ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY TELEPHONE NO.: ATTORNEY FOR (Name): FAX NO. (Optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, COUNTY COURTHOUSE, 220 W. BROADWAY, SAN DIEGO, CA 92101 CENTRAL DIVISION, FAMILY COURT, 1555 6TH AVE., SAN DIEGO, CA 92101 CENTRAL DIVISION, MADGE BRADLEY, 1409 4TH AVE., SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910 PROTECTED PARTY RESTRAINED PARTY EX PARTE REQUEST AND ORDER TO TERMINATE DOMESTIC VIOLENCE TEMPORARY RESTRAINING ORDER CASE NUMBER Use this form only if the following apply: (1) you are the protected party; and (2) you want to dismiss your domestic violence temporary restraining order (DVTRO) and have your hearing taken off the court's calendar. 1. Your name (protected party): 2. Name of restrained party: 3. I ask the court to TERMINATE, in its entirety, the DVTRO issued on my behalf on (date) and set to expire at the hearing on (date) . 4. 5. A copy of the DVTRO (Judicial Council form #DV-110) is attached. The restrained party has a domestic violence restraining order (either temporary or permanent) issued against me. 6. I ask the court to terminate the DVTRO indicated above for the following reasons (be specific): 7. The parties stipulate to terminate the DVTRO indicated above for the following reasons (be specific). NOTE: A stipulation requires that both parties sign under penalty of perjury below. Protected Party: I understand and acknowledge that if the court grants my request or stipulation, the restrained party may be allowed to own, possess, and use guns and ammunition. I make this request of my own free will. I have not been coerced or threatened in any way by the restrained person or anyone else to make this request. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: Signature of Protected Party Restrained Party: I have not coerced or threatened the protected party in any way to make this request. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. (Signature is required only if item 7 is marked above.) Date: Signature of Restrained Party SDSC D-001 (Rev. 7/16) Optional Form EX PARTE REQUEST AND ORDER TO TERMINATE DOMESTIC VIOLENCE TEMPORARY RESTRAINING ORDER Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com SHORT TITLE CASE NUMBER FINDINGS AND ORDER 1. The request/stipulation is GRANTED. The court finds that the protected party's request is made of his or her own free will, and that he or she has not been coerced or threatened in any way by the restrained party or anyone else to make this request. a. The domestic violence temporary restraining order issued on (date) of restrained party) b. c. is terminated effective immediately. against (name The domestic violence prevention action is dismissed. The hearing set for (date) is vacated. at (time) a.m. p.m. in Dept. d. CLETS Entry: The court will transmit this order within one business day to a local law enforcement agency authorized by the Department of Justice for entry into the California Law Enforcement Telecommunications System (CLETS). 2. 3. The request is DENIED and all orders remain in effect until the hearing date. Other: IT IS SO ORDERED. Date: Judge/Commissioner of the Superior Court CLERK'S CERTIFICATE The foregoing document, consisting of _____ page(s), is a full, true, and correct copy of the original copy on file in this office. Clerk of the Superior Court Date: by , Deputy American LegalNet, Inc. www.FormsWorkFlow.com SDSC D-001 (Rev. 7/16) Optional Form EX PARTE REQUEST AND ORDER TO TERMINATE DOMESTIC VIOLENCE TEMPORARY RESTRAINING ORDER Page 2 of 2