order.
In addition to providing the information on this form, you must provide a public mailing address on your request for a
restraining order filed with the court. This will allow the court to contact you if needed and allow the other side to have
their response to your petition served on you. If you want to keep your place of residence confidential, you can use a post
office box or “in care of” address on the request that you file.
Case number for your restraining order (if you know it):
1
Person to Be Protected (name):
M
Sex:
Hair Color:
F Height:
Eye Color:
(mailing address listed on restraining order)
Vehicle (type, model, year):
Vehicle license number and state:
2
Race:
Date of Birth:
Weight:
Age:
(city, state, zip)
(telephone number [optional])
Person to Be Restrained (name):
M
Sex:
Hair Color:
F Height:
Eye Color:
Race:
Date of Birth:
Weight:
Age:
(residence address)
(city, state, zip)
(telephone number)
(work place)
(occupation/title)
(work hours)
(business address)
Driver’s license number and state:
Vehicle (type, model, year):
Social Security Number:
Describe any marks, scars, or tattoos:
Other names used by the restrained person:
(city, state, zip)
(telephone number)
Vehicle license number and state:
Describe any guns or firearms you believe the restrained person owns or has access to (number, types, and locations):
3 Other People to Be Protected
Name
Date of Birth
Sex
Race
This is not a Court Order—Do not file in court file.
Judicial Council of California, www.courtinfo.ca.gov
Revised January 1, 2010, Mandatory Form
Confidential CLETS Information
(Domestic Violence, Civil Harassment, Elder Abuse)
DV-260/CH-102/EA-102, Page 1 of 1
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