SV-110 1 Clerk stamps date here when form is filed. Temporary Restraining Order Petitioner (Educational Institution Officer or Employee) Name: Lawyer for Petitioner (if any): Name: State Bar No.: Firm Name: Street Address: Fill in court name and street address: State: Fax: City: Telephone: Zip: Superior Court of California, County of E-mail Address: 2 Student in Need of Protection Full Name: 3 Court fills in case number when form is filed. Case Number: Respondent (Person From Whom Protection Is Sought) Full Name: Description: Sex: M F Height: Hair Color: Home Address (if known): Weight: Eye Color: Date of Birth: Age: City: 4 Race: Zip: State: Additional Protected Persons In addition to the student, the following family or household members or other students are protected by the temporary orders indicated below: Sex Age Household Member? Relation to Student Full Name No Yes Yes Yes No No Yes Yes No No Additional protected persons are listed at the end of this Order on Attachment 4. 5 Expiration Date This Order expires at the date and time of the hearing below: (Date): (Time): a.m. p.m. This is a Court Order. Judicial Council of California, www.courts.ca.gov New January 1, 2011, Mandatory Form Code of Civil Procedure, §§ 527.85 and 527.9 Approved by DOJ Temporary Restraining Order (CLETS-TSV) SV-110, Page 1 of 4 (Private Postsecondary School Violence Prevention) American LegalNet, Inc. www.FormsWorkFlow.com 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. 6 Personal Conduct Orders Granted Not Granted Not Requested a. You are ordered not to: (1) (2) assault, batter, or stalk the student and other protected persons. make threats of violence against the student and other protected persons. (5) follow or stalk the student and other protected persons during school hours or to or from the school campus or facility. contact the student and other protected persons, directly or indirectly, by any means, including but not limited to, in person, by telephone, in writing, by public or private mail, by e-mail, by fax, or by other electronic means. enter the school campus or facilities of the student and of the other protected persons. (6) (7) take any action to obtain the student and other protected persons’ address or location. other (specify): (3) (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. 7 Stay-Away Order Granted Not Granted a. You must stay at least (specify): listed in 4 and (check all that apply): (1) (2) (3) (4) (5) Not Requested yards away from the student and each other protected person the student’s and other protected persons’ homes the student’s and other protected persons’ jobs or workplaces the student’s and other protected persons’ vehicles the student’s and other protected persons’ schools other (specify): b. This stay-away order does not prevent you from going to or from your home or place of employment. 8 Firearms Prohibition and Relinquishment 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 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 guns have been turned in or sold. (You may use Form SV-800, Proof of Firearms Turned In or Sold, for the receipt.) c. The court has received information that you own or possesses a firearm. This is a Court Order. New January 1, 2011 Temporary Restraining Order (CLETS-TSV) (Private Postsecondary School Violence Prevention) SV-110, Page 2 of 4 Case Number: 9 Other Orders (specify): Granted Not Granted Not Requested Additional orders are attached at the end of this Order on Attachment 9. 10 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 CLETS. b. The clerk will transmit this Order and its proof-of-service form to a law enforcement agency to be entered into CLETS. c. By the close of business on the date that this Order is made, you or your lawyer should deliver a copy of the Order and its proof-of-service form to the law enforcement agency listed below to enter into CLETS. Name of Law Enforcement Agency 11 No Fee to Serve Respondent Address (City, State, Zip) Ordered Not Ordered If the sheriff or marshal serves this Order, he or she will do so for free. 12 Number of pages attached to this Order, if any: Date: Judicial Officer Warnings and Notices to the Respondent 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 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. If you do not obey this Order, you can be charged with a crime. This is a Court Order. New January 1, 2011 Temporary Restraining Order (CLETS-TSV) (Private Postsecondary School Violence Prevention) SV-110, Page 3 of 4 Case Number: After You Have Been Served With a Restraining Order • Obey all the orders. • Read Form SV-120-INFO, How Can I Respond to a Petition for Orders to Stop Private Postsecondary School Violence?, to learn how to respond to this Order. • If you want to respond, fill out Form SV-120, Response to Petition for Orders to Stop Private Postsecondary School Violence, and file it with the court clerk. You do not have to pay any fee to file your response if the petition claims that you inflicted or threatened violence against or stalked the employee. • You must have Form SV-120 served on the petitioner or the petitioner’s attorney. Serve it by mail within the time given in item 6 of Form SV-109, Notice of Court Hearing. You cannot do this yourself. The person who does the service should complete and sign Form SV-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 www.courtinfo.ca.gov/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, tell the judge if you agree or disagree with the orders requested. • Even if you do not go to the hearing, the judge can make restraining orders against you that last for up to three years. Instructions for Law Enforcement This Order is effective when made. It is enforceable anywhere in all 50 states, the District of Columbia, all tribal lands, and all U.S. territories and shall be enforced as if it were an order of that jurisdiction 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 Law Enforcement Telecommunications System (CLETS). If the law enforcement agency has not received proof of service on the restrained person, and the restrained person was not present at the court hearing, the agency shall advise the restrained person of the terms of the Order and then shall enforce it. Violations of this Order are subject to criminal penalties. (Clerk will fill out this part.) —Clerk's Certificate— Clerk’s Certificate [seal] I certify that this Temporary Restraining Order is a true and correct copy of the original on file in the court. Date: Clerk, by___________________________ , Deputy This is a Court Order. New January 1, 2011 Temporary Restraining Order (CLETS-TSV) (Private Postsecondary School Violence Prevention) SV-110, Page 4 of 4