www.courts.ca.gov Clerk stamps date here when form is filed. Fill in court name and street address: Court fills in case number when form is filed.Can an Elder or Dependent Adult Abuse Restraining Order Help Me?Confidential CLETS Information (if known): (Show this person222s legal authority to make this request on an attached sheet of paper. Write 223Attachment 3c227Information About Person Requesting Protective Order224 for a title. You may use form MC-025.) (name of court): (Check a, b, or c): (name) (if you have one for this case) (If you have a lawyer, give your lawyer222s information. If you do not have a lawyer and want to keep your home address private, you may give a different mailing addressinstead. The person in does not have to give telephone, fax, or e-mail.) American LegalNet, Inc. www.FormsWorkFlow.com (check a or b): (Briefly describelimitations on the attached sheet of paper or form MC-025. Write 223Attachment 5b227Description ofProtected Person224 for a title.) (If yes, list them): Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write 223Attachment 6b227Why Others Need Protection224 for a title. Check here if there are more persons. Attach a sheet of paper and write 223Attachment 6a227Additional Protected Persons224 for a title. You may use form MC-025, Attachment. (Explain below): Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write 223Attachment 7227Relationship of Parties224 for a title. (specify): (Check all that apply):(Explain below): American LegalNet, Inc. www.FormsWorkFlow.com (If yes, specify the kind of each case and indicate where and when each was filed): (If yes, attach a copy if you have one.) (specify): (County/State) (if known) Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write 223Attachment 10b(3)227Describe Abuse224 for a title. (Provide date or estimated date): American LegalNet, Inc. www.FormsWorkFlow.com (If yes, explain below): Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write 223Attachment 10b(5)227Use of Weapons224 for a title. (If yes, explain below): Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write 223Attachment 10b(6)227Harm or Injury224 for a title. (check all that apply): (Attach a copy of the order if you have one.) (If yes, describe below what the person was deprived of and how that affected him or her):(If yes, describe prior incidents and provide dates below): Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write 223Attachment 10d227Previous Abuse224 for a title. Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write 223Attachment 10c227Deprivation by Care Custodian224 for a title. American LegalNet, Inc. www.FormsWorkFlow.com specify): Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write 223Attachment 11c227Other Personal Conduct Orders,224 for a title.The person in will be ordered not to take any action to get the addresses or locations of any protected person unless the court finds good cause not to make the order. (check all that apply): (If no, explain below): (specify): Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write 223Attachment 12b227Stay-Away Orders,224 for a title. American LegalNet, Inc. www.FormsWorkFlow.com (Explain below): Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write 223Attachment 13b227My Right to Residence,224 for a title. (address): Unless the abuse is only financial, if the judge grants a protective order, the person in will be prohibited from owning, possessing, purchasing, receiving, or attempting to purchase or receive a gun, other firearm, and ammunition while the protective order is in effect. The person in will also be ordered to turn in to law enforcement, or sell to or store with a gun dealer, any guns or firearms within his or her immediate possession or control. (If you answered no, explain why below): Temporary Restraining Order,Request Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write 223Attachment 15227Temporary Restraining Order224 for a title. You must have your papers personally served on the person in at least five days before the hearing, unless the court orders a shorter time for service. (Form EA-200-INFO explains Form EA-200, , may be used to show the court that the papers have been served.) American LegalNet, Inc. www.FormsWorkFlow.com If you want the sheriff or marshal to serve (notify) the person in about theorders for free, ask the court clerk what you need to do. Check here if there are more items. Put the items and amounts on the attached sheet of paper or form MC-025 and write 223Attachment 18227Lawyer222s Fees and Costs224 for a title. (Identify animals by, e.g., type, breed, name, color, sex.) (specify good cause for granting order) Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write 223Attachment 19a227Possession of Animals224 for a title. Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write 223Attachment 16227Request to Give Less Than Five-Days222 Notice224 for a title. American LegalNet, Inc. www.FormsWorkFlow.com Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write 223Attachment 20227Additional Orders Requested,224 for a title.(specify) Lawyer222s name (if any) Lawyer222s signature Signature of person filling out this request Type or print your name American LegalNet, Inc. www.FormsWorkFlow.com