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APPENDIX A

Judicial Council Legal Forms List

Under Government Code section 68511, the Judicial Council may “prescribe” certain forms.
Use of prescribed forms is mandatory. Under rule 1.31, each mandatory Judicial Council
legal form is identified as mandatory by an asterisk (*) on the list of Judicial Council legal
forms published in this appendix. Mandatory forms bear the word “adopted” in the lower left
corner of the first page.

Optional forms bear the word “approved” in the lower left corner of the first page. Use of an
approved (optional) form is not mandatory, but the form must be accepted by all courts in
appropriate cases (rule 1.35(a)).

A local court may not reject any Judicial Council form, optional or mandatory, for any of the
reasons listed in rule 1.42.

The forms are available on the California Courts Web site in both a fillable and a PDF format
at www.courts.ca.gov/forms.htm.
JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

Adoption
ADOPT-050-INFO 1/1/2021 How to Adopt a Child in California

ADOPT-050-INFO 1/1/2021 How to Adopt a Child in California (Chinese)


C

ADOPT-050-INFO 1/1/2021 How to Adopt a Child in California (Korean)


K

ADOPT-050-INFO 1/1/2021 How to Adopt a Child in California (Spanish)


S

ADOPT-050-INFO 1/1/2021 How to Adopt a Child in California (Vietnamese)


V

ADOPT-200* 9/1/2021 Adoption Request

ADOPT-200 C 9/1/2021 Adoption Request (Chinese)

ADOPT-200 K 9/1/2021 Adoption Request (Korean)

ADOPT-200 S 9/1/2021 Adoption Request (Spanish)

ADOPT-200 V 9/1/2021 Adoption Request (Vietnamese)

ADOPT-205 1/1/2016 Declaration Confirming Parentage in Stepparent Adoption

ADOPT-206 1/1/2021 Declaration Confirming Parentage in Stepparent Adoption:


Gestational Surrogacy

ADOPT-210* 1/1/2021 Adoption Agreement

ADOPT-210 S 1/1/2021 Adoption Agreement (Spanish)

ADOPT-215* 1/1/2021 Adoption Order

ADOPT-215 S 1/1/2021 Adoption Order (Spanish)

ADOPT-216* 7/1/2013 Verification of Compliance with Hague Adoption Convention


Attachment

ADOPT-216 S 7/1/2013 Verification of Compliance with Hague Adoption Convention


Attachment (Spanish)

ADOPT-220* 7/1/2010 Adoption of Indian Child

ADOPT-225* 1/1/2005 Parent of Indian Child Agrees to End Parental Rights

ADOPT-230* 1/1/2007 Adoption Expenses

ADOPT-230 S 1/1/2007 Adoption Expenses (Spanish)

ADOPT-310* 1/1/2018 Contact After Adoption Agreement

ADOPT-315* 1/1/2018 Request to: Enforce, Change, End Contact After Adoption Agreement

ADOPT-320* 1/1/2018 Answer to Request to: Enforce, Change, End Contact After Adoption
Agreement

* Adopted for Mandatory Use. Page 2 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

ADOPT-325* 1/1/2018 Judge's Order to: Enforce, Change, End Contact After Adoption
Agreement

ADOPT-330* 1/1/2008 Request for Appointment of Confidential Intermediary

ADOPT-331* 1/1/2008 Order for Appointment of Confidential Intermediary

Alternative Dispute Resolution


ADR-100* 7/1/2012 Statement of Agreement or Nonagreement

ADR-101* 3/1/1994 ADR Information Form

ADR-102 1/1/2012 Request for Trial De Novo After Judicial Arbitration

ADR-103 7/1/2010 Petition to Confirm, Correct, or Vacate Attorney-Client Fee Arbitration


Award

ADR-104 1/1/2004 Rejection of Award and Request for Trial After Attorney-Client Fee
Arbitration

ADR-105 1/1/2009 Information Regarding Rights After Attorney-Client Fee Arbitration

ADR-106 1/1/2004 Petition to Confirm, Correct, or Vacate Contractual Arbitration Award

ADR-107 7/1/2009 Attendance Sheet for Court-Program Mediation of Civil Case

ADR-109 1/1/2007 Stipulation or Motion For Order Appointing Referee

ADR-110 7/1/2011 Order Appointing Referee

ADR-111 1/1/2006 Report of Referee

ADR-200 1/1/2020 Mediation Disclosure Notification and Acknowledgement

Appellate
APP-001-INFO 1/1/2019 Information on Appeal Procedures
for Unlimited Civil Cases

APP-002 1/1/2017 Notice of Appeal/Cross-Appeal (Unlimited Civil Case)

APP-003 1/1/2019 Appellant's Notice Designating Record on Appeal (Unlimited Civil


Case)

APP-004* 1/1/2021 Civil Case Information Statement (Appellate)

APP-005 1/1/2017 Abandonment Of Appeal (Unlimited Civil Case)

APP-006 1/1/2017 Application for Extension of Time to File Brief (Civil Case)

APP-007 1/1/2017 Request for Dismissal of Appeal (Civil Case)

APP-008 1/1/2017 Certificate of Interested Entities or Persons

APP-009 1/1/2017 Proof of Service (Court of Appeal)

APP-009E 1/1/2017 Proof of Electronic Service

APP-009-INFO 1/1/2021 Information Sheet For Proof of Service (Court of Appeal)

* Adopted for Mandatory Use. Page 3 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

APP-010 1/1/2019 Respondent's Notice Designating Record on Appeal (Unlimited Civil


Case)

APP-011 1/1/2017 Respondent's Notice Electing to Use an Appendix (Unlimited Civil


Case)

APP-012 1/1/2017 Stipulation for Extension of Time to File Brief (Civil Case)

APP-013* 1/1/2020 Memorandum of Costs on Appeal

APP-014 1/1/2019 Appellant's Proposed Settled Statement


(Unlimited Civil Cases)

APP-014A 1/1/2019 Other Party and Nonparty Witness Testimony and other Evidence
Attachment (Unlimited Civil Case)

APP-014-INFO 1/1/2019 Information Sheet for Proposed Settled Statement

APP-015/FW-015- 4/1/2023 Information Sheet on Waiver of Appellate Court Fees — Supreme


INFO* Court, Court of Appeal, Appellate Division

APP-015/FW-015- 4/1/2023 Information Sheet on Waiver of Appellate Court Fees — Supreme


INFO S Court, Court of Appeal, Appellate Division (Spanish)

APP-016/FW-016 7/1/2010 Order on Court Fee Waiver (Court of Appeal or Supreme Court)

APP-016/FW-016 S 7/1/2010 Order on Court Fee Waiver (Court of Appeal or Supreme Court)
(Spanish)

APP-016-GC/FW- 1/1/2021 Order on Court Fee Waiver (Court of Appeal or Supreme Court)
016-GC (Ward or Conservatee)

APP-016-GC/FW- 1/1/2021 Order on Court Fee Waiver (Court of Appeal or Supreme Court)
016-GC S (Ward or Conservatee) (Spanish)

APP-020 1/1/2019 Response to Appellant's Proposed Settled Statement (Unlimited Civil


Case)

APP-022 1/1/2019 Order on Appellant's Proposed Settled Statement


(Unlimited Civil Case)

APP-025 1/1/2019 Appellant Motion to Use a Settled Statement


(Unlimited Civil Case)

APP-031A 1/1/2015 Attached Declaration (Court of Appeal)

APP-060 1/1/2023 Notice of Appeal—Civil Commitment/Mental Health Proceedings

APP-101-INFO 1/1/2021 Information on Appeal Procedures for Limited Civil Cases

APP-102 1/1/2019 Notice of Appeal/Cross-Appeal (Limited Civil Case)

APP-103 1/1/2021 Appellant's Notice Designating Record on Appeal (Limited Civil Case)

APP-104 1/1/2021 Proposed Statement on Appeal (Limited Civil Case)

APP-105 3/1/2014 Order Concerning Appellant's Proposed Statement on Appeal


(Limited Civil Case)

* Adopted for Mandatory Use. Page 4 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

APP-106 1/1/2017 Application for Extension of Time to File Brief (Limited Civil Case)

APP-107 1/1/2017 Abandonment of Appeal (Limited Civil Case)

APP-108 1/1/2020 Notice of Waiver of Oral Argument (Limited Civil Case)

APP-109 1/1/2017 Proof of Service (Appellate Division)

APP-109E 1/1/2017 Proof of Electronic Service (Appellate Division)

APP-109-INFO 1/1/2021 What Is Proof of Service?

APP-110 1/1/2019 Respondent’s Notice Designating Record on Appeal (Limited Civil


Case)

APP-111 1/1/2021 Respondent's Notice Electing to Use an Appendix (Limited Civil Case)

APP-150-INFO 1/1/2021 Information on Writ Proceedings in Misdemeanor, Infraction, and


Limited Civil Cases

APP-151 1/1/2017 Petition for Writ (Misdemeanor, Infraction, or Limited Civil Case)

Attachment
AT-105 7/1/2010 Application for Right to Attach Order, Temporary Protective Order, etc.

AT-115 7/1/2010 Notice of Application and Hearing for Right to Attach Order and Writ
of Attachment

AT-120 7/1/2010 Right to Attach Order After Hearing and Order for Issuance of Writ of
Attachment

AT-125 7/1/2010 Ex Parte Right to Attach Order and Order for Issuance of Writ of
Attachment (Resident)

AT-130 7/1/2010 Ex Parte Right to Attach Order and Order for Issuance of Writ of
Attachment (Nonresident)

AT-135 1/1/2003 Writ of Attachment

AT-138/EJ-125* 4/1/2023 Application and Order for Appearance and Examination

AT-140 7/1/2011 Temporary Protective Order

AT-145 7/1/1983 Application and Notice of Hearing for Order to Terminate, Modify, or
Vacate Temporary Protective Order

AT-150 7/1/2003 Order to Terminate, Modify, or Vacate Temporary Protective Order

AT-155 7/1/2003 Notice of Opposition to Right to Attach Order and Claim of Exemption

AT-160/CD-140* 1/1/2006 Undertaking By Personal Sureties

AT-165 1/1/2003 Notice of Attachment

AT-167/EJ-152 9/1/2022 Memorandum of Garnishee

AT-170 7/1/2003 Application to Set Aside Right to Attach Order and Release Attached
Property, etc.

* Adopted for Mandatory Use. Page 5 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

AT-175 7/1/2003 Order to Set Aside Attachment, to Substitute Undertaking, etc.

AT-180/EJ-185 1/1/1985 Notice of Lien

Birth, Marriage, Death


BMD-001* 9/1/2018 Petition to Establish Fact, Time, and Place of Birth

BMD-001A* 9/1/2018 Declaration in Support of Petition to Establish Fact, Time, and Place
of Birth

BMD-002* 9/1/2018 Petition to Establish Fact, Date, and Place of Marriage

BMD-002A* 9/1/2018 Declaration in Support of Petition to Establish Fact, Date, and Place
of Marriage

BMD-003* 9/1/2018 Petition to Establish Fact, Time, and Place of Death

BMD-003A* 9/1/2018 Declaration in Support of Petition to Establish Fact, Time, and Place
of Death

Case Management
CM-010* 9/1/2021 Civil Case Cover Sheet

CM-011* 9/1/2018 Confidential Cover Sheet False Claims Action

CM-015 1/1/2007 Notice of Related Case

CM-020 1/1/2008 Ex Parte Application for Extension of Time to Serve Pleading and
Orders

CM-110* 9/1/2021 Case Management Statement

CM-180* 1/1/2007 Notice of Stay of Proceedings

CM-181* 1/1/2007 Notice of Termination or Modification of Stay

CM-200* 1/1/2007 Notice of Settlement of Entire Case

Civil
CIV-010* 1/1/2008 Application and Order for Appointment of Guardian Ad Litem—Civil

CIV-025 1/1/2007 Application and Order For Reissuance of Order to Show Cause and
Temporary Restraining Order

CIV-050* 1/1/2007 Statement of Damages (Personal Injury or Wrongful Death)

CIV-090 1/1/2008 Offer to Compromise and Acceptance Under Code of Civil Procedure
Section 998

CIV-100* 1/1/2023 Request for Entry of Default (Application to Enter Default)

CIV-105* 1/1/2023 Request for Entry of Default (Fair Debt Buying Practices Act)

CIV-110* 1/1/2013 Request for Dismissal

CIV-120* 1/1/2012 Notice of Entry of Dismissal and Proof of Service

* Adopted for Mandatory Use. Page 6 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

CIV-130 1/1/2010 Notice of Entry of Judgment or Order

CIV-140 1/1/2019 Declaration of Demurring Party Regarding Meet and Confer

CIV-141 1/1/2019 Declaration of Demurring Party in Support of Automatic Extension

CIV-150* 9/1/2018 Notice of Limited Scope Representation

CIV-151 9/1/2018 Application to be Relieved as Attorney on Completion of Limited


Scope Representation

CIV-152 9/1/2018 Objection to Application to be Relieved as Attorney on Completion of


Limited Scope Representation

CIV-153 9/1/2018 Order on Application to be Relieved as Attorney on Completion of


Limited Scope Representation

CIV-160 9/1/2018 Petition for Order Striking and Releasing Lien, etc. (Government
Employee)

CIV-161 9/1/2018 Order to Show Cause (Government Employee)

CIV-165* 9/1/2019 Order on Unlawful Use of Personal Identifying Information

CIV-170* 9/1/2018 Petition and Declaration Regarding Unresolved Claims and Deposit of
Undistributed Surplus Proceeds of Trustee's Sale

GDC-001* 1/1/2019 Gender Discrimination Notice

GDC-001 C 1/1/2019 Gender Discrimination Notice (Chinese)

GDC-001 K 1/1/2019 Gender Discrimination Notice (Korean)

GDC-001 S 1/1/2019 Gender Discrimination Notice (Spanish)

GDC-001 V 1/1/2019 Gender Discrimination Notice (Vietnamese)

Civil Harassment
CH-100* 1/1/2023 Request for Civil Harassment Restraining Orders

CH-100 C 1/1/2018 Request for Civil Harassment Restraining Orders (Chinese)

CH-100 K 1/1/2018 Request for Civil Harassment Restraining Orders (Korean)

CH-100 S 1/1/2018 Request for Civil Harassment Restraining Orders (Spanish)

CH-100 V 1/1/2018 Request for Civil Harassment Restraining Orders (Vietnamese)

CH-100-INFO 1/1/2023 Can a Civil Harassment Restraining Order Help Me?

CH-100-INFO C 7/1/2014 Can a Civil Harassment Restraining Order Help Me? (Chinese)

CH-100-INFO K 7/1/2014 Can a Civil Harassment Restraining Order Help Me? (Korean)

CH-100-INFO S 7/1/2014 Can a Civil Harassment Restraining Order Help Me? (Spanish)

CH-100-INFO V 7/1/2014 Can a Civil Harassment Restraining Order Help Me? (Vietnamese)

CH-109* 1/1/2023 Notice of Court Hearing

* Adopted for Mandatory Use. Page 7 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

CH-109 C 9/1/2020 Notice of Court Hearing (Chinese)

CH-109 K 9/1/2020 Notice of Court Hearing (Korean)

CH-109 S 9/1/2020 Notice of Court Hearing (Spanish)

CH-109 V 9/1/2020 Notice of Court Hearing (Vietnamese)

CH-110* 1/1/2023 Temporary Restraining Order (CLETS-TCH)

CH-110 C 3/15/2019 Temporary Restraining Order (CLETS-TCH) (Chinese)

CH-110 K 3/15/2019 Temporary Restraining Order (CLETS-TCH) (Korean)

CH-110 S 3/15/2019 Temporary Restraining Order (CLETS-TCH) (Spanish)

CH-110 V 3/15/2019 Temporary Restraining Order (CLETS-TCH) (Vietnamese)

CH-115* 1/1/2020 Request to Continue Court Hearing (Temporary Restraining Order)


(Civil Harassment Prevention)

CH-115 C 1/1/2020 Request to Continue Court Hearing (Temporary Restraining Order)


(Civil Harassment Prevention) (Chinese)

CH-115 K 1/1/2020 Request to Continue Court Hearing (Temporary Restraining Order)


(Civil Harassment Prevention) (Korean)

CH-115 S 1/1/2020 Request to Continue Court Hearing (Temporary Restraining Order)


(Civil Harassment Prevention) (Spanish)

CH-115 V 1/1/2020 Request to Continue Court Hearing (Temporary Restraining Order)


(Civil Harassment Prevention) (Vietnamese)

CH-115-INFO 1/1/2020 How to Ask for a New Hearing Date (Civil Harassment Prevention)

CH-115-INFO C 1/1/2020 How to Ask for a New Hearing Date (Civil Harassment Prevention)
(Chinese)

CH-115-INFO K 1/1/2020 How to Ask for a New Hearing Date (Civil Harassment Prevention)
(Korean)

CH-115-INFO S 1/1/2020 How to Ask for a New Hearing Date (Civil Harassment Prevention)
(Spanish)

CH-115-INFO V 1/1/2020 How to Ask for a New Hearing Date (Civil Harassment Prevention)
(Vietnamese)

CH-116* 9/1/2022 Order on Request to Continue Hearing (Temporary Restraining


Order) (CLETS-TCH) (Civil Harassment Prevention)

CH-116 C 1/1/2020 Order on Request to Continue Hearing (Temporary Restraining


Order) (CLETS-TCH) (Civil Harassment Prevention) (Chinese)

CH-116 K 1/1/2020 Order on Request to Continue Hearing (Temporary Restraining


Order) (CLETS-TCH) (Civil Harassment Prevention) (Korean)

CH-116 S 1/1/2020 Order on Request to Continue Hearing (Temporary Restraining


Order) (CLETS-TCH) (Civil Harassment Prevention) (Spanish)

* Adopted for Mandatory Use. Page 8 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

CH-116 V 1/1/2020 Order on Request to Continue Hearing (Temporary Restraining


Order) (CLETS-TCH) (Civil Harassment Prevention) (Vietnamese)

CH-117* 9/1/2022 Order Granting Alternative Service

CH-120* 1/1/2023 Response to Request for Civil Harassment Restraining Orders

CH-120 C 1/1/2018 Response to Request for Civil Harassment Restraining Orders


(Chinese)

CH-120 K 1/1/2018 Response to Request for Civil Harassment Restraining Orders


(Korean)

CH-120 S 1/1/2018 Response to Request for Civil Harassment Restraining Orders


(Spanish)

CH-120 V 1/1/2018 Response to Request for Civil Harassment Restraining Orders


(Vietnamese)

CH-120-INFO 1/1/2023 How Can I Respond to a Request for Civil Harassment Restraining
Orders?

CH-120-INFO K 7/1/2014 How Can I Respond to a Request for Civil Harassment Restraining
Orders? (Korean)

CH-130* 1/1/2023 Civil Harassment Restraining Order After Hearing (CLETS-CHO)

CH-130 C 3/15/2019 Civil Harassment Restraining Order After Hearing (CLETS-CHO)


(Chinese)

CH-130 K 3/15/2019 Civil Harassment Restraining Order After Hearing (CLETS-CHO)


(Korean)

CH-130 S 3/15/2019 Civil Harassment Restraining Order After Hearing (CLETS-CHO)


(Spanish)

CH-130 V 3/15/2019 Civil Harassment Restraining Order After Hearing (CLETS-CHO)


(Vietnamese)

CH-160* 9/1/2020 Request to Keep Minor's Information Confidential

CH-160 C 9/1/2020 Request to Keep Minor's Information Confidential (Chinese)

CH-160 K 9/1/2020 Request to Keep Minor's Information Confidential (Korean)

CH-160 S 9/1/2020 Request to Keep Minor's Information Confidential (Spanish)

CH-160 V 9/1/2020 Request to Keep Minor's Information Confidential (Vietnamese)

CH-160-INFO 9/1/2020 Privacy Protection for a Minor (Person Under 18 Years Old)

CH-160-INFO C 1/1/2020 Privacy Protection for a Minor (Person Under 18 Years Old) (Chinese)

CH-160-INFO K 1/1/2020 Privacy Protection for a Minor (Person Under 18 Years Old) (Korean)

CH-160-INFO S 1/1/2020 Privacy Protection for a Minor (Person Under 18 Years Old) (Spanish)

CH-160-INFO V 1/1/2020 Privacy Protection for a Minor (Person Under 18 Years Old)
(Vietnamese)

* Adopted for Mandatory Use. Page 9 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

CH-165* 1/1/2021 Order on Request to Keep Minor's Information Confidential

CH-165 C 1/1/2021 Order on Request to Keep Minor's Information Confidential (Chinese)

CH-165 K 1/1/2021 Order on Request to Keep Minor's Information Confidential (Korean)

CH-165 S 1/1/2021 Order on Request to Keep Minor's Information Confidential (Spanish)

CH-165 V 1/1/2021 Order on Request to Keep Minor's Information Confidential


(Vietnamese)

CH-170* 9/1/2020 Notice of Order Protecting Information of Minor

CH-170 C 9/1/2020 Notice of Order Protecting Information of Minor (Chinese)

CH-170 K 9/1/2020 Notice of Order Protecting Information of Minor (Korean)

CH-170 S 9/1/2020 Notice of Order Protecting Information of Minor (Spanish)

CH-170 V 9/1/2020 Notice of Order Protecting Information of Minor (Vietnamese)

CH-175* 9/1/2020 Cover Sheet for Confidential Information

CH-175 C 9/1/2020 Cover Sheet for Confidential Information (Chinese)

CH-175 K 9/1/2020 Cover Sheet for Confidential Information (Korean)

CH-175 S 9/1/2020 Cover Sheet for Confidential Information (Spanish)

CH-175 V 9/1/2020 Cover Sheet for Confidential Information (Vietnamese)

CH-176* 9/1/2020 Request for Release of Minor's Confidential Information

CH-177* 1/1/2021 Notice of Request for Release of Minor's Confidential Information

CH-178* 9/1/2020 Response to Request for Release of Minor's Confidential Information

CH-179* 9/1/2020 Order on Request for Release of Minor's Confidential Information

CH-200 1/1/2023 Proof of Personal Service

CH-200 C 7/1/2014 Proof of Personal Service (Chinese)

CH-200 K 7/1/2014 Proof of Personal Service (Korean)

CH-200 S 7/1/2014 Proof of Personal Service (Spanish)

CH-200 V 7/1/2014 Proof of Personal Service (Vietnamese)

CH-200-INFO 9/1/2022 What Is “Proof of Personal Service”?

CH-200-INFO C 1/1/2012 What Is “Proof of Personal Service”? (Chinese)

CH-200-INFO K 1/1/2012 What Is “Proof of Personal Service”? (Korean)

CH-200-INFO S 1/1/2012 What Is “Proof of Personal Service”? (Spanish)

CH-200-INFO V 1/1/2012 What Is “Proof of Personal Service”? (Vietnamese)

* Adopted for Mandatory Use. Page 10 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

CH-205-INFO 9/1/2022 What If the Person I Want Protection from Is Avoiding (Evading)
Service or Cannot be Located?

CH-210* 9/1/2022 Summons (Civil Harassment Restraining Order)

CH-250 9/1/2022 Proof of Service of Response by Mail (CLETS)

CH-250 C 1/1/2012 Proof of Service of Response by Mail (CLETS) (Chinese)

CH-250 K 1/1/2012 Proof of Service of Response by Mail (CLETS) (Korean)

CH-250 S 1/1/2012 Proof of Service of Response by Mail (CLETS) (Spanish)

CH-250 V 1/1/2012 Proof of Service of Response by Mail (CLETS) (Vietnamese)

CH-600* 1/1/2018 Request to Modify/Terminate Civil Harassment Restraining Order

CH-610* 1/1/2018 Notice of Hearing on Request to Modify/Terminate Civil Harassment


Restraining Order

CH-620* 1/1/2018 Response to Request to Modify/Terminate Civil Harassment


Restraining Order

CH-630* 1/1/2018 Order on Request to Modify/Terminate Civil Harassment Restraining


Order

CH-700* 1/1/2016 Request to Renew Restraining Order

CH-700 C 1/1/2016 Request to Renew Restraining Order (Chinese)

CH-700 K 1/1/2016 Request to Renew Restraining Order (Korean)

CH-700 S 1/1/2016 Request to Renew Restraining Order (Spanish)

CH-700 V 1/1/2016 Request to Renew Restraining Order (Vietnamese)

CH-710* 1/1/2016 Notice of Hearing to Renew Restraining Order

CH-710 C 1/1/2016 Notice of Hearing to Renew Restraining Order (Chinese)

CH-710 K 1/1/2016 Notice of Hearing to Renew Restraining Order (Korean)

CH-710 S 1/1/2016 Notice of Hearing to Renew Restraining Order (Spanish)

CH-710 V 1/1/2016 Notice of Hearing to Renew Restraining Order (Vietnamese)

CH-720* 1/1/2016 Response to Request to Renew Restraining Order

CH-730* 1/1/2012 Order Renewing Civil Harassment Restraining Order (CLETS)

CH-730 C 1/1/2012 Order Renewing Civil Harassment Restraining Order (CLETS)


(Chinese)

CH-730 K 1/1/2012 Order Renewing Civil Harassment Restraining Order (CLETS)


(Korean)

CH-730 S 1/1/2012 Order Renewing Civil Harassment Restraining Order (CLETS)


(Spanish)

* Adopted for Mandatory Use. Page 11 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

CH-730 V 1/1/2012 Order Renewing Civil Harassment Restraining Order (CLETS)


(Vietnamese)

CH-800 1/1/2023 Receipt for Firearms and Firearm Parts (Civil Harassment Prevention)

CH-800 C 7/1/2014 Receipt for Firearms and Firearm Parts (Civil Harassment Prevention)
(Chinese)

CH-800 K 7/1/2014 Receipt for Firearms and Firearm Parts (Civil Harassment Prevention)
(Korean)

CH-800 S 7/1/2014 Receipt for Firearms and Firearm Parts (Civil Harassment Prevention)
(Spanish)

CH-800 V 7/1/2014 Receipt for Firearms and Firearm Parts (Civil Harassment Prevention)
(Vietnamese)

CH-800-INFO 1/1/2023 How Do I Turn In, Sell, or Store My Firearms and Firearm Parts?

CH-800-INFO C 7/1/2014 How Do I Turn In, Sell, or Store My Firearms and Firearm Parts?
(Chinese)

CH-800-INFO K 7/1/2014 How Do I Turn In, Sell, or Store My Firearms and Firearm Parts?
(Korean)

CH-800-INFO S 7/1/2014 How Do I Turn In, Sell, or Store My Firearms and Firearm Parts?
(Spanish)

Claim and Delivery


CD-100* 1/1/2006 Application For Writ of Possession

CD-110* 1/1/2006 Notice of Application for Writ of Possession and Hearing

CD-120* 1/1/2006 Order for Writ of Possession

CD-130* 1/1/2006 Writ of Possession

AT-160/CD-140* 1/1/2006 Undertaking By Personal Sureties

CD-160* 1/1/2006 Application and Notice of Application and Hearing for Order to Quash
Ex Parte Writ of Possession

CD-170* 1/1/2006 Order for Release and Redelivery of Property

CD-180* 1/1/2006 Declaration for Ex Parte Writ of Possession

CD-190* 1/1/2006 Application for Temporary Restraining Order

CD-200* 1/1/2006 Temporary Restraining Order

CLETS
CLETS-001* 1/1/2012 Confidential CLETS Information

Court Records
REC-001(N)* 1/1/2007 Notice of Intent to Destroy Superior Court Records; Offer to Transfer
Possession

* Adopted for Mandatory Use. Page 12 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

REC-001(R) 1/1/2007 Request for Transfer or Extension of Time for Retention of Superior
Court Records

REC-002(N)* 1/1/2007 Notice of Hearing on Request for Transfer or Extension of Time for
Retention of Superior Court Records; Court Record; Release and
Receipt of Records

REC-002(R)* 1/1/2007 Release and Receipt of Superior Court Records

Criminal
CR-100* 1/24/2012 Fingerprint Form

CR-101 3/1/2023 Plea Form, With Explanations and Waiver of Rights—Felony

CR-102 3/1/2023 Domestic Violence Plea Form with Waiver of Rights—Misdemeanor

CR-105 9/1/2018 Defendant's Financial Statement on Eligibility for Appointment of


Counsel and Reimbursement and Record on Appeal at Public
Expense

CR-106 1/1/2020 Proof of Service - Criminal Record Clearing

CR-106-INFO 1/1/2020 Information on How to File a Proof of Service in Criminal Record


Clearing Requests

CR-110/JV-790 1/1/2023 Order for Victim Restitution

CR-111/JV-791 7/1/2015 Abstract of Judgment—Restitution

CR-112/JV-792 1/1/2023 Instructions: Order for Victim Restitution

CR-113/JV-793 1/1/2014 Instructions: Abstract of Judgment—Restitution

CR-115* 1/1/2020 Defendant's Statement of Assets

CR-115 C 1/1/2020 Defendant's Statement of Assets (Chinese)

CR-115 K 1/1/2020 Defendant's Statement of Assets (Korean)

CR-115 S 1/1/2020 Defendant's Statement of Assets (Spanish)

CR-115 V 1/1/2020 Defendant's Statement of Assets (Vietnamese)

CR-117 1/1/2004 Instructions: Defendant's Statement of Assets

CR-117 C 1/1/2004 Instructions: Defendant's Statement of Assets (Chinese)

CR-117 K 1/1/2004 Instructions: Defendant's Statement of Assets (Korean)

CR-117 S 1/1/2004 Instructions: Defendant's Statement of Assets (Spanish)

CR-117 V 1/1/2004 Instructions: Defendant's Statement of Assets (Vietnamese)

CR-118 1/1/2005 Information Regarding Income Deduction Order (Pen. Code, §


1202.42)

CR-119 1/1/2005 Order For Income Deduction

CR-120 1/1/2017 Notice of Appeal—Felony (Defendant)

* Adopted for Mandatory Use. Page 13 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

CR-125/JV-525* 7/1/2007 Order to Attend Court or Provide Documents (For


Subpoena/Subpoena Duces Tecum)

CR-126 1/1/2017 Application for Extension of Time to File Brief (Criminal Case)

CR-131-INFO 9/1/2020 Information on Appeal Procedures for Misdemeanors

CR-132 1/1/2020 Notice of Appeal (Misdemeanor)

CR-133 9/1/2020 Request for Court-Appointed Lawyer in Misdemeanor Appeal

CR-134 1/1/2020 Notice Regarding Record on Appeal (Misdemeanor)

CR-135 1/1/2021 Proposed Statement on Appeal (Misdemeanor)

CR-136 3/1/2014 Order Concerning Appellant's Proposed Statement on Appeal


(Misdemeanor)

CR-137 1/1/2017 Abandonment of Appeal (Misdemeanor)

CR-138 1/1/2020 Notice of Waiver of Oral Argument (Misdemeanor)

CR-141-INFO 1/1/2020 Information on Appeal Procedures for Infractions

CR-141-INFO C 1/1/2020 Information on Appeal Procedures for Infractions (Chinese)

CR-141-INFO K 1/1/2020 Information on Appeal Procedures for Infractions (Korean)

CR-141-INFO S 1/1/2020 Information on Appeal Procedures for Infractions (Spanish)

CR-141-INFO V 1/1/2020 Information on Appeal Procedures for Infractions (Vietnamese)

CR-142 1/1/2020 Notice of Appeal and Record on Appeal (Infraction)

CR-143 1/1/2021 Proposed Statement on Appeal (Infraction)

CR-144 3/1/2014 Order Concerning Appellant's Proposed Statement on Appeal


(Infraction)

CR-145 1/1/2017 Abandonment of Appeal (Infraction)

CR-150* 1/1/2021 Certificate of Identity Theft: Judicial Finding of Factual Innocence

CR-151 1/1/2005 Petition for Certificate of Identity Theft (PEN. CODE, § 530.6)

CR-160* 3/1/2023 Criminal Protective Order—Domestic Violence (CLETS—CPO)

CR-160 C 1/22/2019 Criminal Protective Order—Domestic Violence (CLETS—CPO)


(Chinese)

CR-160 K 1/22/2019 Criminal Protective Order—Domestic Violence (CLETS—CPO)


(Korean)

CR-160 V 1/22/2019 Criminal Protective Order—Domestic Violence (CLETS—CPO)


(Vietnamese)

CR-161* 3/1/2023 Criminal Protective Order—Other Than Domestic Violence


(CLETS—CPO)

* Adopted for Mandatory Use. Page 14 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

CR-162* 3/1/2023 Order to Surrender Firearms in Domestic Violence Case (CLETS-


CPO)

CR-165* 7/1/2016 Notice of Termination of Protective Order in Criminal Proceeding


(CLETS-CANCEL)

CR-168 1/1/2007 Batterer Intervention Program Progress Report

CR-170 1/1/2020 Notification of Decision Whether to Challenge Recommendation

CR-173 1/1/2022 Order for Commitment (Sexually Violent Predator)

CR-174 9/1/2018 Order For Extended Commitment (Sexually Violent Predator)

CR-180 1/1/2019 Petition for Dismissal

CR-180 S 1/1/2019 Petition for Dismissal (Spanish)

CR-181 1/1/2019 Order for Dismissal

CR-181 S 1/1/2019 Order for Dismissal (Spanish)

CR-183/MIL-183 1/1/2016 Petition for Dismissal (Military Personnel)

CR-184/MIL-184 1/22/2019 Order for Dismissal (Military Personnel)

CR-185/JV-796 1/1/2009 Petition for Expungement of DNA Profiles and Samples (Pen. Code, §
299)

CR-186/JV-798 1/1/2009 Order for Expungement of DNA Profiles and Samples (Pen. Code, §
299)

CR-187 1/1/2018 Motion to Vacate Conviction or Sentence

CR-188 9/21/2022 Order on Motion to Vacate Conviction or Sentence

CR-188 S 9/21/2022 Order on Motion to Vacate Conviction or Sentence (Spanish)

CR-190* 1/1/2004 Order Appointing Counsel in Capital Case

CR-191* 1/22/2019 Declaration of Counsel for Appointment in Capital Case

CR-200 1/1/2021 Form Interrogatories—Crime Victim Restitution

CR-210 3/1/2023 Prohibited Persons Relinquishment Form Findings (Pen. Code, §


29810(c))

CR-220 1/22/2019 Proof of Enrollment or Completion (Alcohol or Drug Program)

CR-221 1/1/2021 Order to Install Ignition Interlock Device

CR-222 1/1/2021 Ignition Interlock Installation Verification

CR-223 1/1/2021 Ignition Interlock Calibration Verification

CR-224 1/1/2021 Ignition Interlock Noncompliance Report

CR-225 1/1/2021 Ignition Interlock Removal and Modification to Probation Order

CR-226 1/1/2021 Notice to Employers of Ignition Interlock Restriction

* Adopted for Mandatory Use. Page 15 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

CR-250* 11/1/2012 Notice and Motion for Transfer

CR-251* 3/14/2022 Order for Transfer

CR-252* 11/1/2012 Receiving Court Comment Form

CR-290* 5/1/2023 Felony Abstract of Judgment—Prison Commitment—Determinate

CR-290(A)* 7/1/2012 Felony Abstract of Judgment Attachment Page

CR-290.1* 7/1/2012 Felony Abstract of Judgment—Prison Commitment—Determinate


Single, Concurrent, or Full Term Consecutive Count Form

CR-292* 5/1/2023 Abstract of Judgment—Prison Commitment—Indeterminate

CR-300 1/1/2021 Petition for Revocation

CR-301 7/1/2013 Warrant Request and Order

CR-302 7/1/2013 Request and Order to Recall Warrant

TR-320/CR-320 4/1/2018 Can't Afford to Pay Fine: Traffic and Other Infractions

TR-320/CR-320 S 4/1/2018 Can't Afford to Pay Fine: Traffic and Other Infractions (Spanish)

TR-321/CR-321 4/1/2018 Can't Afford to Pay Fine: Traffic and Other Infractions (Court Order)

TR-321/CR-321 S 4/1/2018 Can't Afford to Pay Fine: Traffic and Other Infractions (Court Order)
(Spanish)

CR-400 7/1/2017 Petition/Application (Health and Safety Code, § 11361.8) Adult


Crime(s)

CR-401 7/1/2017 Proof of Service for Petition/Application (Health and Safety Code, §
11361.8) Adult Crime(s)

CR-402 3/14/2022 Prosecuting Agency's Response to Petition/Application (Health and


Safety Code, § 11361.8) Adult Crime(s)

CR-403 7/1/2017 Order After Petition/Application (Health and Safety Code § 11363.8)
Adult Crimes

CR-404 1/1/2019 Petition/Application for Resentencing and Dismissal

CR-405 1/1/2019 Order After Petition/Application for Resentencing and Dismissal

CR-409 1/1/2019 Petition to Seal Arrest and Related Records

CR-409 C 1/1/2019 Petition to Seal Arrest and Related Records (Chinese)

CR-409 K 1/1/2019 Petition to Seal Arrest and Related Records (Korean)

CR-409 S 1/1/2019 Petition to Seal Arrest and Related Records (Spanish)

CR-409 V 1/1/2019 Petition to Seal Arrest and Related Records (Vietnamese)

CR-409-INFO 1/1/2019 Information on How to File a Petition to Seal Arrest and Related
Records Under Penal Code Section 851.91

* Adopted for Mandatory Use. Page 16 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

CR-409-INFO C 1/1/2019 Information on How to File a Petition to Seal Arrest and Related
Records Under Penal Code Section 851.91 (Chinese)

CR-409-INFO K 1/1/2019 Information on How to File a Petition to Seal Arrest and Related
Records Under Penal Code Section 851.91 (Korean)

CR-409-INFO S 1/1/2019 Information on How to File a Petition to Seal Arrest and Related
Records Under Penal Code Section 851.91 (Spanish)

CR-409-INFO V 1/1/2019 Information on How to File a Petition to Seal Arrest and Related
Records Under Penal Code Section 851.91 (Vietnamese)

CR-410 1/1/2019 Order to Seal arrest and Related Records (Pen. Code, sections
851.91, 851.92)

CR-412/MIL-412 1/1/2020 Petition for Resentencing Based on Health Conditions due to Military
Service Listed in Penal Code Section 1170.91(b)

CR-415* 7/1/2021 Petition to Terminate Sex Offender Registration (Pen. Code, § 290.5)

CR-415-INFO 7/1/2021 Information on Filing a Petition to Terminate Sex Offender Registration

CR-416 7/1/2021 Proof of Service—Sex Offender Registration Termination (Pen. Code,


§ 290.5)

CR-417* 7/1/2021 Response by District Attorney to Petition to Terminate Sex Offender


Registration

CR-418* 7/1/2021 Order on Petition to Terminate Sex Offender Registration (Pen. Code,
§ 290.5)

CR-425 1/1/2023 Request for Resentencing and Dismissal (Pen. Code, § 653.29)

CR-426 1/1/2023 Order After Request for Resentencing and Dismissal (Pen. Code Sec.
653.29)

CR-430 1/1/2022 Petition for Dismissal—Incarcerated Individual Hand Crew (Pen.


Code, § 1203.4b)

CR-430-INFO 1/1/2022 Information on Filing a Petition for Dismissal—Incarcerated Individual


Hand Crew (Pen. Code, § 1203.4b)

CR-431 1/1/2022 Court Cover Letter and Agency Certification—Incarcerated Individual


Hand Crew (Pen. Code, § 1203.4b)

CR-432 1/1/2022 Order on Petition—Incarcerated Individual Hand Crew (Pen. Code, §


1203.4b)

CR-600* 4/25/2019 Capital Case Attorney Pretrial Checklist


(Criminal)

CR-601* 4/25/2019 Capital Case Attorney List of Appearances (Criminal)

CR-602* 4/25/2019 Capital Case Attorney List of Exhibits (Criminal)

CR-603* 4/25/2019 Capital Case Attorney List of Motions (Criminal)

CR-604* 4/25/2019 Capital Case Attorney List of Jury Instructions (Criminal)

* Adopted for Mandatory Use. Page 17 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

CR-605* 4/25/2019 Capital Case Attorney Trial Checklist (Criminal)

Decedents Estates
DE-111* 7/1/2017 Petition for Probate

DE-142/DE-111 (A- 7/1/2017 Waiver of Bond by Heir or Beneficiary


3e)*

DE-115/GC-015* 1/1/2020 Notice of Hearing on Petition to Determine Claim to Property

DE-120* 1/1/2020 Notice of Hearing—Decedent's Estate or Trust

DE-120(MA)/GC- 7/1/2005 Attachment to Notice of Hearing Proof of Service by Mail


020(MA)

DE-120(P) 7/1/2005 Proof of Personal Service of Notice of Hearing-Decedent's Estate or


Trust

DE-120(PA)/GC- 7/1/2005 Attachment to Notice of Hearing Proof of Personal Service


020(PA)

DE-121* 1/1/2013 Notice of Petition to Administer Estate

DE-121(MA) 1/1/2006 Attachment to Notice of Petition to Administer Estate—Proof of


Service by Mail

DE-122/GC-322* 1/1/2006 Citation—Probate

DE-125* 1/1/1998 Summons (Probate)

DE-131* 1/1/1998 Proof of Subscribing Witness

DE-135* 1/1/1998 Proof of Holographic Instrument

DE-140* 1/1/2000 Order for Probate

DE-142/DE-111 (A- 7/1/2017 Waiver of Bond by Heir or Beneficiary


3e)*

DE-147* 1/1/2002 Duties and Liabilities of Personal Representative (Probate)

DE-147S* 1/1/2001 Confidential Supplement to Duties and Liabilities of Personal


Representative (Probate)

DE-150* 1/1/2000 Letters

DE-154/GC-035* 1/1/1998 Request for Special Notice

DE-157* 1/1/2013 Notice of Administration to Creditors (Probate—Decedents’ Estates)

DE-160/GC-040* 1/1/2007 Inventory and Appraisal

DE-161/GC-041* 1/1/2018 Inventory and Appraisal Attachment

DE-165* 1/1/1998 Notice of Proposed Action (Objection-Consent) (Probate)

DE-166* 1/1/1998 Waiver of Notice of Proposed Action (Probate)

DE-172* 1/1/1998 Creditor's Claim (Probate)

* Adopted for Mandatory Use. Page 18 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

DE-174* 1/1/2009 Allowance or Rejection of Creditor’s Claim

DE-200/GC-022* 1/1/2000 Order Prescribing Notice

DE-221* 1/1/2014 Spousal or Domestic Partner Property Petition

DE-226* 1/1/2015 Spousal or Domestic Partner Property Order

DE-260/GC-060* 1/1/2006 Report of Sale and Petition for Order Confirming Sale of Real Property

DE-265/GC-065* 1/1/2015 Order Confirming Sale of Real Property

DE-270/GC-070* 1/1/2000 Ex Parte Petition for Authority to Sell Securities and Order

DE-275/GC-075* 1/1/1998 Ex Parte Petition for Approval of Sale of Personal Property and Order

DE-295/GC-395* 1/1/2006 Ex Parte Petition for Final Discharge and Order

DE-300* 4/1/2022 Maximum Values For Small Estate Set-Aside & Disposition of Estate
Without Administration

DE-305* 1/1/2023 Affidavit Re: Real Property of Small Value

DE-310* 1/1/2023 Petition to Determine Sucession to Real Property

DE-315* 4/1/2022 Order Determining Succession to Real Property

DE-350/GC-100* 1/1/2008 Petition for Appointment of Guardian Ad Litem—Probate

DE-351/GC-101* 1/1/2004 Order Appointing Guardian Ad Litem—Probate

Disability Access Litigation


DAL-001 7/1/2016 Important Information for Building Owners and Tenants

DAL-001 C 10/23/2009 Important Information for Building Owners and Tenants (Chinese)

DAL-001 K 10/23/2009 Important Information for Building Owners and Tenants (Korean)

DAL-001 S 10/23/2009 Important Information for Building Owners and Tenants (Spanish)

DAL-001 V 10/23/2009 Important Information for Building Owners and Tenants (Vietnamese)

DAL-002 7/1/2016 Answer—Disability Access

DAL-005* 7/1/2016 Defendant's Application for Stay of Proceedings and Early Evaluation
Conference, Joint Inspection

DAL-006* 7/1/2013 Confidential Cover Sheet and Declaration Re Documents for Stay and
Early Evaluation Conference

DAL-010* 7/1/2016 Notice of Stay of Proceedings and Early Evaluation Conference, Joint
Inspection

DAL-012 1/1/2016 Proof of Service—Disability Access Litigation

DAL-015* 1/1/2015 Application for Mandatory Evaluation Conference Under Code of Civil
Procedure Section 55.545

DAL-020* 7/1/2013 Notice of Mandatory Evaluation Conference

* Adopted for Mandatory Use. Page 19 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

Discovery
DISC-001 1/1/2008 Form Interrogatories—General

DISC-002 1/1/2009 Form Interrogatories—Employment Law

DISC-003/UD-106 1/1/2014 Form Interrogatories—Unlawful Detainer

DISC-004 1/1/2007 Form Interrogatories—Limited Civil Cases (Economic Litigation)

DISC-005 7/1/2013 Form Interrogatories—Construction Litigation

DISC-010* 1/1/2007 Case Questionnaire—For Limited Civil Cases (Under $25,000)

DISC-020 1/1/2008 Requests for Admission

DISC-030 1/1/2008 Commission to Take Deposition Outside California

Domestic Violence
DV-100* 1/1/2023 Request for Domestic Violence Restraining Order

DV-100 C 1/1/2022 Request for Domestic Violence Restraining Order (Chinese)

DV-100 K 1/1/2022 Request for Domestic Violence Restraining Order (Korean)

DV-100 S 1/1/2022 Request for Domestic Violence Restraining Order (Spanish)

DV-100 V 1/1/2022 Request for Domestic Violence Restraining Order (Vietnamese)

DV-101 1/1/2017 Description of Abuse

DV-101 C 1/1/2017 Description of Abuse (Chinese)

DV-101 K 1/1/2017 Description of Abuse (Korean)

DV-101 S 1/1/2017 Description of Abuse (Spanish)

DV-101 V 1/1/2017 Description of Abuse (Vietnamese)

DV-105* 1/1/2023 Request for Child Custody and Visitation Orders

DV-105 C 1/1/2022 Request for Child Custody and Visitation Orders (Chinese)

DV-105 K 1/1/2022 Request for Child Custody and Visitation Orders (Korean)

DV-105 S 1/1/2022 Request for Child Custody and Visitation Orders (Spanish)

DV-105 V 1/1/2022 Request for Child Custody and Visitation Orders (Vietnamese)

DV-105(A)* 1/1/2023 City and State Where Children Lived (Domestic Violence Prevention)

DV-105(A) C 1/1/2023 City and State Where Children Lived (Domestic Violence Prevention)
(Chinese)

DV-105(A) K 1/1/2023 City and State Where Children Lived (Domestic Violence Prevention)
(Korean)

DV-105(A) V 1/1/2023 City and State Where Children Lived (Domestic Violence Prevention)
(Vietnamese)

* Adopted for Mandatory Use. Page 20 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

DV-108* 1/1/2023 Request for Order: No Travel with Children

DV-108 C 1/1/2023 Request for Order: No Travel with Children (Chinese)

DV-108 K 1/1/2023 Request for Order: No Travel with Children (Korean)

DV-108 S 1/1/2023 Request for Order: No Travel with Children (Spanish)

DV-108 V 1/1/2023 Request for Order: No Travel with Children (Vietnamese)

DV-109* 1/1/2023 Notice of Court Hearing

DV-109 C 9/1/2020 Notice of Court Hearing (Chinese)

DV-109 K 9/1/2020 Notice of Court Hearing (Korean)

DV-109 S 9/1/2020 Notice of Court Hearing (Spanish)

DV-109 V 9/1/2020 Notice of Court Hearing (Vietnamese)

DV-110* 1/1/2023 Temporary Restraining Order (CLETS—TRO)

DV-110 C 1/1/2022 Temporary Restraining Order (CLETS—TRO) (Chinese)

DV-110 K 1/1/2022 Temporary Restraining Order (CLETS—TRO) (Korean)

DV-110 S 1/1/2022 Temporary Restraining Order (CLETS—TRO) (Spanish)

DV-110 V 1/1/2022 Temporary Restraining Order (CLETS—TRO) (Vietnamese)

DV-112 1/1/2012 Waiver of Hearing on Denied Request for Temporary Restraining


Order

DV-112 C 1/1/2012 Waiver of Hearing on Denied Request for Temporary Restraining


Order (Chinese)

DV-112 K 1/1/2012 Waiver of Hearing on Denied Request for Temporary Restraining


Order (Korean)

DV-112 S 1/1/2012 Waiver of Hearing on Denied Request for Temporary Restraining


Order (Spanish)

DV-112 V 1/1/2012 Waiver of Hearing on Denied Request for Temporary Restraining


Order (Vietnamese)

DV-115* 1/1/2020 Request to Continue Hearing (Temporary Restraining Order)


(Domestic Violence Prevention)

DV-115 C 1/1/2020 Request to Continue Hearing (Temporary Restraining Order)


(Domestic Violence Prevention) (Chinese)

DV-115 K 1/1/2020 Request to Continue Hearing (Temporary Restraining Order)


(Domestic Violence Prevention) (Korean)

DV-115 S 1/1/2020 Request to Continue Hearing (Temporary Restraining Order)


(Domestic Violence Prevention) (Spanish)

DV-115 V 1/1/2020 Request to Continue Hearing (Temporary Restraining Order)


(Domestic Violence Prevention) (Vietnamese)

* Adopted for Mandatory Use. Page 21 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

DV-115-INFO 1/1/2020 How to Ask for a New Hearing Date (Domestic Violence Prevention)

DV-115-INFO C 1/1/2020 How to Ask for a New Hearing Date (Domestic Violence Prevention)
(Chinese)

DV-115-INFO K 1/1/2020 How to Ask for a New Hearing Date (Domestic Violence Prevention)
(Korean)

DV-115-INFO S 1/1/2020 How to Ask for a New Hearing Date (Domestic Violence Prevention)
(Spanish)

DV-115-INFO V 1/1/2020 How to Ask for a New Hearing Date (Domestic Violence Prevention)
(Vietnamese)

DV-116* 1/1/2023 Order on Request to Continue Court Hearing (Temporary Restraining


Order) (CLETS-TRO) (Domestic Violence Prevention)

DV-116 C 1/1/2023 Order on Request to Continue Court Hearing (Temporary Restraining


Order) (CLETS-TRO) (Domestic Violence Prevention) (Chinese)

DV-116 K 1/1/2023 Order on Request to Continue Court Hearing (Temporary Restraining


Order) (CLETS-TRO) (Domestic Violence Prevention) (Korean)

DV-116 S 1/1/2020 Order on Request to Continue Court Hearing (Temporary Restraining


Order) (CLETS-TRO) (Domestic Violence Prevention) (Spanish)

DV-116 V 1/1/2023 Order on Request to Continue Court Hearing (Temporary Restraining


Order) (CLETS-TRO) (Domestic Violence Prevention) (Vietnamese)

DV-117* 1/1/2020 Order Granting Alternative Service

DV-120* 1/1/2023 Response to Request for Domestic Violence Restraining Order

DV-120 C 1/1/2022 Response to Request for Domestic Violence Restraining Order


(Chinese)

DV-120 K 1/1/2022 Response to Request for Domestic Violence Restraining Order


(Korean)

DV-120 S 1/1/2022 Response to Request for Domestic Violence Restraining Order


(Spanish)

DV-120 V 1/1/2022 Response to Request for Domestic Violence Restraining Order


(Vietnamese)

DV-120-INFO 1/1/2023 How Can I Respond to a Request for Domestic Violence Restraining
Order?

DV-120-INFO C 1/1/2023 How Can I Respond to a Request for Domestic Violence Restraining
Order? (Chinese)

DV-120-INFO K 1/1/2023 How Can I Respond to a Request for Domestic Violence Restraining
Order? (Korean)

DV-120-INFO S 7/1/2016 How Can I Respond to a Request for Domestic Violence Restraining
Order? (Spanish)

DV-120-INFO V 1/1/2023 How Can I Respond to a Request for Domestic Violence Restraining
Order? (Vietnamese)

* Adopted for Mandatory Use. Page 22 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

DV-125* 1/1/2023 Response to Request for Child Custody and Visitation Orders
(Domestic Violence Prevention)

DV-125 C 1/1/2023 Response to Request for Child Custody and Visitation Orders
(Domestic Violence Prevention) (Chinese)

DV-125 K 1/1/2023 Response to Request for Child Custody and Visitation Orders
(Domestic Violence Prevention) (Korean)

DV-125 V 1/1/2023 Response to Request for Child Custody and Visitation Orders
(Domestic Violence Prevention) (Vietnamese)

DV-130* 1/1/2023 Restraining Order After Hearing (CLETS—OAH) (Order of Protection)

DV-130 C 1/1/2022 Restraining Order After Hearing (CLETS—OAH) (Order of Protection)


(Chinese)

DV-130 K 1/1/2022 Restraining Order After Hearing (CLETS—OAH) (Order of Protection)


(Korean)

DV-130 S 1/1/2022 Restraining Order After Hearing (CLETS—OAH) (Order of Protection)


(Spanish)

DV-130 V 1/1/2022 Restraining Order After Hearing (CLETS—OAH) (Order of Protection)


(Vietnamese)

DV-140* 1/1/2023 Child Custody and Visitation Order (Domestic Violence Prevention)

DV-140 C 1/1/2023 Child Custody and Visitation Order (Domestic Violence Prevention)
(Chinese)

DV-140 K 1/1/2023 Child Custody and Visitation Order (Domestic Violence Prevention)
(Korean)

DV-140 S 1/1/2012 Child Custody and Visitation Order (Domestic Violence Prevention)
(Spanish)

DV-140 V 1/1/2023 Child Custody and Visitation Order (Domestic Violence Prevention)
(Vietnamese)

DV-145* 1/1/2023 Order: No Travel With Children

DV-145 C 1/1/2023 Order: No Travel With Children (Chinese)

DV-145 K 1/1/2023 Order: No Travel With Children (Korean)

DV-145 S 1/1/2023 Order: No Travel With Children (Spanish)

DV-145 V 1/1/2023 Order: No Travel With Children (Vietnamese)

DV-160* 1/1/2019 Request to Keep Minor's Information Confidential


(Domestic Violence Prevention)

DV-160-INFO 1/1/2021 Privacy Protection for a Minor (Person Under 18 Years Old)

DV-160-INFO C 1/1/2021 Privacy Protection for a Minor (Person Under 18 Years Old) (Chinese)

DV-160-INFO K 1/1/2021 Privacy Protection for a Minor (Person Under 18 Years Old) (Korean)

* Adopted for Mandatory Use. Page 23 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

DV-160-INFO S 1/1/2021 Privacy Protection for a Minor (Person Under 18 Years Old) (Spanish)

DV-160-INFO V 1/1/2021 Privacy Protection for a Minor (Person Under 18 Years Old)
(Vietnamese)

DV-165* 1/1/2021 Order on Request to Keep Minor's Information Confidential

DV-165 C 1/1/2021 Order on Request to Keep Minor's Information Confidential (Chinese)

DV-165 K 1/1/2021 Order on Request to Keep Minor's Information Confidential (Korean)

DV-165 S 1/1/2021 Order on Request to Keep Minor's Information Confidential (Spanish)

DV-165 V 1/1/2021 Order on Request to Keep Minor's Information Confidential


(Vietnamese)

DV-170* 1/1/2019 Notice Of Order Protecting Information of Minor


(Domestic Violence Prevention)

DV-175* 9/1/2020 Cover Sheet for Confidential Information

DV-175 C 9/1/2020 Cover Sheet for Confidential Information (Chinese)

DV-175 K 9/1/2020 Cover Sheet for Confidential Information (Korean)

DV-175 S 9/1/2020 Cover Sheet for Confidential Information (Spanish)

DV-175 V 9/1/2020 Cover Sheet for Confidential Information (Vietnamese)

DV-176* 9/1/2020 Request for Release of Minor's Confidential Information

DV-177* 1/1/2021 Notice of Request for Release of Minor's Confidential Information

DV-178* 9/1/2020 Response to Request for Release of Minor's Confidential Information

DV-179* 9/1/2020 Order on Request for Release of Minor's Confidential Information

DV-180* 7/1/2014 Agreement and Judgment of Parentage

DV-180 C 7/1/2014 Agreement and Judgment of Parentage (Chinese)

DV-180 K 7/1/2014 Agreement and Judgment of Parentage (Korean)

DV-180 S 7/1/2014 Agreement and Judgment of Parentage (Spanish)

DV-180 V 7/1/2014 Agreement and Judgment of Parentage (Vietnamese)

DV-200 1/1/2023 Proof of Personal Service (CLETS)

DV-200 C 1/1/2023 Proof of Personal Service (CLETS) (Chinese)

DV-200 K 1/1/2023 Proof of Personal Service (CLETS) (Korean)

DV-200 S 1/1/2023 Proof of Personal Service (CLETS) (Spanish)

DV-200 V 1/1/2023 Proof of Personal Service (CLETS) (Vietnamese)

DV-200-INFO 1/1/2020 What Is “Proof of Personal Service”? (Domestic Violence Prevention)

* Adopted for Mandatory Use. Page 24 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

DV-200-INFO C 1/1/2020 What Is “Proof of Personal Service”? (Domestic Violence Prevention)


(Chinese)

DV-200-INFO K 1/1/2020 What Is “Proof of Personal Service”? (Domestic Violence Prevention)


(Korean)

DV-200-INFO S 1/1/2020 What Is “Proof of Personal Service”? (Domestic Violence Prevention)


(Spanish)

DV-200-INFO V 1/1/2020 What Is “Proof of Personal Service”? (Domestic Violence Prevention)


(Vietnamese)

DV-205-INFO 1/1/2020 What if the Person I Want Protection From is Avoiding (Evading)
Service? (Domestic Violence Prevention)

DV-205-INFO C 1/1/2020 What if the Person I Want Protection From is Avoiding (Evading)
Service? (Domestic Violence Prevention) (Chinese)

DV-205-INFO K 1/1/2020 What if the Person I Want Protection From is Avoiding (Evading)
Service? (Domestic Violence Prevention) (Korean)

DV-205-INFO S 1/1/2020 What if the Person I Want Protection From is Avoiding (Evading)
Service? (Domestic Violence Prevention) (Spanish)

DV-205-INFO V 1/1/2020 What if the Person I Want Protection From is Avoiding (Evading)
Service? (Domestic Violence Prevention) (Vietnamese)

DV-210* 1/1/2020 Summons (Domestic Violence Restraining Order)

DV-210 C 1/1/2020 Summons (Domestic Violence Restraining Order) (Chinese)

DV-210 K 1/1/2020 Summons (Domestic Violence Restraining Order) (Korean)

DV-210 V 1/1/2020 Summons (Domestic Violence Restraining Order) (Vietnamese)

DV-250 1/1/2020 Proof of Service by Mail (CLETS) (Domestic Violence Prevention)

DV-250 C 1/1/2012 Proof of Service by Mail (CLETS) (Domestic Violence Prevention)


(Chinese)

DV-250 K 1/1/2012 Proof of Service by Mail (CLETS) (Domestic Violence Prevention)


(Korean)

DV-250 S 1/1/2012 Proof of Service by Mail (CLETS) (Domestic Violence Prevention)


(Spanish)

DV-250 V 1/1/2012 Proof of Service by Mail (CLETS) (Domestic Violence Prevention)


(Vietnamese)

DV-400* 7/1/2016 Findings and Order to Terminate Restraining Order After Hearing
(CLETS - CANCEL)

DV-400 S 7/1/2016 Findings and Order to Terminate Restraining Order After Hearing
(CLETS - CANCEL) (Spanish)

DV-400-INFO 7/1/2016 How Do I Ask to Change or End a Domestic Violence Restraining


Order After Hearing?

* Adopted for Mandatory Use. Page 25 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

DV-400-INFO C 7/1/2016 How Do I Ask to Change or End a Domestic Violence Restraining


Order After Hearing? (Chinese)

DV-400-INFO K 7/1/2016 How Do I Ask to Change or End a Domestic Violence Restraining


Order After Hearing? (Korean)

DV-400-INFO S 7/1/2016 How Do I Ask to Change or End a Domestic Violence Restraining


Order After Hearing? (Spanish)

DV-400-INFO V 7/1/2016 How Do I Ask to Change or End a Domestic Violence Restraining


Order After Hearing? (Vietnamese)

DV-500-INFO 1/1/2023 Can a Domestic Violence Restraining Order Help Me?

DV-500-INFO C 1/1/2022 Can a Domestic Violence Restraining Order Help Me? (Chinese)

DV-500-INFO K 1/1/2022 Can a Domestic Violence Restraining Order Help Me? (Korean)

DV-500-INFO S 1/1/2022 Can a Domestic Violence Restraining Order Help Me? (Spanish)

DV-500-INFO V 1/1/2022 Can a Domestic Violence Restraining Order Help Me? (Vietnamese)

DV-505-INFO 1/1/2023 How Do I Ask For a Temporary Restraining Order?

DV-505-INFO C 7/1/2016 How Do I Ask For a Temporary Restraining Order? (Chinese)

DV-505-INFO K 7/1/2016 How Do I Ask For a Temporary Restraining Order? (Korean)

DV-505-INFO S 7/1/2016 How Do I Ask For a Temporary Restraining Order? (Spanish)

DV-505-INFO V 7/1/2016 How Do I Ask For a Temporary Restraining Order? (Vietnamese)

DV-520-INFO 1/1/2023 Get Ready for the Court Hearing

DV-520-INFO C 1/1/2012 Get Ready for the Court Hearing (Chinese)

DV-520-INFO K 1/1/2012 Get Ready for the Court Hearing (Korean)

DV-520-INFO S 1/1/2012 Get Ready for the Court Hearing (Spanish)

DV-520-INFO V 1/1/2012 Get Ready for the Court Hearing (Vietnamese)

DV-530-INFO 1/1/2023 How to Enforce Your Restraining Order

DV-530-INFO C 1/1/2012 How to Enforce Your Restraining Order (Chinese)

DV-530-INFO K 1/1/2012 How to Enforce Your Restraining Order (Korean)

DV-530-INFO S 1/1/2012 How to Enforce Your Restraining Order (Spanish)

DV-530-INFO V 1/1/2012 How to Enforce Your Restraining Order (Vietnamese)

DV-570 1/1/2003 Which Financial Form-FL-155 or FL-150?

DV-570 C 1/1/2003 Which Financial Form-FL-155 or FL-150? (Chinese)

DV-570 K 1/1/2003 Which Financial Form-FL-155 or FL-150? (Korean)

DV-570 S 1/1/2003 Which Financial Form-FL-155 or FL-150? (Spanish)

* Adopted for Mandatory Use. Page 26 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

DV-570 V 1/1/2003 Which Financial Form-FL-155 or FL-150? (Vietnamese)

DV-600* 7/1/2015 Order to Register Out-of-State or Tribal Court Protective/Restraining


Order

DV-600 C 7/1/2015 Order to Register Out-of-State or Tribal Court Protective/Restraining


Order (Chinese)

DV-600 K 7/1/2015 Order to Register Out-of-State or Tribal Court Protective/Restraining


Order (Korean)

DV-600 S 7/1/2015 Order to Register Out-of-State or Tribal Court Protective/Restraining


Order (Spanish)

DV-600 V 7/1/2015 Order to Register Out-of-State or Tribal Court Protective/Restraining


Order (Vietnamese)

DV-610 7/1/2012 Fax Transmission Cover Sheet for Registration of Tribal Court
Protective Order

DV-630* 1/22/2019 Order to Register Canadian Domestic


Violence Protective/Restraining Order
(Domestic Violence Prevention)

DV-630 C 1/22/2019 Order to Register Canadian Domestic


Violence Protective/Restraining Order
(Domestic Violence Prevention) (Chinese)

DV-630 K 1/22/2019 Order to Register Canadian Domestic


Violence Protective/Restraining Order
(Domestic Violence Prevention) (Korean)

DV-630 S 1/22/2019 Order to Register Canadian Domestic


Violence Protective/Restraining Order
(Domestic Violence Prevention) (Spanish)

DV-630 V 1/22/2019 Order to Register Canadian Domestic


Violence Protective/Restraining Order
(Domestic Violence Prevention) (Vietnamese)

DV-700* 1/1/2012 Request to Renew Restraining Order

DV-700 C 1/1/2012 Request to Renew Restraining Order (Chinese)

DV-700 K 1/1/2012 Request to Renew Restraining Order (Korean)

DV-700 S 1/1/2012 Request to Renew Restraining Order (Spanish)

DV-700 V 1/1/2012 Request to Renew Restraining Order (Vietnamese)

DV-700-INFO 1/1/2012 How Do I Ask the Court to Renew My Restraining Order?

DV-700-INFO C 1/1/2012 How Do I Ask the Court to Renew My Restraining Order? (Chinese)

DV-700-INFO K 1/1/2012 How Do I Ask the Court to Renew My Restraining Order? (Korean)

DV-700-INFO S 1/1/2012 How Do I Ask the Court to Renew My Restraining Order? (Spanish)

* Adopted for Mandatory Use. Page 27 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

DV-700-INFO V 1/1/2012 How Do I Ask the Court to Renew My Restraining Order?


(Vietnamese)

DV-710* 7/1/2014 Notice of Hearing to Renew Restraining Order

DV-710 C 7/1/2014 Notice of Hearing to Renew Restraining Order (Chinese)

DV-710 K 7/1/2014 Notice of Hearing to Renew Restraining Order (Korean)

DV-710 S 7/1/2014 Notice of Hearing to Renew Restraining Order (Spanish)

DV-710 V 7/1/2014 Notice of Hearing to Renew Restraining Order (Vietnamese)

DV-720* 1/1/2012 Response to Request to Renew Restraining Order

DV-720 C 1/1/2012 Response to Request to Renew Restraining Order (Chinese)

DV-720 K 1/1/2012 Response to Request to Renew Restraining Order (Korean)

DV-720 S 1/1/2012 Response to Request to Renew Restraining Order (Spanish)

DV-720 V 1/1/2012 Response to Request to Renew Restraining Order (Vietnamese)

DV-730* 1/1/2012 Order to Renew Domestic Violence Restraining Order

DV-730 C 1/1/2012 Order to Renew Domestic Violence Restraining Order (Chinese)

DV-730 K 1/1/2012 Order to Renew Domestic Violence Restraining Order (Korean)

DV-730 S 1/1/2012 Order to Renew Domestic Violence Restraining Order (Spanish)

DV-730 V 1/1/2012 Order to Renew Domestic Violence Restraining Order (Vietnamese)

DV-800/JV-252 C 1/1/2019 Proof of Firearms Turned In, Sold, or Stored (Chinese)

DV-800/JV-252 K 1/1/2019 Proof of Firearms Turned In, Sold, or Stored (Korean)

DV-800/JV-252 S 1/1/2019 Proof of Firearms Turned In, Sold, or Stored (Spanish)

DV-800/JV-270 1/1/2023 Proof of Firearms Turned In, Sold, or Stored

DV-800-INFO/JV- 7/1/2014 How Do I Turn In, Sell, or Store My Firearms? (Chinese)


252-INFO C

DV-800-INFO/JV- 7/1/2014 How Do I Turn In, Sell, or Store My Firearms? (Korean)


252-INFO K

DV-800-INFO/JV- 7/1/2014 How Do I Turn In, Sell, or Store My Firearms? (Spanish)


252-INFO S

DV-800-INFO/JV- 7/1/2014 How Do I Turn In, Sell, or Store My Firearms? (Vietnamese)


252-INFO V

DV-800-INFO/JV- 1/1/2023 How Do I Turn In, Sell, or Store My Firearms?


270-INFO

DV-805* 7/1/2016 Proof of Enrollment for Batterer Intervention Program

DV-805 C 7/1/2016 Proof of Enrollment for Batterer Intervention Program (Chinese)

* Adopted for Mandatory Use. Page 28 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

DV-805 K 7/1/2016 Proof of Enrollment for Batterer Intervention Program (Korean)

DV-805 S 7/1/2016 Proof of Enrollment for Batterer Intervention Program (Spanish)

DV-805 V 7/1/2016 Proof of Enrollment for Batterer Intervention Program (Vietnamese)

DV-815 7/1/2016 Batterer Intervention Program Progress Report

DV-815 C 7/1/2016 Batterer Intervention Program Progress Report (Chinese)

DV-815 K 7/1/2016 Batterer Intervention Program Progress Report (Korean)

DV-815 S 7/1/2016 Batterer Intervention Program Progress Report (Spanish)

DV-815 V 7/1/2016 Batterer Intervention Program Progress Report (Vietnamese)

DV-820* 1/1/2023 Prohibited Items Finding and Orders


(Domestic Violence Prevention)

DV-830* 1/1/2023 Noncompliance with Firearms and Ammunition Order, or Warrant

DV-840/FL-840* 1/1/2023 Notice of Compliance Hearing for Firearms and Ammunition


(Domestic Violence Prevention)

DV-900* 7/1/2016 Order Transferring Wireless Phone Account

DV-900 C 7/1/2016 Order Transferring Wireless Phone Account (Chinese)

DV-900 K 7/1/2016 Order Transferring Wireless Phone Account (Korean)

DV-900 S 7/1/2016 Order Transferring Wireless Phone Account (Spanish)

DV-900 V 7/1/2016 Order Transferring Wireless Phone Account (Vietnamese)

DV-901* 7/1/2016 Attachment to Order Transferring Wireless Phone Account

DV-901 C 7/1/2016 Attachment to Order Transferring Wireless Phone Account (Chinese)

DV-901 K 7/1/2016 Attachment to Order Transferring Wireless Phone Account (Korean)

DV-901 S 7/1/2016 Attachment to Order Transferring Wireless Phone Account (Spanish)

DV-901 V 7/1/2016 Attachment to Order Transferring Wireless Phone Account


(Vietnamese)

Elder or Dependent Adult Abuse


EA-100* 1/1/2023 Request for Elder or Dependent Adult Abuse Restraining Orders
(Elder or Dependent Adult Abuse Prevention)

EA-100 C 1/1/2021 Request for Elder or Dependent Adult Abuse Restraining Orders
(Elder or Dependent Adult Abuse Prevention) (Chinese)

EA-100 K 1/1/2021 Request for Elder or Dependent Adult Abuse Restraining Orders
(Elder or Dependent Adult Abuse Prevention) (Korean)

EA-100 S 1/1/2021 Request for Elder or Dependent Adult Abuse Restraining Orders
(Elder or Dependent Adult Abuse Prevention) (Spanish)

* Adopted for Mandatory Use. Page 29 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

EA-100 V 1/1/2021 Request for Elder or Dependent Adult Abuse Restraining Orders
(Elder or Dependent Adult Abuse Prevention) (Vietnamese)

EA-100-INFO 1/1/2023 Can a Restraining Order to Prevent Elder or Dependent Adult Abuse
Help Me? (Elder or Dependent Adult Abuse Prevention)

EA-100-INFO C 1/1/2012 Can a Restraining Order to Prevent Elder or Dependent Adult Abuse
Help Me? (Elder or Dependent Adult Abuse Prevention) (Chinese)

EA-100-INFO K 1/1/2012 Can a Restraining Order to Prevent Elder or Dependent Adult Abuse
Help Me? (Elder or Dependent Adult Abuse Prevention) (Korean)

EA-100-INFO S 1/1/2012 Can a Restraining Order to Prevent Elder or Dependent Adult Abuse
Help Me? (Elder or Dependent Adult Abuse Prevention) (Spanish)

EA-100-INFO V 1/1/2012 Can a Restraining Order to Prevent Elder or Dependent Adult Abuse
Help Me? (Elder or Dependent Adult Abuse Prevention) (Vietnamese)

EA-109* 1/1/2023 Notice of Court Hearing

EA-110* 1/1/2023 Temporary Restraining Order (CLETS–TEA or TEF)

EA-110 C 1/1/2017 Temporary Restraining Order (CLETS–TEA or TEF) (Chinese)

EA-110 K 1/1/2017 Temporary Restraining Order (CLETS–TEA or TEF) (Korean)

EA-110 S 1/1/2017 Temporary Restraining Order (CLETS–TEA or TEF) (Spanish)

EA-110 V 1/1/2017 Temporary Restraining Order (CLETS–TEA or TEF) (Vietnamese)

EA-115* 1/1/2020 Request to Continue Court Hearing (Temporary Restraining Order)


(Elder or Dependent Adult Abuse Prevention)

EA-115 C 1/1/2020 Request to Continue Court Hearing (Temporary Restraining Order)


(Elder or Dependent Adult Abuse Prevention) (Chinese)

EA-115 K 1/1/2020 Request to Continue Court Hearing (Temporary Restraining Order)


(Elder or Dependent Adult Abuse Prevention) (Korean)

EA-115 S 1/1/2020 Request to Continue Court Hearing (Temporary Restraining Order)


(Elder or Dependent Adult Abuse Prevention) (Spanish)

EA-115 V 1/1/2020 Request to Continue Court Hearing (Temporary Restraining Order)


(Elder or Dependent Adult Abuse Prevention) (Vietnamese)

EA-115-INFO 1/1/2020 How to Ask for a New Hearing Date (Elder or Dependent Adult Abuse
Prevention)

EA-115-INFO C 1/1/2020 How to Ask for a New Hearing Date (Elder or Dependent Adult Abuse
Prevention) (Chinese)

EA-115-INFO K 1/1/2020 How to Ask for a New Hearing Date (Elder or Dependent Adult Abuse
Prevention) (Korean)

EA-115-INFO S 1/1/2020 How to Ask for a New Hearing Date (Elder or Dependent Adult Abuse
Prevention) (Spanish)

EA-115-INFO V 1/1/2020 How to Ask for a New Hearing Date (Elder or Dependent Adult Abuse
Prevention) (Vietnamese)

* Adopted for Mandatory Use. Page 30 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

EA-116* 1/1/2020 Order on Request to Continue Hearing (Temporary Restraining


Order) (CLETS-TEA or TEF) (Elder or Dependent Adult Abuse
Prevention)

EA-116 C 1/1/2020 Order on Request to Continue Hearing (Temporary Restraining


Order) (CLETS-TEA or TEF) (Elder or Dependent Adult Abuse
Prevention) (Chinese)

EA-116 K 1/1/2020 Order on Request to Continue Hearing (Temporary Restraining


Order) (CLETS-TEA or TEF) (Elder or Dependent Adult Abuse
Prevention) (Korean)

EA-116 S 1/1/2020 Order on Request to Continue Hearing (Temporary Restraining


Order) (CLETS-TEA or TEF) (Elder or Dependent Adult Abuse
Prevention) (Spanish)

EA-116 V 1/1/2020 Order on Request to Continue Hearing (Temporary Restraining


Order) (CLETS-TEA or TEF) (Elder or Dependent Adult Abuse
Prevention) (Vietnamese)

EA-120* 1/1/2023 Response to Request for Elder or Dependent Adult Abuse Restraining
Orders (Elder or Dependent Adult Abuse Prevention)

EA-120 C 1/1/2021 Response to Request for Elder or Dependent Adult Abuse Restraining
Orders (Elder or Dependent Adult Abuse Prevention) (Chinese)

EA-120 K 1/1/2021 Response to Request for Elder or Dependent Adult Abuse Restraining
Orders (Elder or Dependent Adult Abuse Prevention) (Korean)

EA-120 S 1/1/2021 Response to Request for Elder or Dependent Adult Abuse Restraining
Orders (Elder or Dependent Adult Abuse Prevention) (Spanish)

EA-120 V 1/1/2021 Response to Request for Elder or Dependent Adult Abuse Restraining
Orders (Elder or Dependent Adult Abuse Prevention) (Vietnamese)

EA-120-INFO 1/1/2023 How Can I Respond to a Request for Elder or Dependent Adult Abuse
Restraining Orders? (Elder or Dependent Adult Abuse Prevention)

EA-120-INFO C 7/1/2014 How Can I Respond to a Request for Elder or Dependent Adult Abuse
Restraining Orders? (Elder or Dependent Adult Abuse Prevention)
(Chinese)

EA-120-INFO K 7/1/2014 How Can I Respond to a Request for Elder or Dependent Adult Abuse
Restraining Orders? (Elder or Dependent Adult Abuse Prevention)
(Korean)

EA-120-INFO S 7/1/2014 How Can I Respond to a Request for Elder or Dependent Adult Abuse
Restraining Orders? (Elder or Dependent Adult Abuse Prevention)
(Spanish)

EA-120-INFO V 7/1/2014 How Can I Respond to a Request for Elder or Dependent Adult Abuse
Restraining Orders? (Elder or Dependent Adult Abuse Prevention)
(Vietnamese)

EA-130* 1/1/2023 Elder or Dependent Adult Abuse RestrainingOrder After Hearing


(CLETS-EAR or EAF) (Elder or Dependent Adult Abuse Prevention)

* Adopted for Mandatory Use. Page 31 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

EA-130 C 1/1/2021 Elder or Dependent Adult Abuse RestrainingOrder After Hearing


(CLETS-EAR or EAF) (Elder or Dependent Adult Abuse Prevention)
(Chinese)

EA-130 K 1/1/2021 Elder or Dependent Adult Abuse RestrainingOrder After Hearing


(CLETS-EAR or EAF) (Elder or Dependent Adult Abuse Prevention)
(Korean)

EA-130 S 1/1/2021 Elder or Dependent Adult Abuse RestrainingOrder After Hearing


(CLETS-EAR or EAF) (Elder or Dependent Adult Abuse Prevention)
(Spanish)

EA-130 V 1/1/2021 Elder or Dependent Adult Abuse RestrainingOrder After Hearing


(CLETS-EAR or EAF) (Elder or Dependent Adult Abuse Prevention)
(Vietnamese)

EA-200 1/1/2023 Proof of Personal Service

EA-200 C 7/1/2014 Proof of Personal Service (Chinese)

EA-200 K 7/1/2014 Proof of Personal Service (Korean)

EA-200 S 7/1/2014 Proof of Personal Service (Spanish)

EA-200 V 7/1/2014 Proof of Personal Service (Vietnamese)

EA-200-INFO 1/1/2023 What Is “Proof of Personal Service”?

EA-200-INFO C 1/1/2012 What Is “Proof of Personal Service”? (Chinese)

EA-200-INFO K 1/1/2012 What Is “Proof of Personal Service”? (Korean)

EA-200-INFO S 1/1/2012 What Is “Proof of Personal Service”? (Spanish)

EA-200-INFO V 1/1/2012 What Is “Proof of Personal Service”? (Vietnamese)

EA-250 1/1/2023 Proof of Service of Response by Mail

EA-260 1/1/2012 Proof of Service of Order After Hearing by Mail

EA-300* 1/1/2023 Request for Elder or Dependent Adult Restraining Order Allowing
Contact

EA-300-INFO 1/1/2023 Can An Elder or Dependent Adult Restraining Order Allowing Contact
Help Me?

EA-309* 1/1/2023 Notice of Court Hearing to Allow Contact

EA-315* 1/1/2023 Request to Continue Court Hearing on Request to Allow Contact

EA-315-INFO 1/1/2023 How to Ask for a New Date for a Hearing to Allow Contact

EA-316* 1/1/2023 Order on Request to Continue Hearing on Request to Allow Contact

EA-320* 1/1/2023 Response to Request for Elder or Dependent Adult Restraining Order
Allowing Contact

EA-320-INFO 1/1/2023 How Can I Respond to a Request for an Elder or Dependent Adult
Restraining Order Allowing Contact?

* Adopted for Mandatory Use. Page 32 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

EA-330* 1/1/2023 Elder or Dependent Adult Restraining Order Allowing Contact After
Hearing

EA-600* 1/1/2018 Request to Modify/Terminate Elder or Dependent Adult Abuse


Restraining Order

EA-610* 1/1/2018 Notice of Hearing to Modify/Terminate Elder or Dependent Adult


Abuse Restraining Order

EA-620* 1/1/2018 Response to Request to Modify/Terminate Elder or Dependent Adult


Abuse Restraining Order

EA-630* 1/1/2018 Order on Request to Modify/Terminate Elder or Dependent Adult


Abuse Restraining Order

EA-700* 1/1/2012 Request to Renew Restraining Order

EA-710* 1/1/2012 Notice of Hearing to Renew Restraining Order

EA-720* 1/1/2012 Response to Request to Renew Restraining Order

EA-730* 1/1/2012 Order Renewing Elder or Dependent Adult Abuse Restraining Order

EA-800 1/1/2023 Receipt for Firearms and Firearm Parts

EA-800 C 7/1/2014 Receipt for Firearms and Firearm Parts (Chinese)

EA-800 K 7/1/2014 Receipt for Firearms and Firearm Parts (Korean)

EA-800 S 7/1/2014 Receipt for Firearms and Firearm Parts (Spanish)

EA-800 V 7/1/2014 Receipt for Firearms and Firearm Parts (Vietnamese)

EA-800-INFO 1/1/2023 How Do I Turn In, Sell, or Store My Firearms and Firearm Parts?

EA-800-INFO C 7/1/2014 How Do I Turn In, Sell, or Store My Firearms and Firearm Parts?
(Chinese)

EA-800-INFO K 7/1/2014 How Do I Turn In, Sell, or Store My Firearms and Firearm Parts?
(Korean)

EA-800-INFO S 7/1/2014 How Do I Turn In, Sell, or Store My Firearms and Firearm Parts?
(Spanish)

EA-800-INFO V 7/1/2014 How Do I Turn In, Sell, or Store My Firearms and Firearm Parts?
(Vietnamese)

Electronic Filing and Service


EFS-005-CV 7/1/2016 Consent to Electronic Service and Notice of Electronic Notification
Address

EFS-005-JV/JV-141 1/1/2019 E-Mail Notice of Hearing: Consent, Withdrawal of Consent, Address


Change

EFS-005-JV/JV- 1/1/2019 E-Mail Notice of Hearing: Consent, Withdrawal of Consent, Address


141 S Change (Spanish)

* Adopted for Mandatory Use. Page 33 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

EFS-006 1/1/2019 Withdrawal of Consent to Electronic Service


(Electronic Filing and Service)

EFS-007 7/1/2013 Request for Exemption from Mandatory Electronic Filing and Service

EFS-008 7/1/2013 Order of Exemption from Electronic Filing and Service

EFS-010 1/1/2011 Notice of Change of Electronic Service Address

EFS-020* 2/1/2017 Proposed Order (Cover Sheet)

POS-050/EFS-050 2/1/2017 Proof of Electronic Service

POS-050(D)/EFS- 1/1/2010 Attachment to Proof of Electronic Service (Documents Served)


050(D)

POS-050(P)/EFS- 2/1/2017 Attachment to Proof of Electronic Service (Persons Served)


050(P)

Emancipation of Minors
EM-100* 9/1/2018 Petition for Declaration of Emancipation of Minor, Order Prescribing
Notice, Declaration of Emancipation, and Order Denying Petition

EM-100-INFO* 9/1/2018 Emancipation Pamphlet

EM-100-INFO C 9/1/2018 Emancipation Pamphlet (Chinese)

EM-100-INFO K 9/1/2018 Emancipation Pamphlet (Korean)

EM-100-INFO S 9/1/2018 Emancipation Pamphlet (Spanish)

EM-100-INFO V 9/1/2018 Emancipation Pamphlet (Vietnamese)

EM-109* 9/1/2018 Notice of Hearing—Emancipation of Minor

EM-115* 9/1/2018 Emancipation of Minor Income and Expense Declaration

EM-130* 9/1/2018 Declaration of Emancipation of Minor After Hearing

EM-140 9/1/2018 Emancipated Minor's Application to California Department of Motor


Vehicles

Emergency Protective Order


EPO-001* 1/1/2023 Emergency Protective Order (CLETS-EPO)

EPO-001 C 1/1/2014 Emergency Protective Order (CLETS-EPO) (Chinese)

EPO-001 K 1/1/2014 Emergency Protective Order (CLETS-EPO) (Korean)

EPO-001 S 1/1/2014 Emergency Protective Order (CLETS-EPO) (Spanish)

EPO-001 V 1/1/2014 Emergency Protective Order (CLETS-EPO) (Vietnamese)

EPO-002* 1/1/2023 Gun Violence Emergency Protective Order (CLETS-EGV)

EPO-002 C 9/1/2021 Gun Violence Emergency Protective Order (CLETS-EGV) (Chinese)

EPO-002 K 9/1/2021 Gun Violence Emergency Protective Order (CLETS-EGV) (Korean)

* Adopted for Mandatory Use. Page 34 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

EPO-002 S 1/1/2023 Gun Violence Emergency Protective Order (CLETS-EGV) (Spanish)

EPO-002 V 9/1/2021 Gun Violence Emergency Protective Order (CLETS-EGV)


(Vietnamese)

Enforcement of Judgment
EJ-001* 7/1/2014 Abstract of Judgment—Civil and Small Claims

EJ-100 7/1/2014 Acknowledgment of Satisfaction of Judgment

EJ-105 7/1/1983 Application for Entry of Judgment on Sister-State Judgment

EJ-110 7/1/1983 Notice of Entry of Judgment on Sister-State Judgment

EJ-115* 7/1/2015 Notice of Application for Recognition and Entry of Tribal Court Money
Judgment

AT-138/EJ-125* 4/1/2023 Application and Order for Appearance and Examination

EJ-130 9/1/2020 Writ of Execution

EJ-150 9/1/2020 Notice of Levy

AT-167/EJ-152 9/1/2022 Memorandum of Garnishee

EJ-155* 9/1/2021 Exemptions From the Enforcement of Judgments

EJ-156 7/15/2022 Current Dollar Amounts of Exemptions From Enforcement of


Judgments

EJ-157 1/1/2021 Ex Parte Application for Order on Deposit Account Exemption

EJ-157-INFO 9/1/2020 Instructions for Ex Parte Application for Order on Deposit Account
Exemption

EJ-158 1/1/2021 Declaration Regarding Notice and Service for Ex Parte Application for
Order on Deposit Account Exemption

EJ-159 1/1/2021 Order on Application for Designation of Deposit Account Exemption

EJ-160 1/1/2009 Claim of Exemption

WG-007/EJ-165* 1/1/2007 Financial Statement

EJ-170 7/1/1983 Notice of Opposition to Claim of Exemption

WG-010/EJ-175 1/1/2007 Notice of Hearing on Claim of Exemption

EJ-180 1/1/1985 Notice of Hearing on Right to Homestead Exemption

EJ-182 1/1/1985 Notice of Rehearing on Right to Homestead Exemption

AT-180/EJ-185 1/1/1985 Notice of Lien

EJ-186 4/1/2022 Current Dollar Amounts Under Code of Civil Procedure Section
699.730(b)

EJ-190 1/1/2023 Application for and Renewal of Judgment

* Adopted for Mandatory Use. Page 35 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

EJ-195* 1/1/2023 Notice of Renewal of Judgment

Expedited Jury Trial


EJT-001-INFO* 7/1/2016 Expedited Jury Trial Information Sheet

EJT-003* 7/1/2016 Request to Opt Out of Mandatory Expedited Jury Trial Procedures

EJT-004* 7/1/2016 Objection to Request to Opt Out of Mandatory Expedited Jury Trial
Procedures

EJT-005 7/1/2016 Order on Request to Opt Out of Mandatory Expedited Jury Trial
Procedures

EJT-018 7/1/2016 Agreement of Parties (Mandatory Expedited Jury Trial Procedures)

EJT-020 7/1/2016 [Proposed] Consent Order for Voluntary Expedited Jury Trial

EJT-022A 7/1/2016 Attachment to [Proposed] Consent Order or Agreement of Parties

Family Law
FL-100* 1/1/2020 Petition—Marriage/Domestic Partnership (Family Law)

FL-100 A 1/1/2020 Petition—Marriage/Domestic Partnership (Family Law) (Arabic)

FL-100 C 1/1/2020 Petition—Marriage/Domestic Partnership (Family Law) (Chinese)

FL-100 K 1/1/2020 Petition—Marriage/Domestic Partnership (Family Law) (Korean)

FL-100 S 1/1/2020 Petition—Marriage/Domestic Partnership (Family Law) (Spanish)

FL-100 V 1/1/2020 Petition—Marriage/Domestic Partnership (Family Law) (Vietnamese)

FL-105/GC-120* 1/1/2009 Declaration Under Uniform Child Custody Jurisdiction and


Enforcement Act (UCCJEA)

FL-105/GC-120 S 1/1/2009 Declaration Under Uniform Child Custody Jurisdiction and


Enforcement Act (UCCJEA) (Spanish)

FL-105(A)/GC- 1/1/2009 Attachment to Declaration Under Uniform Child Custody Jurisdiction


120(A)* and Enforcement Act (UCCJEA)

FL-107-INFO 1/1/2015 Legal Steps for a Divorce or Legal Separation

FL-107-INFO C 1/1/2015 Legal Steps for a Divorce or Legal Separation (Chinese)

FL-107-INFO K 1/1/2015 Legal Steps for a Divorce or Legal Separation (Korean)

FL-107-INFO S 1/1/2015 Legal Steps for a Divorce or Legal Separation (Spanish)

FL-107-INFO V 1/1/2015 Legal Steps for a Divorce or Legal Separation (Vietnamese)

FL-110* 1/1/2015 Summons (Family Law)

FL-110 A 1/1/2015 Summons (Family Law) (Arabic)

FL-110 C 1/1/2015 Summons (Family Law) (Chinese)

FL-110 K 1/1/2015 Summons (Family Law) (Korean)

* Adopted for Mandatory Use. Page 36 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

FL-110 V 1/1/2015 Summons (Family Law) (Vietnamese)

FL-115 1/1/2021 Proof of Service of Summons

FL-115 S 1/1/2021 Proof of Service of Summons (Spanish)

FL-117 1/1/2021 Notice and Acknowledgment of Receipt

FL-117 S 1/1/2021 Notice and Acknowledgment of Receipt (Spanish)

FL-120* 1/1/2020 Response—Marriage/Domestic Partnership (Family Law)

FL-120 A 1/1/2020 Response—Marriage/Domestic Partnership (Family Law) (Arabic)

FL-120 C 1/1/2020 Response—Marriage/Domestic Partnership (Family Law) (Chinese)

FL-120 K 1/1/2020 Response—Marriage/Domestic Partnership (Family Law) (Korean)

FL-120 S 1/1/2020 Response—Marriage/Domestic Partnership (Family Law) (Spanish)

FL-120 V 1/1/2020 Response—Marriage/Domestic Partnership (Family Law)


(Vietnamese)

FL-130 1/1/2023 Appearance, Stipulations, and Waivers (Family Law—Uniform


Parentage—Custody and Support)

FL-130 S 1/1/2021 Appearance, Stipulations, and Waivers (Family Law—Uniform


Parentage—Custody and Support) (Spanish)

FL-130(A) 1/1/2023 Declaration and Conditional Waiver of Rights Under the


Servicemembers Civil Relief Act of 2003

FL-140* 7/1/2013 Declaration of Disclosure

FL-140 S 7/1/2013 Declaration of Disclosure (Spanish)

FL-141* 7/1/2013 Declaration Regarding Service of Declaration of Disclosure and


Income and Expense Declaration

FL-141 S 7/1/2013 Declaration Regarding Service of Declaration of Disclosure and


Income and Expense Declaration (Spanish)

FL-142 1/1/2005 Schedule of Assets and Debts

FL-142 S 1/1/2005 Schedule of Assets and Debts (Spanish)

FL-144 1/1/2007 Stipulation and Waiver of Final Declaration of Disclosure

FL-144 S 1/1/2007 Stipulation and Waiver of Final Declaration of Disclosure (Spanish)

FL-145 1/1/2006 Form Interrogatories—Family Law

FL-145 S 1/1/2006 Form Interrogatories—Family Law (Spanish)

FL-150* 1/1/2019 Income and Expense Declaration

FL-150 C 1/1/2019 Income and Expense Declaration (Chinese)

FL-150 K 1/1/2019 Income and Expense Declaration (Korean)

* Adopted for Mandatory Use. Page 37 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

FL-150 S 1/1/2019 Income and Expense Declaration (Spanish)

FL-150 T 1/1/2019 Income and Expense Declaration (Tagalog)

FL-150 V 1/1/2019 Income and Expense Declaration (Vietnamese)

FL-155 1/1/2004 Financial Statement (Simplified)

FL-155 S 1/1/2004 Financial Statement (Simplified) (Spanish)

FL-157 1/1/2021 Spousal or Domestic Partner Support Declaration Attachment

FL-157 S 1/1/2021 Spousal or Domestic Partner Support Declaration Attachment


(Spanish)

FL-158 1/1/2012 Supporting Declaration for Attorney's Fees and Costs Attachment

FL-160* 7/1/2016 Property Declaration

FL-160 S 7/1/2016 Property Declaration (Spanish)

FL-161* 7/1/2013 Continuation of Property Declaration

FL-165* 1/1/2023 Request to Enter Default (Family Law—Uniform Parentage)

FL-165 S 1/1/2005 Request to Enter Default (Family Law—Uniform Parentage) (Spanish)

FL-170* 1/17/2020 Declaration for Default or Uncontested Dissolution or Legal


Separation (Family Law)

FL-170 S 1/17/2020 Declaration for Default or Uncontested Dissolution or Legal


Separation (Family Law) (Spanish)

FL-172 1/1/2012 Case Information—Family Law

FL-174 1/1/2012 Family Centered Case Resolution Order

FL-180* 7/1/2012 Judgment

FL-180 C 7/1/2012 Judgment (Chinese)

FL-180 K 7/1/2012 Judgment (Korean)

FL-180 S 7/1/2012 Judgment (Spanish)

FL-180 V 7/1/2012 Judgment (Vietnamese)

FL-182 7/1/2012 Judgment Checklist—Dissolution/Legal Separation

FL-190* 1/1/2005 Notice of Entry of Judgment (Family Law—Uniform


Parentage—Custody and Support)

FL-190 S 1/1/2005 Notice of Entry of Judgment (Family Law—Uniform


Parentage—Custody and Support) (Spanish)

FL-191* 7/1/2005 Child Support Case Registry Form

FL-191 C 7/1/2005 Child Support Case Registry Form (Chinese)

FL-191 K 7/1/2005 Child Support Case Registry Form (Korean)

* Adopted for Mandatory Use. Page 38 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

FL-191 S 7/1/2005 Child Support Case Registry Form (Spanish)

FL-191 T 7/1/2005 Child Support Case Registry Form (Tagalog)

FL-191 V 7/1/2005 Child Support Case Registry Form (Vietnamese)

FL-192* 1/1/2022 Notice of Rights and Responsibilities Health-Care Costs and


Reimbursement Procedures

FL-192 C 1/1/2015 Notice of Rights and Responsibilities Health-Care Costs and


Reimbursement Procedures (Chinese)

FL-192 K 1/1/2015 Notice of Rights and Responsibilities Health-Care Costs and


Reimbursement Procedures (Korean)

FL-192 S 1/1/2015 Notice of Rights and Responsibilities Health-Care Costs and


Reimbursement Procedures (Spanish)

FL-192 T 1/1/2021 Notice of Rights and Responsibilities Health-Care Costs and


Reimbursement Procedures (Tagalog)

FL-192 V 1/1/2021 Notice of Rights and Responsibilities Health-Care Costs and


Reimbursement Procedures (Vietnamese)

FL-195 9/1/2021 Income Withholding for Support

FL-195 C 9/1/2021 Income Withholding for Support (Chinese)

FL-195 K 9/1/2021 Income Withholding for Support (Korean)

FL-195 S 9/1/2021 Income Withholding for Support (Spanish)

FL-195 T 9/1/2021 Income Withholding for Support (Tagalog)

FL-195 V 9/1/2021 Income Withholding for Support (Vietnamese)

FL-196 9/1/2021 Income Withholding for Support—Instructions

FL-196 C 9/1/2021 Income Withholding for Support—Instructions (Chinese)

FL-196 K 9/1/2021 Income Withholding for Support—Instructions (Korean)

FL-196 S 9/1/2021 Income Withholding for Support—Instructions (Spanish)

FL-196 T 9/1/2021 Income Withholding for Support—Instructions (Tagalog)

FL-196 V 9/1/2021 Income Withholding for Support—Instructions (Vietnamese)

FL-200 9/1/2021 Petition To Determine Parental Relationship (Uniform Parentage)

FL-200 S 9/1/2021 Petition To Determine Parental Relationship (Uniform Parentage)


(Spanish)

FL-210* 1/1/2015 Summons

FL-210 C 1/1/2015 Summons (Chinese)

FL-210 K 1/1/2015 Summons (Korean)

FL-210 V 1/1/2015 Summons (Vietnamese)

* Adopted for Mandatory Use. Page 39 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

FL-211* 1/1/2023 Confidential Cover Sheet—Parentage Action Involving Assisted


Reproduction

FL-220 9/1/2021 Response to Petition to Determine Parental Relationship (Uniform


Parentage)

FL-220 S 9/1/2021 Response to Petition to Determine Parental Relationship (Uniform


Parentage) (Spanish)

FL-230* 1/1/2020 Declaration for Default or Uncontested Judgment (Uniform Parentage,


Custody and Support)

FL-230 S 1/1/2020 Declaration for Default or Uncontested Judgment (Uniform Parentage,


Custody and Support) (Spanish)

FL-235 1/1/2020 Advisement and Waiver of Rights Re: Establishment of Parental


Relationship (Uniform Parentage)

FL-235 C 1/1/2020 Advisement and Waiver of Rights Re: Establishment of Parental


Relationship (Uniform Parentage) (Chinese)

FL-235 K 1/1/2020 Advisement and Waiver of Rights Re: Establishment of Parental


Relationship (Uniform Parentage) (Korean)

FL-235 S 1/1/2020 Advisement and Waiver of Rights Re: Establishment of Parental


Relationship (Uniform Parentage) (Spanish)

FL-235 V 1/1/2020 Advisement and Waiver of Rights Re: Establishment of Parental


Relationship (Uniform Parentage) (Vietnamese)

FL-240* 1/1/2021 Stipulation for Entry of Judgment Re: Determination of Parental


Relationship

FL-240 S 1/1/2021 Stipulation for Entry of Judgment Re: Determination of Parental


Relationship (Spanish)

FL-250* 1/1/2020 Judgment (Uniform Parentage—Custody and Support)

FL-250 C 1/1/2020 Judgment (Uniform Parentage—Custody and Support) (Chinese)

FL-250 K 1/1/2020 Judgment (Uniform Parentage—Custody and Support) (Korean)

FL-250 S 1/1/2020 Judgment (Uniform Parentage—Custody and Support) (Spanish)

FL-250 V 1/1/2020 Judgment (Uniform Parentage—Custody and Support) (Vietnamese)

FL-260* 9/1/2021 Petition for Custody and Support of Minor Children

FL-260 S 9/1/2021 Petition for Custody and Support of Minor Children (Spanish)

FL-270* 1/1/2020 Response to Petition for Custody and Support of Minor Children

FL-270 S 1/1/2020 Response to Petition for Custody and Support of Minor Children
(Spanish)

FL-272* 1/1/2020 Notice of Motion to Cancel (Set Aside) Judgment of Parentage

FL-272 S 1/1/2020 Notice of Motion to Cancel (Set Aside) Judgment of Parentage


(Spanish)

* Adopted for Mandatory Use. Page 40 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

FL-273* 1/1/2020 Declaration in Support of Motion to Cancel (Set Aside) Judgment of


Parentage (Family Law - Governmental)

FL-273 S 1/1/2020 Declaration in Support of Motion to Cancel (Set Aside) Judgment of


Parentage (Family Law - Governmental) (Spanish)

FL-274 1/1/2020 Information Sheet for Completing Notice of Motion to Cancel (Set
Aside) Judgment of Parentage

FL-274 S 1/1/2020 Information Sheet for Completing Notice of Motion to Cancel (Set
Aside) Judgment of Parentage (Spanish)

FL-276* 1/1/2020 Response to Notice of Motion to Cancel (Set Aside) Judgment of


Parentage

FL-276 S 1/1/2020 Response to Notice of Motion to Cancel (Set Aside) Judgment of


Parentage (Spanish)

FL-278* 9/1/2021 Order After Hearing on Motion to Cancel (Set Aside) Judgment of
Parentage (Family Law - Governmental)

FL-278 S 9/1/2021 Order After Hearing on Motion to Cancel (Set Aside) Judgment of
Parentage (Family Law - Governmental) (Spanish)

FL-280* 1/1/2020 Request for Hearing and Application to Cancel (Set Aside) Voluntary
Declaration of Parentage or Paternity

FL-280 S 1/1/2020 Request for Hearing and Application to Cancel (Set Aside) Voluntary
Declaration of Parentage or Paternity (Spanish)

FL-281 1/1/2020 Information Sheet for Completing Request for Hearing and
Application to Cancel (Set Aside) Voluntary Declaration of Parentage
or Paternity (Family Law - Governmental)

FL-281 S 1/1/2020 Information Sheet for Completing Request for Hearing and
Application to Cancel (Set Aside) Voluntary Declaration of Parentage
or Paternity (Family Law - Governmental) (Spanish)

FL-285* 1/1/2020 Responsive Declaration to Application to Cancel (Set Aside)


Voluntary Declaration of Parentage or Paternity

FL-285 S 1/1/2020 Responsive Declaration to Application to Cancel (Set Aside)


Voluntary Declaration of Parentage or Paternity (Spanish)

FL-290* 1/1/2020 Order After Hearing on Motion to Cancel (Set Aside) Voluntary
Declaration of Parentage or Paternity (Family Law - Governmental)

FL-290 S 1/1/2020 Order After Hearing on Motion to Cancel (Set Aside) Voluntary
Declaration of Parentage or Paternity (Family Law - Governmental)
(Spanish)

FL-300* 7/1/2016 Request for Order

FL-300 S 7/1/2016 Request for Order (Spanish)

FL-300-INFO 1/1/2020 Information Sheet for Request for Order (Family Law)

FL-300-INFO C 1/1/2020 Information Sheet for Request for Order (Family Law) (Chinese)

* Adopted for Mandatory Use. Page 41 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

FL-300-INFO K 1/1/2020 Information Sheet for Request for Order (Family Law) (Korean)

FL-300-INFO S 1/1/2020 Information Sheet for Request for Order (Family Law) (Spanish)

FL-300-INFO V 1/1/2020 Information Sheet for Request for Order (Family Law) (Vietnamese)

FL-303 7/1/2020 Declaration Regarding Notice and Service of Request for Temporary
Emergency (Ex Parte) Orders

FL-303 S 7/1/2020 Declaration Regarding Notice and Service of Request for Temporary
Emergency (Ex Parte) Orders (Spanish)

FL-304-INFO 7/1/2020 How to Reschedule a Hearing in Family Court

FL-304-INFO S 7/1/2020 How to Reschedule a Hearing in Family Court (Spanish)

FL-305* 7/1/2016 Temporary Emergency (Ex Parte) Orders

FL-305 C 7/1/2016 Temporary Emergency (Ex Parte) Orders (Chinese)

FL-305 K 7/1/2016 Temporary Emergency (Ex Parte) Orders (Korean)

FL-305 S 7/1/2016 Temporary Emergency (Ex Parte) Orders (Spanish)

FL-305 V 7/1/2016 Temporary Emergency (Ex Parte) Orders (Vietnamese)

FL-306 1/1/2014 Request to Reschedule Hearing (Family


Law—Governmental—Uniform Parentage—Custody and Support)

FL-306 9/1/2017 Request to Continue Hearing

FL-306 S 9/1/2017 Request to Continue Hearing (Spanish)

FL-307 7/1/2020 Request to Reschedule Hearing Involving Temporary Emergency (Ex


Parte) Orders (Family Law—Governmental—Uniform
Parentage—Custody and Support)

FL-307 7/1/2020 REQUEST TO RESCHEDULE HEARING INVOLVING TEMPORARY


EMERGENCY (EX PARTE) ORDERS (Family
Law—Governmental—Uniform Parentage—Custody and Support)

FL-307 S 7/1/2020 Request to Reschedule Hearing Involving Temporary Emergency (Ex


Parte) Orders (Family Law—Governmental—Uniform
Parentage—Custody and Support) (Spanish)

FL-308 7/1/2020 Agreement and Order to Reschedule Hearing (Family


Law—Governmental—Uniform Parentage—Custody and Support)

FL-308 S 7/1/2020 Agreement and Order to Reschedule Hearing (Family


Law—Governmental—Uniform Parentage—Custody and Support)
(Spanish)

FL-309* 7/1/2020 Order on Request to Reschedule Hearing (Family


Law—Governmental—Uniform Parentage—Custody and Support)

FL-309 S 7/1/2020 Order on Request to Reschedule Hearing (Family


Law—Governmental—Uniform Parentage—Custody and Support)
(Spanish)

* Adopted for Mandatory Use. Page 42 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

FL-310 7/1/2020 RESPONSIVE DECLARATION TO REQUEST TO RESCHEDULE


HEARING (Family Law—Governmental—Uniform
Parentage—Custody and Support)

FL-311 1/1/2023 Child Custody and Visitation (Parenting Time) Application Attachment

FL-311 S 1/1/2023 Child Custody and Visitation (Parenting Time) Application Attachment
(Spanish)

FL-312* 7/1/2016 Request for Child Abduction Prevention Orders

FL-312 S 7/1/2016 Request for Child Abduction Prevention Orders (Spanish)

FL-313-INFO 1/1/2012 Child Custody Information Sheet—Recommending Counseling

FL-313-INFO C 1/1/2012 Child Custody Information Sheet—Recommending Counseling


(Chinese)

FL-313-INFO K 1/1/2012 Child Custody Information Sheet—Recommending Counseling


(Korean)

FL-313-INFO S 1/1/2012 Child Custody Information Sheet—Recommending Counseling


(Spanish)

FL-313-INFO T 1/1/2012 Child Custody Information Sheet—Recommending Counseling


(Tagalog)

FL-313-INFO V 1/1/2012 Child Custody Information Sheet—Recommending Counseling


(Vietnamese)

FL-314-INFO 1/1/2012 Child Custody Information Sheet—Child Custody Mediation

FL-314-INFO C 1/1/2012 Child Custody Information Sheet—Child Custody Mediation (Chinese)

FL-314-INFO K 1/1/2012 Child Custody Information Sheet—Child Custody Mediation (Korean)

FL-314-INFO S 1/1/2012 Child Custody Information Sheet—Child Custody Mediation (Spanish)

FL-314-INFO V 1/1/2012 Child Custody Information Sheet—Child Custody Mediation


(Vietnamese)

FL-315* 1/1/2018 Request or Response to Request for Separate Trial

FL-316 7/1/2012 Request for Orders Regarding Noncompliance With Disclosure


Requirements

FL-318-INFO 1/1/2009 Retirement Plan Joinder—Information Sheet

FL-319 1/1/2012 Request for Attorney's Fees and Costs Attachment

FL-320* 7/1/2016 Responsive Declaration to Request for Order

FL-320 S 7/1/2016 Responsive Declaration to Request for Order (Spanish)

FL-320-INFO 7/1/2016 Information Sheet: Responsive Declaration to Request for Order

FL-320-INFO S 7/1/2016 Information Sheet: Responsive Declaration to Request for Order


(Spanish)

* Adopted for Mandatory Use. Page 43 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

FL-321 7/1/2012 Witness List

FL-322 1/1/2008 Declaration of Counsel for a Child Regarding Qualifications

FL-322 S 1/1/2008 Declaration of Counsel for a Child Regarding Qualifications (Spanish)

FL-323* 1/1/2023 Order Appointing Counsel for a Child

FL-323 C 1/1/2012 Order Appointing Counsel for a Child (Chinese)

FL-323 K 1/1/2012 Order Appointing Counsel for a Child (Korean)

FL-323 S 1/1/2012 Order Appointing Counsel for a Child (Spanish)

FL-323 V 1/1/2012 Order Appointing Counsel for a Child (Vietnamese)

FL-323-INFO 7/1/2017 Attorney for Child in a Family Law Case—Information Sheet

FL-323-INFO C 7/1/2017 Attorney for Child in a Family Law Case—Information Sheet (Chinese)

FL-323-INFO K 7/1/2017 Attorney for Child in a Family Law Case—Information Sheet (Korean)

FL-323-INFO S 7/1/2017 Attorney for Child in a Family Law Case—Information Sheet (Spanish)

FL-323-INFO V 7/1/2017 Attorney for Child in a Family Law Case—Information Sheet


(Vietnamese)

FL-324 S 1/1/2014 Declaration of Supervised Visitation Provider (Professional) (Spanish)

FL-324(NP) 1/1/2021 Declaration of Supervised Visitation Provider (NonProfessional)

FL-324(P)* 9/1/2021 Declaration of Supervised Visitation Provider (Professional)

FL-325* 1/1/2020 Declaration of Court-Connected Child Custody Evaluator Regarding


Qualifications

FL-326* 1/1/2020 Declaration of Private Child Custody Evaluator Regarding


Qualifications

FL-327* 9/1/2022 Order Appointing Child Custody Evaluator

FL-327 S 1/1/2021 Order Appointing Child Custody Evaluator (Spanish)

FL-327(A)* 9/1/2022 Additional Orders Regarding Child Custody Evaluations Under Family
Code Section 3118

FL-327(A) S 1/1/2021 Additional Orders Regarding Child Custody Evaluations Under Family
Code Section 3118 (Spanish)

FL-328* 9/1/2022 Notice Regarding Confidentiality of Child Custody Evaluation Report


Under Family Code Section 3111

FL-329* 9/22/2022 Confidential Child Custody Evaluation Report Under Family Code
Section 3118

FL-329-INFO 1/1/2010 Child Custody Evaluation Information Sheet

FL-329-INFO S 1/1/2010 Child Custody Evaluation Information Sheet (Spanish)

FL-330 1/1/2012 Proof of Personal Service

* Adopted for Mandatory Use. Page 44 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

FL-330-INFO 1/1/2012 Information Sheet for Proof of Personal Service

FL-330-INFO C 1/1/2012 Information Sheet for Proof of Personal Service (Chinese)

FL-330-INFO K 1/1/2012 Information Sheet for Proof of Personal Service (Korean)

FL-330-INFO S 1/1/2012 Information Sheet for Proof of Personal Service (Spanish)

FL-330-INFO V 1/1/2012 Information Sheet for Proof of Personal Service (Vietnamese)

FL-334 1/1/2012 Declaration Regarding Address Verification—Postjudgment Request


to Modify a Child Custody, Visitation, or Child Support Order

FL-335 1/1/2012 Proof of Service by Mail

FL-335-INFO 1/1/2012 Information Sheet for Proof of Service by Mail

FL-335-INFO C 1/1/2012 Information Sheet for Proof of Service by Mail (Chinese)

FL-335-INFO K 1/1/2012 Information Sheet for Proof of Service by Mail (Korean)

FL-335-INFO S 1/1/2012 Information Sheet for Proof of Service by Mail (Spanish)

FL-335-INFO V 1/1/2012 Information Sheet for Proof of Service by Mail (Vietnamese)

FL-336* 7/1/2016 Order to Pay Waived Court Fees and Costs (Superior court)

FL-337* 7/1/2016 Application to Set Aside Order to Pay Waived Court


Fees—Attachment

FL-338* 7/1/2009 Order After Hearing on Motion to Set Aside Order to Pay Waived
Court Fees

FL-340* 1/1/2012 Findings and Order After Hearing (Family Law—Custody and
Support—Uniform Parentage)

FL-340 C 1/1/2012 Findings and Order After Hearing (Family Law—Custody and
Support—Uniform Parentage) (Chinese)

FL-340 K 1/1/2012 Findings and Order After Hearing (Family Law—Custody and
Support—Uniform Parentage) (Korean)

FL-340 S 1/1/2012 Findings and Order After Hearing (Family Law—Custody and
Support—Uniform Parentage) (Spanish)

FL-340 V 1/1/2012 Findings and Order After Hearing (Family Law—Custody and
Support—Uniform Parentage) (Vietnamese)

FL-341 1/1/2023 Child Custody And Visitation (Parenting Time) Order Attachment

FL-341 S 7/1/2016 Child Custody And Visitation (Parenting Time) Order Attachment
(Spanish)

FL-341(A)* 1/1/2015 Supervised Visitation Order

FL-341(A) S 1/1/2015 Supervised Visitation Order (Spanish)

FL-341(B)* 7/1/2016 Child Abduction Prevention Order Attachment

* Adopted for Mandatory Use. Page 45 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

FL-341(B) S 7/1/2016 Child Abduction Prevention Order Attachment (Spanish)

FL-341(C) 7/1/2016 Children's Holiday Schedule Attachment

FL-341(C) S 7/1/2016 Children's Holiday Schedule Attachment (Spanish)

FL-341(D) 7/1/2016 Additional Provisions—Physical Custody Attachment

FL-341(D) S 7/1/2016 Additional Provisions—Physical Custody Attachment (Spanish)

FL-341(E) 7/1/2016 Joint Legal Custody Attachment

FL-341(E) S 7/1/2016 Joint Legal Custody Attachment (Spanish)

FL-342* 1/1/2020 Child Support Information and Order Attachment

FL-342 C 1/1/2020 Child Support Information and Order Attachment (Chinese)

FL-342 K 1/1/2020 Child Support Information and Order Attachment (Korean)

FL-342 S 1/1/2020 Child Support Information and Order Attachment (Spanish)

FL-342 V 1/1/2020 Child Support Information and Order Attachment (Vietnamese)

FL-342(A)* 1/1/2008 Non-Guideline Child Support Findings Attachment

FL-343 1/1/2021 Spousal, Domestic Partner, or Family Support Order Attachment

FL-343 S 1/1/2021 Spousal, Domestic Partner, or Family Support Order Attachment


(Spanish)

FL-344* 1/1/2007 Property Order Attachment to Findings and Order After Hearing

FL-344 S 1/1/2007 Property Order Attachment to Findings and Order After Hearing
(Spanish)

FL-345 1/1/2021 Property Order Attachment to Judgment

FL-345 S 1/1/2021 Property Order Attachment to Judgment (Spanish)

FL-346 1/1/2012 Attorney's Fees and Costs Order Attachment

FL-347* 1/1/2018 Bifurcation of Status of Marriage or Domestic


Partnership—Attachment

FL-348 1/1/2009 Pension Benefits—Attachment to Judgment (Attach to form FL-180)

FL-348 S 1/1/2009 Pension Benefits—Attachment to Judgment (Attach to form FL-180)


(Spanish)

FL-349 1/1/2021 Spousal or Domestic Partner Support Factors Under Family Code
Section 4320—Attachment

FL-349 S 1/1/2021 Spousal or Domestic Partner Support Factors Under Family Code
Section 4320—Attachment (Spanish)

FL-350* 1/1/2022 Stipulation to Establish or Modify Child Support and Order

FL-350 C 1/1/2022 Stipulation to Establish or Modify Child Support and Order (Chinese)

* Adopted for Mandatory Use. Page 46 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

FL-350 K 1/1/2022 Stipulation to Establish or Modify Child Support and Order (Korean)

FL-350 S 1/1/2022 Stipulation to Establish or Modify Child Support and Order (Spanish)

FL-350 T 1/1/2022 Stipulation to Establish or Modify Child Support and Order (Tagalog)

FL-350 V 1/1/2022 Stipulation to Establish or Modify Child Support and Order


(Vietnamese)

FL-355 1/1/2004 Stipulation and Order for Custody and/or Visitation of Children

FL-355 S 1/1/2004 Stipulation and Order for Custody and/or Visitation of Children
(Spanish)

FL-356* 1/1/2021 Confidential Request for Special Immigrant Juvenile Findings - Family
Law

FL-356 S 1/1/2021 Confidential Request for Special Immigrant Juvenile Findings - Family
Law (Spanish)

FL-357/GC-224/JV- 7/1/2016 Special Immigrant Juvenile Findings


357*

FL-357/GC-224/JV- 7/1/2016 Special Immigrant Juvenile Findings (Spanish)


357 S

FL-358* 7/1/2016 Confidential Response to Request for Special Immigrant Juvenile


Findings

FL-358 S 7/1/2016 Confidential Response to Request for Special Immigrant Juvenile


Findings (Spanish)

FL-360* 1/1/2007 Request for Hearing And Application to Set Aside Support Order
Under Family Code Section 3691

FL-365* 1/1/2003 Responsive Declaration to Application to Set Aside Support Order

FL-367* 1/1/2003 Order After Hearing on Motion to Set Aside Support Order

FL-370* 1/1/2003 Pleading on Joinder—Employees Benefit Plan

FL-371* 1/1/2003 Notice of Motion and Declaration for Joinder

FL-372* 1/1/2003 Request for Joinder of Employee Benefit Plan Order

FL-373* 1/1/2003 Responsive Declaration to Motion for Joinder and Consent Order of
Joinder

FL-374* 1/1/2003 Notice of Appearance and Response of Employee Benefit Plan

FL-375* 1/1/2003 Summons (Joinder)

FL-380* 1/1/2003 Application for Expedited Child Support Order

FL-381* 1/1/2003 Response to Application for Expedited Child Support Order and
Notice of Hearing

FL-382* 1/1/2003 Expedited Child Support Order

* Adopted for Mandatory Use. Page 47 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

FL-390* 1/1/2003 Notice of Motion and Motion for Simplified Modification of Order for
Child, Spousal, or Family Support

FL-391 7/1/2008 Information Sheet—Simplified Way to Change Child, Spousal, or


Family Support

FL-392* 1/1/2003 Responsive Declaration to Motion for Simplified Modification of Order


for Child, Spousal, or Family Support

FL-393 7/1/2008 Information Sheet—How to Oppose a Request to Change Child,


Spousal, or Family Support

FL-396* 1/1/2003 Request for Production of an Income and Expense Declaration After
Judgment

FL-397* 1/1/2003 Request for Income and Benefit Information From Employer

FL-398* 12/2/2005 Notice of Activation of Military Service and Deployment and Request
to Modify a Support Order

FL-400* 1/1/2003 Order for Child Support Security Deposit and Evidence of Deposit

FL-401* 1/1/2003 Application for Disbursement and Order for Disbursement From Child
Support Security Deposit

FL-410* 1/1/2015 Order to Show Cause and Affidavit for Contempt

FL-410 C 1/1/2015 Order to Show Cause and Affidavit for Contempt (Chinese)

FL-410 K 1/1/2015 Order to Show Cause and Affidavit for Contempt (Korean)

FL-410 V 1/1/2015 Order to Show Cause and Affidavit for Contempt (Vietnamese)

FL-411* 1/1/2003 Affidavit of Facts Constituting Contempt (Financial and Injunctive


Orders)

FL-412* 1/1/2003 Affidavit of Facts Constituting Contempt

FL-415 7/1/2003 Findings and Order Regarding Contempt

FL-420* 1/1/2003 Declaration of Payment History

FL-421 7/1/2003 Payment History Attachment

FL-430* 1/1/2014 Ex Parte Application to Issue, Modify, or Terminate an Earnings


Assignment Order

FL-435* 1/1/2005 Earnings Assignment Order For Spousal or Partner Support

FL-440 1/1/2003 Statement for Registration of California Support Order

FL-445* 1/1/2021 Request for Hearing Regarding Registration of California Support


Order (Family Law–Governmental)

FL-445 S 1/1/2021 Request for Hearing Regarding Registration of California Support


Order (Family Law–Governmental) (Spanish)

FL-450* 7/1/2008 Request for Hearing Regarding Earnings Assignment

* Adopted for Mandatory Use. Page 48 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

FL-455* 1/1/2003 Stay of Service of Earnings Assignment and Order

FL-460 1/1/2003 Qualified Domestic Relations Order for Support

FL-461 1/1/2003 Attachment to Qualified Domestic Relations Order for Support

FL-470* 1/1/2007 Application and Order for Health Insurance Coverage

FL-475* 1/1/2003 Employer's Health Insurance Return

FL-478* 1/1/2007 Request and Notice of Hearing Regarding Health Insurance


Assignment

FL-478 C 1/1/2007 Request and Notice of Hearing Regarding Health Insurance


Assignment (Chinese)

FL-478 K 1/1/2007 Request and Notice of Hearing Regarding Health Insurance


Assignment (Korean)

FL-478 S 1/1/2007 Request and Notice of Hearing Regarding Health Insurance


Assignment (Spanish)

FL-478 T 1/1/2007 Request and Notice of Hearing Regarding Health Insurance


Assignment (Tagalog)

FL-478 V 1/1/2007 Request and Notice of Hearing Regarding Health Insurance


Assignment (Vietnamese)

FL-478-INFO 1/1/2007 Information Sheet and Instructions for Request and Notice of Hearing
Regarding Health Insurance Assignment

FL-478-INFO C 1/1/2007 Information Sheet and Instructions for Request and Notice of Hearing
Regarding Health Insurance Assignment (Chinese)

FL-478-INFO K 1/1/2007 Information Sheet and Instructions for Request and Notice of Hearing
Regarding Health Insurance Assignment (Korean)

FL-478-INFO S 1/1/2007 Information Sheet and Instructions for Request and Notice of Hearing
Regarding Health Insurance Assignment (Spanish)

FL-478-INFO T 1/1/2007 Information Sheet and Instructions for Request and Notice of Hearing
Regarding Health Insurance Assignment (Tagalog)

FL-478-INFO V 1/1/2007 Information Sheet and Instructions for Request and Notice of Hearing
Regarding Health Insurance Assignment (Vietnamese)

FL-480* 1/1/2015 Abstract of Support Judgment

FL-485* 7/1/2013 Notice of Delinquency

FL-490* 1/1/2022 Application to Determine Arrears

FL-490 C 1/1/2022 Application to Determine Arrears (Chinese)

FL-490 K 1/1/2022 Application to Determine Arrears (Korean)

FL-490 S 1/1/2022 Application to Determine Arrears (Spanish)

FL-490 T 1/1/2022 Application to Determine Arrears (Tagalog)

* Adopted for Mandatory Use. Page 49 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

FL-490 V 1/1/2022 Application to Determine Arrears (Vietnamese)

FL-510* 7/1/2017 Summons (UIFSA)

FL-520* 1/1/2017 Response to Uniform Support Petition (UIFSA)

FL-530* 1/1/2020 Judgment Regarding Parental Obligations (UIFSA)

FL-530 S 1/1/2020 Judgment Regarding Parental Obligations (UIFSA) (Spanish)

FL-540* 1/1/2023 JOINT APPLICATION FOR RECOGNITION OF TRIBAL COURT


ORDER DIVIDING RETIREMENT PLAN OR OTHER DEFERRED
COMPENSATION

FL-541* 1/1/2023 APPLICATION FOR RECOGNITION OF TRIBAL COURT ORDER


DIVIDING RETIREMENT PLAN OR OTHER DEFERRED
COMPENSATION

FL-560* 1/1/2017 Ex Parte Application for Transfer and Order (UIFSA)

FL-570 1/1/2020 Notice of Registration of Out-of-State Support Order

FL-570 S 1/1/2020 Notice of Registration of Out-of-State Support Order (Spanish)

FL-575* 1/1/2021 Request for Hearing Regarding Registration of Out-of-State Support


Order

FL-575 S 1/1/2021 Request for Hearing Regarding Registration of Out-of-State Support


Order (Spanish)

FL-580 1/1/2006 Registration of Out-of-State Custody Order

FL-585 1/1/2003 Registration of Out-of-State Custody Order

FL-590A* 7/1/2017 UIFSA Child Support Order Jurisdictional Attachment

FL-592* 7/1/2017 Notice of Registration of an International Hague Convention Support


Order

FL-594* 1/1/2017 Request for Heaing Regarding Registration of an International Hague


Convention Support Order

FL-600* 1/1/2020 Summons and Complaint or Supplemental Complaint Regarding


Parental Obligations (Governmental)

FL-600 C 1/1/2020 Summons and Complaint or Supplemental Complaint Regarding


Parental Obligations (Governmental) (Chinese)

FL-600 K 1/1/2020 Summons and Complaint or Supplemental Complaint Regarding


Parental Obligations (Governmental) (Korean)

FL-600 S 1/1/2020 Summons and Complaint or Supplemental Complaint Regarding


Parental Obligations (Governmental) (Spanish)

FL-600 T 1/1/2020 Summons and Complaint or Supplemental Complaint Regarding


Parental Obligations (Governmental) (Tagalog)

FL-600 V 1/1/2020 Summons and Complaint or Supplemental Complaint Regarding


Parental Obligations (Governmental) (Vietnamese)

* Adopted for Mandatory Use. Page 50 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

FL-605* 1/1/2007 Notice and Acknowledgment of Receipt

FL-610* 1/1/2020 Answer to Complaint or Supplemental Complaint Regarding Parental


Obligations (Governmental)

FL-610 C 1/1/2020 Answer to Complaint or Supplemental Complaint Regarding Parental


Obligations (Governmental) (Chinese)

FL-610 K 1/1/2020 Answer to Complaint or Supplemental Complaint Regarding Parental


Obligations (Governmental) (Korean)

FL-610 S 1/1/2021 Answer to Complaint or Supplemental Complaint Regarding Parental


Obligations (Governmental) (Spanish)

FL-610 T 1/1/2020 Answer to Complaint or Supplemental Complaint Regarding Parental


Obligations (Governmental) (Tagalog)

FL-610 V 1/1/2020 Answer to Complaint or Supplemental Complaint Regarding Parental


Obligations (Governmental) (Vietnamese)

FL-611 1/1/2003 Information Sheet for Service of Process

FL-611 C 1/1/2003 Information Sheet for Service of Process (Chinese)

FL-611 K 1/1/2003 Information Sheet for Service of Process (Korean)

Fl-611 S 1/1/2003 Information Sheet for Service of Process (Spanish)

FL-611 T 1/1/2003 Information Sheet for Service of Process (Tagalog)

FL-611 V 1/1/2003 Information Sheet for Service of Process (Vietnamese)

FL-615* 1/1/2020 Stipulation for Judgment or Supplemental Judgment Regarding


Parental Obligations and Judgment (Governmental)

FL-615 S 1/1/2020 Stipulation for Judgment or Supplemental Judgment Regarding


Parental Obligations and Judgment (Governmental) (Spanish)

FL-616* 1/1/2003 Declaration for Amended Proposed Judgment

FL-618* 1/1/2010 Request for Dismissal

FL-618 S 1/1/2010 Request for Dismissal (Spanish)

FL-620* 1/1/2023 Request to Enter Default Judgment

FL-625* 1/1/2020 Stipulation and Order (Governmental)

FL-625 C 1/1/2020 Stipulation and Order (Governmental) (Chinese)

FL-625 K 1/1/2020 Stipulation and Order (Governmental) (Korean)

FL-625 S 1/1/2020 Stipulation and Order (Governmental) (Spanish)

FL-625 T 1/1/2020 Stipulation and Order (Governmental) (Tagalog)

FL-625 V 1/1/2020 Stipulation and Order (Governmental) (Vietnamese)

FL-626 1/1/2009 Stipulation and Order Waiving Unassigned Arrears

* Adopted for Mandatory Use. Page 51 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

FL-626 C 1/1/2009 Stipulation and Order Waiving Unassigned Arrears (Chinese)

FL-626 K 1/1/2009 Stipulation and Order Waiving Unassigned Arrears (Korean)

FL-626 S 1/1/2009 Stipulation and Order Waiving Unassigned Arrears (Spanish)

FL-626 T 1/1/2009 Stipulation and Order Waiving Unassigned Arrears (Tagalog)

FL-626 V 1/1/2009 Stipulation and Order Waiving Unassigned Arrears (Vietnamese)

FL-627* 1/1/2003 Order for Genetic (Parentage) Testing

FL-630* 1/1/2020 Judgment Regarding Parental Obligations (Governmental)

FL-630 C 1/1/2020 Judgment Regarding Parental Obligations (Governmental) (Chinese)

FL-630 K 1/1/2020 Judgment Regarding Parental Obligations (Governmental) (Korean)

FL-630 S 1/1/2020 Judgment Regarding Parental Obligations (Governmental) (Spanish)

FL-630 T 1/1/2020 Judgment Regarding Parental Obligations (Governmental) (Tagalog)

FL-630 V 1/1/2020 Judgment Regarding Parental Obligations (Governmental)


(Vietnamese)

FL-632* 7/1/2015 Notice Regarding Payment of Support

FL-634* 1/1/2011 Notice of Change of Responsibility for Managing Child Support Case

FL-634 S 1/1/2011 Notice of Change of Responsibility for Managing Child Support Case
(Spanish)

FL-640* 1/1/2012 Notice and Motion to Cancel (Set Aside) Support Order Based on
Presumed Income

FL-640 C 1/1/2012 Notice and Motion to Cancel (Set Aside) Support Order Based on
Presumed Income (Chinese)

FL-640 K 1/1/2012 Notice and Motion to Cancel (Set Aside) Support Order Based on
Presumed Income (Korean)

FL-640 S 1/1/2012 Notice and Motion to Cancel (Set Aside) Support Order Based on
Presumed Income (Spanish)

FL-640 T 1/1/2012 Notice and Motion to Cancel (Set Aside) Support Order Based on
Presumed Income (Tagalog)

FL-640 V 1/1/2012 Notice and Motion to Cancel (Set Aside) Support Order Based on
Presumed Income (Vietnamese)

FL-640-INFO 1/1/2012 Information Sheet for Notice and Motion to Cancel (Set Aside)
Support Order Based on Presumed Income

FL-640-INFO C 1/1/2012 Information Sheet for Notice and Motion to Cancel (Set Aside)
Support Order Based on Presumed Income (Chinese)

FL-640-INFO K 1/1/2012 Information Sheet for Notice and Motion to Cancel (Set Aside)
Support Order Based on Presumed Income (Korean)

* Adopted for Mandatory Use. Page 52 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

FL-640-INFO S 1/1/2012 Information Sheet for Notice and Motion to Cancel (Set Aside)
Support Order Based on Presumed Income (Spanish)

FL-640-INFO T 1/1/2012 Information Sheet for Notice and Motion to Cancel (Set Aside)
Support Order Based on Presumed Income (Tagalog)

FL-640-INFO V 1/1/2012 Information Sheet for Notice and Motion to Cancel (Set Aside)
Support Order Based on Presumed Income (Vietnamese)

FL-643 1/1/2007 Declaration Of Obligor's Income During Judgment Perio—Presumed


Income Set-Aside Request

FL-645* 1/1/2003 Notice to Local Child Support Agency of Intent to Take Independent
Action to Enforce Support Order

FL-646* 1/1/2003 Response of Local Child Support Agency to Notice of Intent to Take
Independent Action to Enforce Support Order

FL-650* 1/1/2003 Statement for Registration of California Support Order

FL-651* 1/1/2004 Notice of Registration of California Support Order

FL-660* 1/1/2003 Ex Parte Motion by Local Child Support Agency and Declaration for
Joinder of Other Parent

FL-661 1/1/2012 Notice of Motion and Declaration for Joinder of Other Parent in
Governmental Action

FL-661-INFO 1/1/2012 Information Sheet For Notice of Motion and Declaration for Joinder of
Other Parent in Governmental Action

FL-662* 1/1/2012 Responsive Declaration to Motion For Joinder of Other


Parent—Consent Order of Joinder

FL-662-INFO 1/1/2012 Information Sheet for Responsive Declaration to Motion for Joinder of
Other Parent—Consent Order of Joinder

FL-663* 1/1/2009 Stipulation and Order For Joinder of Other Parent

FL-663 C 1/1/2009 Stipulation and Order For Joinder of Other Parent (Chinese)

FL-663 K 1/1/2009 Stipulation and Order For Joinder of Other Parent (Korean)

FL-663 S 1/1/2009 Stipulation and Order For Joinder of Other Parent (Spanish)

FL-663 T 1/1/2009 Stipulation and Order For Joinder of Other Parent (Tagalog)

FL-663 V 1/1/2009 Stipulation and Order For Joinder of Other Parent (Vietnamese)

FL-665* 1/1/2020 Findings and Recommendation of Commissioner (Governmental)

FL-665 S 1/1/2020 Findings and Recommendation of Commissioner (Governmental)


(Spanish)

FL-666* 1/1/2003 Notice of Objection

FL-666 C 1/1/2003 Notice of Objection (Chinese)

FL-666 K 1/1/2003 Notice of Objection (Korean)

* Adopted for Mandatory Use. Page 53 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

FL-666 S 1/1/2003 Notice of Objection (Spanish)

FL-666 T 1/1/2003 Notice of Objection (Tagalog)

FL-666 V 1/1/2003 Notice of Objection (Vietnamese)

FL-667* 1/1/2003 Review of Commissioner's Findings of Fact and Recommendation

FL-670* 1/1/2003 Notice of Motion for Judicial Review of License Denial

FL-675* 1/1/2003 Order After Judicial Review of License Denial

FL-676* 1/1/2022 Request for Determination of Support Arrears (Governmental)

FL-676 C 1/1/2022 Request for Determination of Support Arrears (Governmental)


(Chinese)

FL-676 K 1/1/2022 Request for Determination of Support Arrears (Governmental)


(Korean)

FL-676 S 1/1/2022 Request for Determination of Support Arrears (Governmental)


(Spanish)

FL-676 T 1/1/2022 Request for Determination of Support Arrears (Governmental)


(Tagalog)

FL-676 V 1/1/2022 Request for Determination of Support Arrears (Governmental)


(Vietnamese)

FL-676-INFO 1/1/2022 Information Sheet: Request for Determination of Support Arrears


(Governmental)

FL-676-INFO C 1/1/2022 Information Sheet: Request for Determination of Support Arrears


(Governmental) (Chinese)

FL-676-INFO K 1/1/2022 Information Sheet: Request for Determination of Support Arrears


(Governmental) (Korean)

FL-676-INFO S 1/1/2022 Information Sheet: Request for Determination of Support Arrears


(Governmental) (Spanish)

FL-676-INFO T 1/1/2022 Information Sheet: Request for Determination of Support Arrears


(Governmental) (Tagalog)

FL-676-INFO V 1/1/2022 Information Sheet: Request for Determination of Support Arrears


(Governmental) (Vietnamese)

FL-677* 1/1/2012 Notice of Opposition and Notice of Motion on Claim of Exemption

FL-678* 1/1/2003 Order Determining Claim of Exemption or Third-Party Claim

FL-680* 1/1/2012 Notice of Motion

FL-680 C 1/1/2012 Notice of Motion (Chinese)

FL-680 K 1/1/2012 Notice of Motion (Korean)

FL-680 S 1/1/2012 Notice of Motion (Spanish)

* Adopted for Mandatory Use. Page 54 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

FL-680 T 1/1/2012 Notice of Motion (Tagalog)

FL-680 V 1/1/2012 Notice of Motion (Vietnamese)

FL-681 7/1/2005 Clerk Calendar Cover Sheet (For Court Clerk Use Only)

FL-683* 7/1/2005 Order to Show Cause

FL-683 C 7/1/2005 Order to Show Cause (Chinese)

FL-683 K 7/1/2005 Order to Show Cause (Korean)

FL-683 S 7/1/2005 Order to Show Cause (Spanish)

FL-683 T 7/1/2005 Order to Show Cause (Tagalog)

FL-683 V 7/1/2005 Order to Show Cause (Vietnamese)

FL-684* 1/1/2010 Request for Order and Supporting Declaration

FL-684 C 1/1/2010 Request for Order and Supporting Declaration (Chinese)

FL-684 K 1/1/2010 Request for Order and Supporting Declaration (Korean)

FL-684 S 1/1/2010 Request for Order and Supporting Declaration (Spanish)

FL-684 T 1/1/2010 Request for Order and Supporting Declaration (Tagalog)

FL-684 V 1/1/2010 Request for Order and Supporting Declaration (Vietnamese)

FL-685* 1/1/2012 Response to Governmental Notice of Motion or Order to Show Cause

FL-685 C 1/1/2012 Response to Governmental Notice of Motion or Order to Show Cause


(Chinese)

FL-685 K 1/1/2012 Response to Governmental Notice of Motion or Order to Show Cause


(Korean)

FL-685 S 1/1/2012 Response to Governmental Notice of Motion or Order to Show Cause


(Spanish)

FL-685 T 1/1/2012 Response to Governmental Notice of Motion or Order to Show Cause


(Tagalog)

FL-685 V 1/1/2012 Response to Governmental Notice of Motion or Order to Show Cause


(Vietnamese)

FL-686* 1/1/2020 Proof of Service by Mail (Governmental)

FL-687* 1/1/2020 Order After Hearing (Governmental)

FL-687 S 1/1/2020 Order After Hearing (Governmental) (Spanish)

FL-688* 1/1/2022 Short Form Order After Hearing (Governmental)

FL-688 C 1/1/2022 Short Form Order After Hearing (Governmental) (Chinese)

FL-688 K 1/1/2022 Short Form Order After Hearing (Governmental) (Korean)

FL-688 S 1/1/2022 Short Form Order After Hearing (Governmental) (Spanish)

* Adopted for Mandatory Use. Page 55 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

FL-688 T 1/1/2022 Short Form Order After Hearing (Governmental) (Tagalog)

FL-688 V 1/1/2022 Short Form Order After Hearing (Governmental) (Vietnamese)

FL-692* 1/1/2020 Minutes and Order or Judgment (Governmental)

FL-692 S 1/1/2020 Minutes and Order or Judgment (Governmental) (Spanish)

FL-694 1/1/2020 Advisement and Waiver of Rights for Stipulation (Governmental)

FL-694 C 1/1/2020 Advisement and Waiver of Rights for Stipulation (Governmental)


(Chinese)

FL-694 K 1/1/2020 Advisement and Waiver of Rights for Stipulation (Governmental)


(Korean)

FL-694 S 1/1/2020 Advisement and Waiver of Rights for Stipulation (Governmental)


(Spanish)

FL-694 T 1/1/2020 Advisement and Waiver of Rights for Stipulation (Governmental)


(Tagalog)

FL-694 V 1/1/2020 Advisement and Waiver of Rights for Stipulation (Governmental)


(Vietnamese)

FL-697* 1/1/2003 Declaration for Default or Uncontested Judgment

FL-800* 9/1/2021 Joint Petition for Summary Dissolution

FL-800 C 9/1/2021 Joint Petition for Summary Dissolution (Chinese)

FL-800 K 9/1/2021 Joint Petition for Summary Dissolution (Korean)

FL-800 S 9/1/2021 Joint Petition for Summary Dissolution (Spanish)

FL-800 V 9/1/2021 Joint Petition for Summary Dissolution (Vietnamese)

FL-810* 9/1/2021 Summary Dissolution Information

FL-810 C 9/1/2019 Summary Dissolution Information (Chinese)

FL-810 K 9/1/2019 Summary Dissolution Information (Korean)

FL-810 S 9/1/2019 Summary Dissolution Information (Spanish)

FL-810 V 9/1/2019 Summary Dissolution Information (Vietnamese)

FL-820* 1/1/2012 Request for Judgment, Judgment of Dissolution of Marriage, and


Notice of Entry of Judgment

FL-820 C 1/1/2012 Request for Judgment, Judgment of Dissolution of Marriage, and


Notice of Entry of Judgment (Chinese)

FL-820 K 1/1/2012 Request for Judgment, Judgment of Dissolution of Marriage, and


Notice of Entry of Judgment (Korean)

FL-820 V 1/1/2012 Request for Judgment, Judgment of Dissolution of Marriage, and


Notice of Entry of Judgment (Vietnamese)

* Adopted for Mandatory Use. Page 56 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

FL-825* 1/1/2012 Judgment of Dissolution and Notice of Entry of Judgment

FL-825 C 1/1/2012 Judgment of Dissolution and Notice of Entry of Judgment (Chinese)

FL-825 K 1/1/2012 Judgment of Dissolution and Notice of Entry of Judgment (Korean)

FL-825 V 1/1/2012 Judgment of Dissolution and Notice of Entry of Judgment


(Vietnamese)

FL-830* 7/1/2015 Notice of Revocation of Joint Petition for Summary Dissolution

FL-830 S 7/1/2015 Notice of Revocation of Joint Petition for Summary Dissolution


(Spanish)

DV-840/FL-840* 1/1/2023 Notice of Compliance Hearing for Firearms and Ammunition


(Domestic Violence Prevention)

FL-910* 1/1/2020 Request of Minor to Marry or Establish a Domestic Partnership

FL-912 1/1/2020 Consent for Minor to Marry or Establish a Domestic Partnership

FL-915* 1/1/2020 Order and Notices to Minor on Request to Marry or Establish a


Domestic Partnership

FL-920 1/1/2003 Notice of Consolidation

FL-935 1/1/2008 Application and Order for Appointment of Guardian Ad Litem of


Minor—Family Law

FL-940 1/1/2003 Office of the Family Law Facilitator Disclosure

FL-940 C 1/1/2003 Office of the Family Law Facilitator Disclosure (Chinese)

FL-940 K 1/1/2003 Office of the Family Law Facilitator Disclosure (Korean)

FL-940 S 1/1/2003 Office of the Family Law Facilitator Disclosure (Spanish)

FL-940 V 1/1/2003 Office of the Family Law Facilitator Disclosure (Vietnamese)

FL-945 1/1/2003 Family Law Information Center Disclosure

FL-950* 9/1/2017 Notice of Limited Scope Representation

FL-955* 9/1/2017 Notice of Completion of Limited Scope Representation

FL-955-INFO 9/1/2017 Information for Client About Notice of Completion of Limited Scope
Representation

FL-955-INFO S 9/1/2017 Information for Client About Notice of Completion of Limited Scope
Representation (Spanish)

FL-956* 9/1/2017 Objection to Application to be Relieved as Counsel Upon Completion


of Limited Scope Representation

FL-957* 9/1/2017 Response to Objection to Proposed Notice of Completion of Limited


Scope Representation

FL-958* 1/1/2018 Order on Completion of Limited Scope Representation

* Adopted for Mandatory Use. Page 57 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

FL-960* 1/1/2003 Notice of Withdrawal of Attorney of Record

FL-970* 1/1/2003 Request and Declaration for Final Judgment of Dissolution of Marriage

FL-980 1/1/2013 Application for Order for Publication or Posting

FL-982 1/1/2013 Order for Publication or Posting

FL-985 1/1/2013 Proof of Service by Posting

Fee Waiver
FW-001* 4/1/2023 Request to Waive Court Fees

FW-001 S 4/1/2023 Request to Waive Court Fees (Spanish)

FW-001-GC* 4/1/2023 Request to Waive Court Fees (Ward or Conservatee)

FW-001-GC S 4/1/2023 Request to Waive Court Fees (Ward or Conservatee) (Spanish)

FW-001-INFO 8/1/2022 Information Sheet on Waiver of Superior Court Fees and Costs

FW-001-INFO S 8/1/2022 Information Sheet on Waiver of Superior Court Fees and Costs
(Spanish)

FW-002* 7/1/2015 Request to Waive Additional Court Fees (Superior Court)

FW-002 S 7/1/2009 Request to Waive Additional Court Fees (Superior Court) (Spanish)

FW-002-GC* 9/1/2015 Request to Waive Additional Court Fees (Superior Court) (Ward or
Conservatee)

FW-003* 9/1/2019 Order on Court Fee Waiver (Superior Court)

FW-003 S 9/1/2019 Order on Court Fee Waiver (Superior Court) (Spanish)

FW-003-GC* 9/1/2019 Order on Court Fee Waiver (Superior Court) (Ward or Conservatee)

FW-003-GC S 9/1/2019 Order on Court Fee Waiver (Superior Court) (Ward or Conservatee)
(Spanish)

FW-005* 9/1/2019 Notice: Waiver of Court Fees (Superior Court)

FW-005 S 9/1/2019 Notice: Waiver of Court Fees (Superior Court) (Spanish)

FW-005-GC* 9/1/2019 Notice: Waiver of Court Fees (Superior Court) (Ward or Conservatee)

FW-005-GC S 9/1/2019 Notice: Waiver of Court Fees (Superior Court) (Ward or Conservatee)
(Spanish)

FW-006* 7/1/2009 Request for Hearing About Court Fee Waiver Order (Superior Court)

FW-006 S 7/1/2009 Request for Hearing About Court Fee Waiver Order (Superior Court)
(Spanish)

FW-006-GC* 9/1/2015 Request for Hearing About Court Fee Waiver Order (Superior Court)
(Ward or Conservatee)

FW-007* 1/1/2010 Notice on Hearing About Court Fees

* Adopted for Mandatory Use. Page 58 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

FW-007 S 1/1/2010 Notice on Hearing About Court Fees (Spanish)

FW-007-GC* 9/1/2015 Notice on Hearing About Court Fees (Ward or Conservatee)

FW-008* 9/1/2019 Order on Court Fee Waiver After Hearing (Superior Court)

FW-008 S 9/1/2019 Order on Court Fee Waiver After Hearing (Superior Court) (Spanish)

FW-008-GC* 9/1/2019 Order on Court Fee Waiver After Hearing (Superior Court) (Ward or
Conservatee)

FW-008-GC S 9/1/2019 Order on Court Fee Waiver After Hearing (Superior Court) (Ward or
Conservatee) (Spanish)

FW-010* 7/1/2009 Notice to Court of Improved Financial Situation or Settlement

FW-010 S 7/1/2009 Notice to Court of Improved Financial Situation or Settlement


(Spanish)

FW-010-GC* 9/1/2015 Notice to Court of Improved Financial Situation or Settlement (Ward


or Conservatee)

FW-011* 7/1/2009 Notice to Appear for Reconsideration of Fee Waiver

FW-011 S 7/1/2009 Notice to Appear for Reconsideration of Fee Waiver (Spanish)

FW-011-GC* 9/1/2015 Notice to Appear for Reconsideration of Fee Waiver (Ward or


Conservatee)

FW-012* 9/1/2019 Order on Court Fee Waiver After Reconsideration Hearing (Superior
Court)

FW-012 S 9/1/2019 Order on Court Fee Waiver After Reconsideration Hearing (Superior
Court) (Spanish)

FW-012-GC* 9/1/2019 Order on Court Fee Waiver After Reconsideration Hearing (Superior
Court) (Ward or Conservatee)

FW-012-GC S 9/1/2019 Order on Court Fee Waiver After Reconsideration Hearing (Superior
Court) (Ward or Conservatee) (Spanish)

APP-015/FW-015- 4/1/2023 Information Sheet on Waiver of Appellate Court Fees — Supreme


INFO* Court, Court of Appeal, Appellate Division

APP-015/FW-015- 4/1/2023 Information Sheet on Waiver of Appellate Court Fees — Supreme


INFO S Court, Court of Appeal, Appellate Division (Spanish)

APP-016/FW-016 7/1/2010 Order on Court Fee Waiver (Court of Appeal or Supreme Court)

APP-016/FW-016 S 7/1/2010 Order on Court Fee Waiver (Court of Appeal or Supreme Court)
(Spanish)

APP-016-GC/FW- 1/1/2021 Order on Court Fee Waiver (Court of Appeal or Supreme Court)
016-GC (Ward or Conservatee)

APP-016-GC/FW- 1/1/2021 Order on Court Fee Waiver (Court of Appeal or Supreme Court)
016-GC S (Ward or Conservatee) (Spanish)

FW-020 1/1/2021 Request for Court Reporter by Party with Fee Waiver

* Adopted for Mandatory Use. Page 59 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

Guardianships and Conservatorships


APP-016-GC/FW- 1/1/2021 Order on Court Fee Waiver (Court of Appeal or Supreme Court)
016-GC (Ward or Conservatee)

APP-016-GC/FW- 1/1/2021 Order on Court Fee Waiver (Court of Appeal or Supreme Court)
016-GC S (Ward or Conservatee) (Spanish)

FW-001-GC* 4/1/2023 Request to Waive Court Fees (Ward or Conservatee)

FW-001-GC S 4/1/2023 Request to Waive Court Fees (Ward or Conservatee) (Spanish)

FW-002-GC* 9/1/2015 Request to Waive Additional Court Fees (Superior Court) (Ward or
Conservatee)

FW-003-GC* 9/1/2019 Order on Court Fee Waiver (Superior Court) (Ward or Conservatee)

FW-003-GC S 9/1/2019 Order on Court Fee Waiver (Superior Court) (Ward or Conservatee)
(Spanish)

FW-005-GC* 9/1/2019 Notice: Waiver of Court Fees (Superior Court) (Ward or Conservatee)

FW-005-GC S 9/1/2019 Notice: Waiver of Court Fees (Superior Court) (Ward or Conservatee)
(Spanish)

FW-006-GC* 9/1/2015 Request for Hearing About Court Fee Waiver Order (Superior Court)
(Ward or Conservatee)

FW-007-GC* 9/1/2015 Notice on Hearing About Court Fees (Ward or Conservatee)

FW-008-GC* 9/1/2019 Order on Court Fee Waiver After Hearing (Superior Court) (Ward or
Conservatee)

FW-008-GC S 9/1/2019 Order on Court Fee Waiver After Hearing (Superior Court) (Ward or
Conservatee) (Spanish)

FW-010-GC* 9/1/2015 Notice to Court of Improved Financial Situation or Settlement (Ward


or Conservatee)

FW-011-GC* 9/1/2015 Notice to Appear for Reconsideration of Fee Waiver (Ward or


Conservatee)

FW-012-GC* 9/1/2019 Order on Court Fee Waiver After Reconsideration Hearing (Superior
Court) (Ward or Conservatee)

FW-012-GC S 9/1/2019 Order on Court Fee Waiver After Reconsideration Hearing (Superior
Court) (Ward or Conservatee) (Spanish)

GC-005 1/1/2019 Application for Appointment of Counsel

GC-006 1/1/2019 Order Appointing Legal Counsel

GC-010 1/1/2020 Certification of Attorney Qualifications

GC-020(C)* 7/1/2005 Clerk's Certificate of Posting Notice of Hearing—Guardianship or


Conservatorship

DE-120(MA)/GC- 7/1/2005 Attachment to Notice of Hearing Proof of Service by Mail


020(MA)

* Adopted for Mandatory Use. Page 60 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

GC-020(P) 7/1/2005 Proof of Personal Service of Notice of Hearing-Guardianship or


Conservatorship

DE-120(PA)/GC- 7/1/2005 Attachment to Notice of Hearing Proof of Personal Service


020(PA)

GC-021* 1/1/2000 Order Dispensing with Notice

DE-200/GC-022* 1/1/2000 Order Prescribing Notice

DE-154/GC-035* 1/1/1998 Request for Special Notice

DE-160/GC-040* 1/1/2007 Inventory and Appraisal

DE-161/GC-041* 1/1/2018 Inventory and Appraisal Attachment

GC-042* 1/1/2008 Notice of Filing of Inventory and Appraisal and How to Object to the
Inventory or the Appraised Value of Property

GC-042(MA) 1/1/2008 Attachment to Notice of Filing of Inventory and Appraisal and How to
Object to the Inventory or the Appraised Value of Property

GC-045 1/1/2008 Objections to Inventory and Appraisal of Conservator or Guardian

GC-050* 1/1/2009 Notice of Taking Possession or Control of An Asset of Minor or


Conservatee

DE-260/GC-060* 1/1/2006 Report of Sale and Petition for Order Confirming Sale of Real Property

DE-265/GC-065* 1/1/2015 Order Confirming Sale of Real Property

DE-270/GC-070* 1/1/2000 Ex Parte Petition for Authority to Sell Securities and Order

DE-275/GC-075* 1/1/1998 Ex Parte Petition for Approval of Sale of Personal Property and Order

GC-079* 1/1/2008 Pre-Move Notice of Proposed Change of Personal Residence of


Conservatee or Ward

GC-079(MA) 1/1/2008 Attachment to Pre-Move Notice of Proposed Change of Personal


Residence of Conservatee or Ward

GC-080* 1/1/2008 Post-Move Notice of Change of Residence of Conservatee or Ward

GC-080(MA) 1/1/2008 Attachment to Post-Move Notice of Change of Residence of


Conservatee or Ward

DE-350/GC-100* 1/1/2008 Petition for Appointment of Guardian Ad Litem—Probate

DE-351/GC-101* 1/1/2004 Order Appointing Guardian Ad Litem—Probate

GC-110* 7/1/2008 Petition for Appointment of Temporary Guardian

GC-110(P)* 1/1/2009 Petition for Appointment of Temporary Guardian of the Person

GC-111* 7/1/2008 Petition for Appointment of Temporary Conservator

GC-112 1/1/2009 Ex Parte Application for Good Cause Exception to Notice of Hearing
on Petition for Appointment of Temporary Conservator

* Adopted for Mandatory Use. Page 61 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

GC-112(A-1) 1/1/2009 Declaration in Support of Ex Parte Application for Good Cause


Exception to Notice of Hearing on Petition for Appointment of
Temporary Conservator

GC-112(A-2) 1/1/2009 Declaration Continuation Page

GC-115 1/1/2009 Order on Ex Parte Application for Good Cause Exception to Notice of
Hearing on Petition for Appointment of Temporary Conservator

FL-105/GC-120* 1/1/2009 Declaration Under Uniform Child Custody Jurisdiction and


Enforcement Act (UCCJEA)

FL-105/GC-120 S 1/1/2009 Declaration Under Uniform Child Custody Jurisdiction and


Enforcement Act (UCCJEA) (Spanish)

FL-105(A)/GC- 1/1/2009 Attachment to Declaration Under Uniform Child Custody Jurisdiction


120(A)* and Enforcement Act (UCCJEA)

GC-140* 1/1/2009 Order Appointing Temporary Guardian

GC-141* 1/1/2009 Order Appointing Temporary Conservator

GC-150* 1/1/2015 Letters of Temporary Guardianship or Conservatorship

GC-205 C 1/1/2001 Information on Probate Guardianship of the Person (Chinese)

GC-205 K 1/1/2001 Information on Probate Guardianship of the Person (Korean)

GC-205 S 1/1/2001 Information on Probate Guardianship of the Person (Spanish)

GC-205 V 1/1/2001 Information on Probate Guardianship of the Person (Vietnamese)

GC-205-INFO 1/1/2023 Information on Probate Guardianship of the Person

GC-206-INFO 1/1/2023 Information on Probate Guardianship of the Estate

GC-207-INFO/JV- 1/1/2023 Comparison of Guardians With Other Nonparent Caregivers


352-INFO*

GC-207-INFO/JV- 1/1/2023 Comparison of Guardians With Other Nonparent Caregivers (Spanish)


352-INFO S

GC-210* 7/1/2016 Petition for Appointment of Guardian of Minor

GC-210(A-PF)/GC- 7/1/2009 Professional Fiduciary Attachment to Petition for Appointment of


310(A-PF)* Guardian or Conservator

GC-210(CA)* 1/1/2022 Child Information Attachment to Probate Guardianship Petition

GC-210(CA) S 1/1/2022 Child Information Attachment to Probate Guardianship Petition


(Spanish)

GC-210(P)* 7/1/2016 Petition for Appointment of Guardian of the Person

GC-210(P) C 7/1/2016 Petition for Appointment of Guardian of the Person (Chinese)

GC-210(P) K 7/1/2016 Petition for Appointment of Guardian of the Person (Korean)

GC-210(P) S 7/1/2016 Petition for Appointment of Guardian of the Person (Spanish)

* Adopted for Mandatory Use. Page 62 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

GC-210(P) V 7/1/2016 Petition for Appointment of Guardian of the Person (Vietnamese)

GC-210(PE) 7/1/2016 Petition to Extend Guardianship of the Person

GC-212* 7/1/2009 Confidential Guardian Screening Form

GC-215 1/1/2023 OBJECTION TO PETITION FOR APPOINTMENT OF GUARDIAN

GC-220* 1/1/2016 Petition for Special Immigrant Juvenile Findings

FL-357/GC-224/JV- 7/1/2016 Special Immigrant Juvenile Findings


357*

FL-357/GC-224/JV- 7/1/2016 Special Immigrant Juvenile Findings (Spanish)


357 S

GC-240* 7/1/2016 Order Appointing Guardian or Extending Guardianship of the Person

GC-240 C 7/1/2016 Order Appointing Guardian or Extending Guardianship of the Person


(Chinese)

GC-240 K 7/1/2016 Order Appointing Guardian or Extending Guardianship of the Person


(Korean)

GC-240 S 7/1/2016 Order Appointing Guardian or Extending Guardianship of the Person


(Spanish)

GC-240 V 7/1/2016 Order Appointing Guardian or Extending Guardianship of the Person


(Vietnamese)

GC-248* 1/1/2001 Duties of Guardian

GC-248 C 1/1/2001 Duties of Guardian (Chinese)

GC-248 K 1/1/2001 Duties of Guardian (Korean)

GC-248 S 1/1/2001 Duties of Guardian (Spanish)

GC-248 V 1/1/2001 Duties of Guardian (Vietnamese)

GC-250* 7/1/2016 Letters of Guardianship

GC-251* 7/1/2003 Confidential Guardianship Status Report

GC-255* 1/1/2006 Petition for Termination of Guardianship

GC-260* 1/1/2006 Order Terminating Guardianship (Probate—Guardianships and


Conservatorships)

GC-310* 1/1/2019 Petition for Appointment of Probate Conservator

GC-310 C 1/1/2019 Petition for Appointment of Probate Conservator (Chinese)

GC-310 K 1/1/2019 Petition for Appointment of Probate Conservator (Korean)

GC-310 S 1/1/2019 Petition for Appointment of Probate Conservator (Spanish)

GC-310 V 1/1/2019 Petition for Appointment of Probate Conservator (Vietnamese)

* Adopted for Mandatory Use. Page 63 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

GC-210(A-PF)/GC- 7/1/2009 Professional Fiduciary Attachment to Petition for Appointment of


310(A-PF)* Guardian or Conservator

GC-312* 1/1/2001 Confidential Supplemental Information (Probate Conservatorship)

GC-313* 1/1/2019 Attachment Requesting Special Orders Regarding a Major


Neurocognitive Disorder

GC-314* 7/1/2009 Confidential Conservator Screening Form

GC-320* 7/1/2016 Citation for Conservatorship

DE-122/GC-322* 1/1/2006 Citation—Probate

GC-330 1/1/2023 Order Appointing Court Investigator

GC-331 1/1/2023 Order Appointing Court Investigator (Review and Successor


Conservator Investigations)

GC-333* 1/1/2019 Ex Parte Application for Order Authorizing Completion of Capacity


Declaration—HIPAA

GC-334* 1/1/2019 Ex Parte Order Re Completion of Capacity Declaration—HIPAA

GC-335* 1/1/2019 Capacity Declaration—Conservatorship

GC-335A* 1/1/2019 Major Neurocognitive Disorder Attachment to Capacity


Declaration—Conservatorship

GC-336* 1/1/2009 Ex Parte Order Authorizing Disclosure of (Proposed) Conservatee’s


Health Information to Court Investigator—HIPAA

GC-340* 1/15/2016 Order Appointing Probate Conservator

GC-340 C 1/15/2016 Order Appointing Probate Conservator (Chinese)

GC-340 K 1/15/2016 Order Appointing Probate Conservator (Korean)

GC-340 S 1/15/2016 Order Appointing Probate Conservator (Spanish)

GC-340 V 1/15/2016 Order Appointing Probate Conservator (Vietnamese)

GC-341* 1/1/2008 Notice of Conservatee’s Rights

GC-341 C 1/1/2008 Notice of Conservatee’s Rights (Chinese)

GC-341 K 1/1/2008 Notice of Conservatee’s Rights (Korean)

GC-341 S 1/1/2008 Notice of Conservatee’s Rights (Spanish)

GC-341 V 1/1/2008 Notice of Conservatee’s Rights (Vietnamese)

GC-341(MA) 1/1/2008 Attachment to Notice of Conservatee’s Rights

GC-348* 1/1/2011 Duties of Conservator and Acknowledgment of Receipt of Handbook


for Conservators

GC-348 S 1/1/2011 Duties of Conservator and Acknowledgment of Receipt of Handbook


for Conservators (Spanish)

* Adopted for Mandatory Use. Page 64 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

GC-350* 7/1/2015 Letters of Conservatorship

GC-355 7/1/2011 Determination of Conservatee's Appropriate Level of Care

GC-360* 1/1/2016 Conservatorship Registration Cover Sheet and Attestation of


Conservatee's Non-Residence in California

GC-361* 1/1/2016 Notice of Intent to Register Conservatorship

GC-362* 1/1/2016 Conservatorship Registrant's Acknowledgment of Receipt of


Handbook for Conservators

GC-363 1/1/2020 Petition for Transfer Orders (California Conservatorship Jurisdiction


Act)

GC-364 1/1/2019 Provisional Order for Transfer (California Conservatorship Jurisdiction


Act)

GC-365 1/1/2019 Final Order Confirming Transfer (California Conservatorship


Jurisdiction Act)

GC-366 1/1/2020 Petition for Orders Accepting Transfer (California Conservatorship


Jurisdiction Act)

GC-367 1/1/2019 Provisional Order Accepting Transfer (California Conservatorship


Jurisdiction Act)

GC-368 1/1/2019 Final Order Accepting Transfer (California Conservatorship


Jurisdiction Act)

GC-380* 1/1/2019 Petition for Exclusive Authority to Give Consent for Medical Treatment

GC-385* 1/1/2019 Order Authorizing Conservator to Give Consent for Medical Treatment

DE-295/GC-395* 1/1/2006 Ex Parte Petition for Final Discharge and Order

GC-399* 1/1/2017 Notice of Conservatee's Death

GC-400(A)(1) 1/1/2008 Schedule A, Receipts, Dividends—Standard Account

GC-400(A)(2) 1/1/2008 Schedule A, Receipts, Interest—Standard Account

GC-400(A)(3) 1/1/2008 Schedule A, Receipts, Pensions, Annuities, and Other Regular


Periodic Payments—Standard Account

GC-400(A)(4) 1/1/2008 Schedule A, Receipts, Rent—Standard Account

GC-400(A)(5) 1/1/2008 Schedule A, Receipts, Social Security, Veterans’ Benefits, Other


Public Benefits—Standard Account

GC-400(A)(6) 1/1/2008 Schedule A, Receipts, Other Receipts—Standard Account

GC-400(A)(C) 1/1/2008 Schedule A and C, Receipts and Disbursements


Worksheet—Standard Account

GC-400(AP)/GC- 1/1/2008 Additional Property Received During Period of Account—Standard


405(AP) and Simplified Accounts

* Adopted for Mandatory Use. Page 65 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

GC-400(B)/GC- 1/1/2015 Schedule B, Gains on Sales—Standard and Simplified Accounts


405(B)

GC-400(C)(1) 1/1/2008 Schedule C, Disbursements, Conservatee’s Caregiver


Expenses—Standard Account

GC-400(C)(10) 1/1/2008 Schedule C, Disbursements, Rental Property Expenses—Standard


Account

GC-400(C)(11) 1/1/2008 Schedule C, Disbursements, Other Expenses—Standard Account

GC-400(C)(2) 1/1/2008 Schedule C, Disbursements, Conservatee’s Residential or Long-Term


Care Facility Living Expenses—Standard Account

GC-400(C)(3) 1/1/2008 Schedule C, Disbursements, Ward’s Education Expenses—Standard


Account

GC-400(C)(4) 1/1/2008 Schedule C, Disbursements, Fiduciary and Attorney Fees—Standard


Account

GC-400(C)(5) 1/1/2008 Schedule C, Disbursements, General Administration


Expenses—Standard Account

GC-400(C)(6) 1/1/2008 Schedule C, Disbursements, Investment Expenses—Standard


Account

GC-400(C)(7) 1/1/2008 Schedule C, Disbursements, Living Expenses—Standard Account

GC-400(C)(8) 1/1/2008 Schedule C, Disbursements, Medical Expenses—Standard Account

GC-400(C)(9) 1/1/2008 Schedule C, Disbursements, Property Sale Expenses—Standard


Account

GC-400(D)/GC- 1/1/2015 Schedule D, Losses on Sales—Standard and Simplified Accounts


405(D)

GC-400(DIST)/GC- 1/1/2008 Distributions to Conservatee or Ward—Standard and Simplified


405(DIST) Accounts

GC-400(E)(1)/GC- 1/1/2008 Cash Assets on Hand at End of Account Period—Standard and


405(E)(1) Simplified Accounts

GC-400(E)(2)/GC- 1/1/2008 Non-Cash Assets on Hand at End of Account Period —Standard and
405(E)(2) Simplified Accounts

GC-400(F)/GC- 1/1/2008 Schedule F, Changes in Form of Assets—Standard and Simplified


405(F) Accounts

GC-400(G)/GC- 1/1/2008 Schedule G, Liabilities at End of Account Period—Standard and


405(G) Simplified Accounts

GC-400(NI) 1/1/2008 Net Income From a Trade or Business—Standard Account

GC-400(NL) 1/1/2008 Net Loss From a Trade or Business—Standard Account

GC-400(OCH)/GC- 1/1/2008 Other Charges—Standard and Simplified Accounts


405(OCH)

* Adopted for Mandatory Use. Page 66 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

GC-400(OCR)/GC- 1/1/2008 Other Credits—Standard and Simplified Accounts


405(OCR)

GC-400(PH)(1)/GC- 1/1/2008 Cash Assets on Hand at Beginning of Account Period—Standard and


405(PH)(1) Simplified Accounts

GC-400(PH)(2)/GC- 1/1/2008 Non-Cash Assets on Hand at Beginning of Account Period—Standard


405(PH)(2) and Simplified Accounts

GC-400(SUM)/GC- 1/1/2008 Summary of Account—Standard and Simplified Accounts


405(SUM)*

GC-405(A)* 1/1/2008 Schedule A, Receipts—Simplified Account

GC-405(C)* 1/1/2008 Schedule C, Disbursements—Simplified Account

GC-410 1/1/2020 Request and Order for Waiver of Accounting

GC-505 7/1/2007 Forms You Need to Ask the Court to Appoint a Guardian of the Person

GC-505 S 7/1/2007 Forms You Need to Ask the Court to Appoint a Guardian of the
Person (Spanish)

GC-510 7/1/2007 What Is "Proof of Service" in a Guardianship?

GC-510 S 7/1/2007 What Is "Proof of Service" in a Guardianship? (Spanish)

Gun Violence Prevention


GV-009 1/1/2023 Notice of Court Hearing

GV-020* 1/1/2023 Response to Gun Violence Emergency Protective Order (Gun


Violence Prevention)

GV-020-INFO 1/1/2023 How Can I Respond to a Gun Violence Emergency Protective Order?

GV-025 9/1/2019 Proof of Service by Mail (Gun Violence Prevention)

GV-030* 1/1/2023 Gun Violence Restraining Order After Hearing on EPO-002 (CLETS-
HGV) (Gun Violence Prevention)

GV-100* 1/1/2023 Petition for Gun Violence Restraining Order

GV-100 C 1/1/2019 Petition for Gun Violence Restraining Order (Chinese)

GV-100 K 9/1/2020 Petition for Gun Violence Restraining Order (Korean)

GV-100 S 1/1/2019 Petition for Gun Violence Restraining Order (Spanish)

GV-100 V 1/1/2019 Petition for Gun Violence Restraining Order (Vietnamese)

GV-100-INFO 1/1/2023 Can a Gun Violence Restraining Order Help Me?

GV-100-INFO C 9/1/2020 Can a Gun Violence Restraining Order Help Me? (Chinese)

GV-100-INFO K 9/1/2020 Can a Gun Violence Restraining Order Help Me? (Korean)

GV-100-INFO S 1/1/2019 Can a Gun Violence Restraining Order Help Me? (Spanish)

GV-100-INFO V 9/1/2020 Can a Gun Violence Restraining Order Help Me? (Vietnamese)

* Adopted for Mandatory Use. Page 67 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

GV-109* 1/1/2023 Notice of Court Hearing (Gun Violence Prevention)

GV-109 C 9/1/2020 Notice of Court Hearing (Gun Violence Prevention) (Chinese)

GV-109 K 9/1/2020 Notice of Court Hearing (Gun Violence Prevention) (Korean)

GV-109 S 1/1/2019 Notice of Court Hearing (Gun Violence Prevention) (Spanish)

GV-109 V 1/1/2019 Notice of Court Hearing (Gun Violence Prevention) (Vietnamese)

GV-110* 1/1/2023 Temporary Gun Violence Restraining Order (CLETS-TGV) (Gun


Violence Prevention)

GV-110 C 9/1/2020 Temporary Gun Violence Restraining Order (CLETS-TGV) (Gun


Violence Prevention) (Chinese)

GV-110 K 9/1/2020 Temporary Gun Violence Restraining Order (CLETS-TGV) (Gun


Violence Prevention) (Korean)

GV-110 S 1/1/2019 Temporary Gun Violence Restraining Order (CLETS-TGV) (Gun


Violence Prevention) (Spanish)

GV-110 V 1/1/2019 Temporary Gun Violence Restraining Order (CLETS-TGV) (Gun


Violence Prevention) (Vietnamese)

GV-115* 1/1/2020 Request to Continue Court Hearing for Gun Violence Restraining
Order (EPO-002 or Temporary Restraining Order) (Gun Violence
Prevention)

GV-115 C 1/1/2020 Request to Continue Court Hearing for Gun Violence Restraining
Order (EPO-002 or Temporary Restraining Order) (Gun Violence
Prevention) (Chinese)

GV-115 K 1/1/2020 Request to Continue Court Hearing for Gun Violence Restraining
Order (EPO-002 or Temporary Restraining Order) (Gun Violence
Prevention) (Korean)

GV-115 S 1/1/2020 Request to Continue Court Hearing for Gun Violence Restraining
Order (EPO-002 or Temporary Restraining Order) (Gun Violence
Prevention) (Spanish)

GV-115 V 1/1/2020 Request to Continue Court Hearing for Gun Violence Restraining
Order (EPO-002 or Temporary Restraining Order) (Gun Violence
Prevention) (Vietnamese)

GV-116* 1/1/2023 Order on Request to Continue Hearing (EPO-002 or Temporary


Restraining Order) (CLETS-EGV or CLETS-TGV) (Gun Violence
Prevention)

GV-116 C 1/1/2020 Order on Request to Continue Hearing (EPO-002 or Temporary


Restraining Order) (CLETS-EGV or CLETS-TGV) (Gun Violence
Prevention) (Chinese)

GV-116 K 1/1/2020 Order on Request to Continue Hearing (EPO-002 or Temporary


Restraining Order) (CLETS-EGV or CLETS-TGV) (Gun Violence
Prevention) (Korean)

* Adopted for Mandatory Use. Page 68 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

GV-116 S 1/1/2020 Order on Request to Continue Hearing (EPO-002 or Temporary


Restraining Order) (CLETS-EGV or CLETS-TGV) (Gun Violence
Prevention) (Spanish)

GV-116 V 1/1/2020 Order on Request to Continue Hearing (EPO-002 or Temporary


Restraining Order) (CLETS-EGV or CLETS-TGV) (Gun Violence
Prevention) (Vietnamese)

GV-120* 1/1/2023 Response to Petition for Gun Violence Restraining Order (Gun
Violence Prevention)

GV-120 C 9/1/2020 Response to Petition for Gun Violence Restraining Order (Gun
Violence Prevention) (Chinese)

GV-120 K 9/1/2020 Response to Petition for Gun Violence Restraining Order (Gun
Violence Prevention) (Korean)

GV-120 S 1/1/2019 Response to Petition for Gun Violence Restraining Order (Gun
Violence Prevention) (Spanish)

GV-120 V 9/1/2020 Response to Petition for Gun Violence Restraining Order (Gun
Violence Prevention) (Vietnamese)

GV-120-INFO 1/1/2023 How Can I Respond to a Petition for a Gun Violence Restraining
Order? (Gun Violence Prevention

GV-120-INFO C 9/1/2020 How Can I Respond to a Petition for a Gun Violence Restraining
Order? (Gun Violence Prevention (Chinese)

GV-120-INFO K 9/1/2020 How Can I Respond to a Petition for a Gun Violence Restraining
Order? (Gun Violence Prevention (Korean)

GV-120-INFO S 1/1/2019 How Can I Respond to a Petition for a Gun Violence Restraining
Order? (Gun Violence Prevention (Spanish)

GV-120-INFO V 9/1/2020 How Can I Respond to a Petition for a Gun Violence Restraining
Order? (Gun Violence Prevention (Vietnamese)

GV-125* 1/1/2023 Consent to Gun Violence Restraining Order and Surrender of


Firearms (Gun Violence Prevention)

GV-130* 1/1/2023 Gun Violence Restraining Order After Hearing or Consent to Gun
Violence Restraining Order (CLETS-OGV) (Gun Violence Prevention)

GV-130 C 9/1/2020 Gun Violence Restraining Order After Hearing or Consent to Gun
Violence Restraining Order (CLETS-OGV) (Gun Violence Prevention)
(Chinese)

GV-130 K 9/1/2020 Gun Violence Restraining Order After Hearing or Consent to Gun
Violence Restraining Order (CLETS-OGV) (Gun Violence Prevention)
(Korean)

GV-130 S 9/1/2020 Gun Violence Restraining Order After Hearing or Consent to Gun
Violence Restraining Order (CLETS-OGV) (Gun Violence Prevention)
(Spanish)

* Adopted for Mandatory Use. Page 69 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

GV-130 V 9/1/2020 Gun Violence Restraining Order After Hearing or Consent to Gun
Violence Restraining Order (CLETS-OGV) (Gun Violence Prevention)
(Vietnamese)

GV-200 9/1/2019 Proof of Personal Service

GV-200 C 9/1/2019 Proof of Personal Service (Chinese)

GV-200 K 9/1/2019 Proof of Personal Service (Korean)

GV-200 S 1/1/2019 Proof of Personal Service (Spanish)

GV-200 V 9/1/2019 Proof of Personal Service (Vietnamese)

GV-200-INFO 1/1/2019 What Is “Proof of Personal Service”?

GV-200-INFO C 1/1/2016 What Is “Proof of Personal Service”? (Chinese)

GV-200-INFO K 1/1/2016 What Is “Proof of Personal Service”? (Korean)

GV-200-INFO S 1/1/2019 What Is “Proof of Personal Service”? (Spanish)

GV-200-INFO V 1/1/2016 What Is “Proof of Personal Service”? (Vietnamese)

GV-250 1/1/2019 Proof of Service by Mail

GV-250 C 1/1/2019 Proof of Service by Mail (Chinese)

GV-250 K 1/1/2019 Proof of Service by Mail (Korean)

GV-250 S 1/1/2019 Proof of Service by Mail (Spanish)

GV-250 V 1/1/2019 Proof of Service by Mail (Vietnamese)

GV-600* 9/1/2020 Request to Terminate Gun Violence Restraining Order

GV-600 C 9/1/2020 Request to Terminate Gun Violence Restraining Order (Chinese)

GV-600 K 9/1/2020 Request to Terminate Gun Violence Restraining Order (Korean)

GV-600 S 9/1/2020 Request to Terminate Gun Violence Restraining Order (Spanish)

GV-600 V 9/1/2020 Request to Terminate Gun Violence Restraining Order (Vietnamese)

GV-610* 9/1/2020 Notice of Hearing on Request to Terminate Gun Violence Restraining


Order

GV-610 C 9/1/2020 Notice of Hearing on Request to Terminate Gun Violence Restraining


Order (Chinese)

GV-610 K 9/1/2020 Notice of Hearing on Request to Terminate Gun Violence Restraining


Order (Korean)

GV-610 S 1/1/2019 Notice of Hearing on Request to Terminate Gun Violence Restraining


Order (Spanish)

GV-610 V 9/1/2020 Notice of Hearing on Request to Terminate Gun Violence Restraining


Order (Vietnamese)

GV-620* 9/1/2020 Response to Request to Terminate Gun Violence Restraining Order

* Adopted for Mandatory Use. Page 70 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

GV-620 C 9/1/2020 Response to Request to Terminate Gun Violence Restraining Order


(Chinese)

GV-620 K 9/1/2020 Response to Request to Terminate Gun Violence Restraining Order


(Korean)

GV-620 S 1/1/2019 Response to Request to Terminate Gun Violence Restraining Order


(Spanish)

GV-620 V 9/1/2020 Response to Request to Terminate Gun Violence Restraining Order


(Vietnamese)

GV-630* 9/1/2020 Order on Request to Terminate Gun Violence Restraining Order

GV-630 C 9/1/2020 Order on Request to Terminate Gun Violence Restraining Order


(Chinese)

GV-630 K 9/1/2020 Order on Request to Terminate Gun Violence Restraining Order


(Korean)

GV-630 S 1/1/2019 Order on Request to Terminate Gun Violence Restraining Order


(Spanish)

GV-630 V 9/1/2020 Order on Request to Terminate Gun Violence Restraining Order


(Vietnamese)

GV-700* 9/1/2020 Request to Renew Gun Violence Restraining Order

GV-700 C 9/1/2020 Request to Renew Gun Violence Restraining Order (Chinese)

GV-700 K 9/1/2020 Request to Renew Gun Violence Restraining Order (Korean)

GV-700 S 1/1/2019 Request to Renew Gun Violence Restraining Order (Spanish)

GV-700 V 9/1/2020 Request to Renew Gun Violence Restraining Order (Vietnamese)

GV-710* 1/1/2023 Notice of Hearing on Request to Renew Gun Violence Restraining


Order (Gun Violence Prevention)

GV-710 C 1/1/2019 Response to Request to Renew Gun Violence Restraining Order


(Chinese)

GV-710 K 1/1/2019 Response to Request to Renew Gun Violence Restraining Order


(Korean)

GV-710 S 1/1/2019 Notice of Hearing on Request to Renew Gun Violence Restraining


Order (Gun Violence Prevention) (Spanish)

GV-710 V 1/1/2019 Response to Request to Renew Gun Violence Restraining Order


(Vietnamese)

GV-720* 1/1/2019 Response to Request to Renew Gun Violence Restraining Order

GV-720 C 9/1/2020 Notice of Hearing on Request to Renew Gun Violence Restraining


Order (Gun Violence Prevention) (Chinese)

GV-720 K 9/1/2020 Notice of Hearing on Request to Renew Gun Violence Restraining


Order (Gun Violence Prevention) (Korean)

* Adopted for Mandatory Use. Page 71 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

GV-720 S 1/1/2019 Response to Request to Renew Gun Violence Restraining Order


(Spanish)

GV-720 V 9/1/2020 Notice of Hearing on Request to Renew Gun Violence Restraining


Order (Gun Violence Prevention) (Vietnamese)

GV-730* 1/1/2023 Order on Request to Renew Gun Violence Restraining Order (Gun
Violence Prevention)

GV-730 C 1/1/2019 Order on Request to Renew Gun Violence Restraining Order (Gun
Violence Prevention) (Chinese)

GV-730 K 1/1/2019 Order on Request to Renew Gun Violence Restraining Order (Gun
Violence Prevention) (Korean)

GV-730 S 1/1/2019 Order on Request to Renew Gun Violence Restraining Order (Gun
Violence Prevention) (Spanish)

GV-730 V 1/1/2019 Order on Request to Renew Gun Violence Restraining Order (Gun
Violence Prevention) (Vietnamese)

GV-800 1/1/2023 Receipt for Firearms, Firearm Parts, Ammunition, and Magazines

GV-800 C 9/1/2019 Receipt for Firearms, Firearm Parts, Ammunition, and Magazines
(Chinese)

GV-800 K 9/1/2019 Receipt for Firearms, Firearm Parts, Ammunition, and Magazines
(Korean)

GV-800 S 9/1/2019 Receipt for Firearms, Firearm Parts, Ammunition, and Magazines
(Spanish)

GV-800 V 9/1/2019 Receipt for Firearms, Firearm Parts, Ammunition, and Magazines
(Vietnamese)

GV-800-INFO 1/1/2023 How Do I Turn In, Sell, or Store My Firearms, Firearm Parts,
Ammunition, and Magazines?

GV-800-INFO C 9/1/2019 How Do I Turn In, Sell, or Store My Firearms, Firearm Parts,
Ammunition, and Magazines? (Chinese)

GV-800-INFO K 9/1/2019 How Do I Turn In, Sell, or Store My Firearms, Firearm Parts,
Ammunition, and Magazines? (Korean)

GV-800-INFO S 9/1/2019 How Do I Turn In, Sell, or Store My Firearms, Firearm Parts,
Ammunition, and Magazines? (Spanish)

GV-800-INFO V 9/1/2019 How Do I Turn In, Sell, or Store My Firearms, Firearm Parts,
Ammunition, and Magazines? (Vietnamese)

Habeas Corpus
HC-001 1/1/2019 Petition for Writ of Habeas Corpus

HC-002 9/1/2018 Petition for Writ of Habeas Corpus—LPS Act (Mental Health)

HC-003 9/1/2018 Petition for Writ of Habeas Corpus—Penal Commitment (Mental


Health)

* Adopted for Mandatory Use. Page 72 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

HC-004 9/1/2018 Notice and Request for Ruling

HC-100* 4/25/2019 Declaration of Counsel Re Minimum Qualifications for Appointment in


Death Penalty-Related Habeas Corpus Proceedings

HC-101* 4/25/2019 Order Appointing Counsel in Death Penalty-Related Habeas Corpus


Proceedings

HC-200* 4/25/2019 Petitioner's Notice of Appeal-Dealth Penalty-Related Habeas Corpus


Decision

Indian Child Welfare Act


ICWA-005-INFO 1/1/2022 Information Sheet on Indian Child Inquiry Attachment and Notice of
Child Custody Proceeding for Indian Child

ICWA-005-INFO S 1/1/2022 Information Sheet on Indian Child Inquiry Attachment and Notice of
Child Custody Proceeding for Indian Child (Spanish)

ICWA-010(A)* 1/1/2020 Indian Child Inquiry Attachment

ICWA-010(A) S 1/1/2020 Indian Child Inquiry Attachment (Spanish)

ICWA-020* 3/25/2020 Parental Notification of Indian Status

ICWA-020 S 3/25/2020 Parental Notification of Indian Status (Spanish)

ICWA-030* 1/1/2021 Notice of Child Custody Proceeding for Indian Child

ICWA-030 S 1/1/2021 Notice of Child Custody Proceeding for Indian Child (Spanish)

ICWA-030(A) 1/1/2008 Attachment to Notice of Child Custody Proceeding for Indian Child

ICWA-030(A) S 1/1/2008 Attachment to Notice of Child Custody Proceeding for Indian Child
(Spanish)

ICWA-040 1/1/2020 Notice of Designation of Tribal Representative in a Court Proceeding


Involving an Indian Child

ICWA-050 1/1/2008 Notice of Petition and Petition to Transfer Case Involving an Indian
Child to Tribal Jurisdiction

ICWA-060* 1/1/2020 Order on Petition to Transfer Case Involving an Indian Child to Tribal
Jurisdiction

ICWA-070* 1/1/2020 Request for Ex Parte Hearing to Return Physical Custody of an Indian
Child

ICWA-080* 1/1/2020 Order on Request for Ex Parte Hearing to Return Physical Custody of
an Indian Child

ICWA-090* 1/1/2021 Order After Hearing on Ex Parte Request to Return Physical Custody
of an Indian Child

ICWA-100 1/1/2021 Tribal Information Form

ICWA-100-INFO 1/1/2021 Instructions Sheet for Tribal Information Form

* Adopted for Mandatory Use. Page 73 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

ICWA-101* 1/1/2021 Agreement of Parent or Indian Custodian to Temporary Custody of


Indian Child

Interpreter
INT-001* 1/1/2009 Semiannual Report to the Judicial Council on the Use of Noncertified
or Nonregistered Interpreters

INT-002(A)* 1/1/2009 Semiannual Report to the Judicial Council on the Use of


Nonregistered Interpreters

INT-100-INFO* 1/1/2018 Procedures to Appoint a Noncertified or Nonregistered Spoken


Language Interpreter as Either Provisionally Qualified or Temporary

INT-110* 1/1/2018 Qualifications of a Noncertified or Nonregistered Spoken Language


Interpreter

INT-120* 1/1/2009 Certification of Unavailability of Certified or Registered Interpreter

INT-140 1/1/2018 Temporary Use of a Noncertified or Nonregistered Spoken Language


Interpreter

INT-200 7/1/2008 Foreign Language Interpreter's Duties—Civil And Small Claims (For
Noncertified And Nonregistered Interpreters)

INT-300 7/1/2016 Request for Interpreter (Civil)

INT-300 C 1/1/2018 Request for Interpreter (Civil) (Chinese)

INT-300 CT 1/1/2018 Request for Interpreter (Civil) (Chinese Traditional)

INT-300 F 1/1/2018 Request for Interpreter (Civil) (Farsi)

INT-300 HM 1/1/2018 Request for Interpreter (Civil) (Hmong)

INT-300 K 1/1/2018 Request for Interpreter (Civil) (Korean)

INT-300 P 1/1/2018 Request for Interpreter (Civil) (Punjabi)

INT-300 R 1/1/2018 Request for Interpreter (Civil) (Russian)

INT-300 S 1/1/2018 Request for Interpreter (Civil) (Spanish)

INT-300 TG 1/1/2018 Request for Interpreter (Civil) (Tagalog)

INT-300 V 1/1/2018 Request for Interpreter (Civil) (Vietnamese)

Judgment
JUD-100 1/1/2002 Judgment

Jury Selection
JURY-001 9/1/2018 Juror Questionnaire for Civil Cases

JURY-002 9/1/2018 Juror Questionnaire for Criminal Cases/Capital Case Supplement

JURY-003 9/1/2018 Juror Questionnaire for Expedited Jury Trials

* Adopted for Mandatory Use. Page 74 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

JURY-010 9/1/2018 Juror's Motion to Set Aside Sanctions and Order

Juvenile Law
JV-050-INFO 1/1/2015 What happens if your child is taken from your home?

JV-050-INFO C 1/1/2015 What happens if your child is taken from your home? (Chinese)

JV-050-INFO CM 1/1/2015 What happens if your child is taken from your home? (Cambodian)

JV-050-INFO H 1/1/2015 What happens if your child is taken from your home? (Hmong)

JV-050-INFO K 1/1/2015 What happens if your child is taken from your home? (Korean)

JV-050-INFO R 1/1/2015 What happens if your child is taken from your home? (Russian)

JV-050-INFO S 1/1/2015 What happens if your child is taken from your home? (Spanish)

JV-050-INFO V 1/1/2015 What happens if your child is taken from your home? (Vietnamese)

JV-060-INFO 1/1/2019 Juvenile Justice Court: Information for Parents

JV-060-INFO C 1/1/2019 Juvenile Justice Court: Information for Parents (Chinese)

JV-060-INFO K 1/1/2019 Juvenile Justice Court: Information for Parents (Korean)

JV-060-INFO S 1/1/2019 Juvenile Justice Court: Information for Parents (Spanish)

JV-060-INFO V 1/1/2019 Juvenile Justice Court: Information for Parents (Vietnamese)

JV-100* 2/1/2023 Juvenile Dependency Petition (Version One)

JV-100 S 1/1/2020 Juvenile Dependency Petition (Version One) (Spanish)

JV-101(A)* 2/1/2023 Additional Children Attachment—Juvenile Dependency Petition

JV-101(A) S 7/1/2016 Additional Children Attachment—Juvenile Dependency Petition


(Spanish)

JV-110* 2/1/2023 Juvenile Dependency Petition (Version Two)

JV-110 S 1/1/2020 Juvenile Dependency Petition (Version Two) (Spanish)

JV-120 S 1/1/2007 Serious Physical Harm (Spanish)

JV-121 2/1/2023 Failure To Protect § 300(b)

JV-121 S 7/1/2016 Failure To Protect § 300(b) (Spanish)

JV-122 1/1/2007 Serious Emotional Damage

JV-122 S 1/1/2007 Serious Emotional Damage (Spanish)

JV-123* 1/1/2007 Sexual Abuse

JV-123 S 1/1/2007 Sexual Abuse (Spanish)

JV-124 1/1/2007 Severe Physical Abuse

JV-124 S 1/1/2007 Severe Physical Abuse (Spanish)

* Adopted for Mandatory Use. Page 75 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

JV-125 1/1/2007 Caused Another Child's Death Through Abuse or Neglect

JV-125 S 1/1/2007 Caused Another Child's Death Through Abuse or Neglect (Spanish)

JV-126 1/1/2007 No Provision For Support

JV-126 S 1/1/2007 No Provision For Support (Spanish)

JV-127 1/1/2007 Freed For Adoption

JV-127 S 1/1/2007 Freed For Adoption (Spanish)

JV-128 1/1/2007 Cruelty

JV-128 S 1/1/2007 Cruelty (Spanish)

JV-129 1/1/2007 Abuse of Sibling

JV-129 S 1/1/2007 Abuse of Sibling (Spanish)

JV-130-INFO 1/1/2013 Paying for Lawyers in Dependency Court—Information for Parents


and Guardians

JV-130-INFO S 1/1/2013 Paying for Lawyers in Dependency Court—Information for Parents


and Guardians (Spanish)

JV-131 1/1/2013 Order to Appear For Financial Evaluation

JV-132 4/1/2023 Financial Declaration—Juvenile Dependency

JV-133 1/1/2013 Recommendation Regarding Ability to Repay Cost of Legal Services

JV-134 1/1/2013 Response to Recommendation Regarding Ability to Repay Cost of


Legal Services

JV-135 1/1/2013 Order for Repayment of Cost of Legal Services

JV-136 1/1/2013 Juvenile Dependency—Cost of Appointed Counsel: Repayment


Recommendation/Response/Order

JV-140* 1/1/2007 Notification of Mailing Address

JV-140 S 1/1/2007 Notification of Mailing Address (Spanish)

EFS-005-JV/JV-141 1/1/2019 E-Mail Notice of Hearing: Consent, Withdrawal of Consent, Address


Change

EFS-005-JV/JV- 1/1/2019 E-Mail Notice of Hearing: Consent, Withdrawal of Consent, Address


141 S Change (Spanish)

JV-150* 1/1/2007 Supplemental Petition For More Restrictive Placement (Attachment)

JV-150 S 1/1/2007 Supplemental Petition For More Restrictive Placement (Attachment)


(Spanish)

JV-180* 1/1/2020 Request to Change Court Order

JV-180 S 1/1/2020 Request to Change Court Order (Spanish)

JV-183* 1/1/2016 Court Order on Form JV-180, Request to Change Court Order

* Adopted for Mandatory Use. Page 76 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

JV-184* 1/1/2009 Order After Hearing on Form JV-180, Request to Change Court Order

JV-185 1/1/2016 Child's Information Sheet—Request to Change Court Order

JV-190* 1/1/2007 Waiver Of Rights—Juvenile Dependency

JV-190 S 1/1/2007 Waiver Of Rights—Juvenile Dependency (Spanish)

JV-195* 7/1/1998 Waiver of Reunification Services

JV-195 S 7/1/1998 Waiver of Reunification Services (Spanish)

JV-200* 1/1/2016 Custody Order—Juvenile—Final Judgment

JV-200 S 1/1/2016 Custody Order—Juvenile—Final Judgment (Spanish)

JV-205* 1/1/2016 Visitation (Parenting Time) Order—Juvenile

JV-205 S 1/1/2016 Visitation (Parenting Time) Order—Juvenile (Spanish)

JV-206 1/1/2016 Reasons for No or Supervised Visitation - Juvenile

JV-210 1/1/2023 Application to Commence Juvenile Court Proceedings and Decision


of Social Worker (Welfare & Institutions Code, § 329)

JV-212 9/1/2018 Application to Review Decision by Social Worker Not to Commence


Proceedings

JV-213 1/1/2023 Probate Court Request for Juvenile Court Review of Decision Not to
Commence Proceedings

JV-214* 9/1/2018 Request for Hearing on Waiver of Presumptive Transfer

JV-214(A)* 9/1/2018 Notice of and Order on Request for Hearing on Waiver of


Presumptive Transfer

JV-214-INFO 9/1/2018 Instructions for Requesting a Hearing to Review Waiver of


Presumptive Transfer of Specialty Mental Health Services

JV-215* 9/1/2018 Order After Hearing on Waiver of Presumptive Transfer

JV-216 9/1/2018 Order Delegating Judicial Authority Over Psychotropic Medication

JV-217-INFO 1/1/2019 Guide to Psychotropic Medication Forms

JV-218 7/1/2016 Child's Opinion About the Medicine

JV-218 S 7/1/2016 Child's Opinion About the Medicine (Spanish)

JV-219 1/1/2018 Statement About Medicine Prescribed

JV-219 S 1/1/2018 Statement About Medicine Prescribed (Spanish)

JV-220* 1/1/2018 Application For Psychotropic Medication

JV-220(A)* 1/1/2018 Physician’s Statement—Attachment

JV-220(B)* 1/1/2018 Physician's Request to Continue Medication—Attachment

JV-221* 1/1/2021 Proof of Notice of Application

* Adopted for Mandatory Use. Page 77 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

JV-222* 1/1/2018 Input on Application for Psychotropic Medication

JV-222 S 1/1/2018 Input on Application for Psychotropic Medication (Spanish)

JV-223* 9/1/2020 Order on Application for Psychotropic Medication

JV-224* 1/1/2018 County Report on Psychotropic Medication

JV-225* 1/1/2014 Your Child’s Health and Education

JV-225 S 1/1/2014 Your Child’s Health and Education (Spanish)

JV-226 7/1/2013 Authorization to Release Health and Mental Health Information

JV-227 1/1/2014 Consent to Release Educational Information

JV-228 9/1/2020 Position on Release of Information to Medical Board of California

JV-228-INFO 9/1/2020 Background on Release of Information to Medical Board of California

JV-229* 9/1/2020 Withdrawal of Release of Information to Medical Board of California

JV-235* 1/1/2023 Placing Agency's Request for Review of Placement in Short-Term


Residential Therapeutic Program or Community Treatment Facility

JV-236* 1/1/2023 Input on Placement in Short-Term Residential Therapeutic Program


or Community Treatment Facility

JV-237* 1/1/2023 Proof of Service—Short-Term Residential Therapeutic Program ooor


Community Treatment Facility Placement

JV-238 1/1/2023 Notice of Hearing on Placement in Short-Term Residential


Therapeutic Program or Community Treatment Facility

JV-239* 1/1/2023 Order on Placement in Short-Term Residential Therapeutic Program


or Community Treatment Facility

JV-240* 1/1/2023 Notice of Request for Approval of Short-Term Residential Therapeutic


Program or Community Treatment Facility Without a Hearing

JV-245* 1/1/2023 Request For Juvenile Restraining Order

JV-245 C 1/1/2023 Request For Juvenile Restraining Order (Chinese)

JV-245 K 1/1/2023 Request For Juvenile Restraining Order (Korean)

JV-245 S 1/1/2023 Request For Juvenile Restraining Order (Spanish)

JV-245 V 1/1/2023 Request For Juvenile Restraining Order (Vietnamese)

JV-247* 1/1/2023 Response to Request for Juvenile Restraining Order

JV-247 S 7/1/2014 Response to Request for Juvenile Restraining Order (Spanish)

JV-250* 1/1/2023 Notice of Hearing and Temporary Restraining Order—Juvenile


(CLETS—TJV)

JV-250 C 9/1/2019 Notice of Hearing and Temporary Restraining Order—Juvenile


(CLETS—TJV) (Chinese)

* Adopted for Mandatory Use. Page 78 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

JV-250 K 9/1/2019 Notice of Hearing and Temporary Restraining Order—Juvenile


(CLETS—TJV) (Korean)

JV-250 S 9/1/2019 Notice of Hearing and Temporary Restraining Order—Juvenile


(CLETS—TJV) (Spanish)

JV-250 V 9/1/2019 Notice of Hearing and Temporary Restraining Order—Juvenile


(CLETS—TJV) (Vietnamese)

JV-251* 1/1/2023 Request to Reschedule Restraining Order Hearing

JV-251 S 7/1/2016 Request to Reschedule Restraining Order Hearing (Spanish)

JV-253* 1/1/2023 Order on Request to Reschedule Restraining Order Hearing

JV-255* 1/1/2023 Juvenile Restraining Order After Hearing (CLETS—OJV)

JV-255 C 9/1/2019 Juvenile Restraining Order After Hearing (CLETS—OJV) (Chinese)

JV-255 K 9/1/2019 Juvenile Restraining Order After Hearing (CLETS—OJV) (Korean)

JV-255 S 9/1/2019 Juvenile Restraining Order After Hearing (CLETS—OJV) (Spanish)

JV-255 V 9/1/2019 Juvenile Restraining Order After Hearing (CLETS—OJV)


(Vietnamese)

JV-257* 1/1/2014 Change to Restraining Order After Hearing

JV-257 C 1/1/2014 Change to Restraining Order After Hearing (Cambodian)

JV-257 K 1/1/2014 Change to Restraining Order After Hearing (Korean)

JV-257 S 1/1/2014 Change to Restraining Order After Hearing (Spanish)

JV-257 V 1/1/2014 Change to Restraining Order After Hearing (Vietnamese)

JV-258* 1/1/2023 Request for Juvenile Restraining Order Against a Child

JV-259* 1/1/2023 Response to Request for Juvenile Restraining Order Against a Child

JV-260* 1/1/2023 Notice of Court Hearing and Temporary Restraining Order Against a
Child (CLETS—TJC)

JV-265* 1/1/2023 Juvenile Restraining Order After Hearing—Against a Child


(CLETS—OJC)

JV-268* 1/1/2023 Proof of Personal Service (CLETS-JUV)

DV-800/JV-252 C 1/1/2019 Proof of Firearms Turned In, Sold, or Stored (Chinese)

DV-800/JV-252 K 1/1/2019 Proof of Firearms Turned In, Sold, or Stored (Korean)

DV-800/JV-252 S 1/1/2019 Proof of Firearms Turned In, Sold, or Stored (Spanish)

DV-800/JV-270 1/1/2023 Proof of Firearms Turned In, Sold, or Stored

DV-800-INFO/JV- 7/1/2014 How Do I Turn In, Sell, or Store My Firearms? (Chinese)


252-INFO C

* Adopted for Mandatory Use. Page 79 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

DV-800-INFO/JV- 7/1/2014 How Do I Turn In, Sell, or Store My Firearms? (Korean)


252-INFO K

DV-800-INFO/JV- 7/1/2014 How Do I Turn In, Sell, or Store My Firearms? (Spanish)


252-INFO S

DV-800-INFO/JV- 7/1/2014 How Do I Turn In, Sell, or Store My Firearms? (Vietnamese)


252-INFO V

DV-800-INFO/JV- 1/1/2023 How Do I Turn In, Sell, or Store My Firearms?


270-INFO

JV-272* 1/1/2023 Prohibited Items Finding and Orders

JV-274* 1/1/2023 Noncompliance With Firearms and Ammunition Order, or Warrant

JV-280* 1/1/2007 Notice of Review Hearing

JV-280 S 1/1/2007 Notice of Review Hearing (Spanish)

JV-281 1/1/2014 Notice of Hearing—Nonminor

JV-282 1/1/2019 Proof of Service—Nonminor

JV-285 9/1/2020 Relative Information

JV-285 S 9/1/2020 Relative Information (Spanish)

JV-287 9/1/2020 Confidential Information

JV-287 S 1/1/2011 Confidential Information (Spanish)

JV-290 9/1/2020 Caregiver Information Form

JV-290 C 9/1/2020 Caregiver Information Form (Chinese)

JV-290 K 9/1/2020 Caregiver Information Form (Korean)

JV-290 S 10/1/2007 Caregiver Information Form (Spanish)

JV-290 V 9/1/2020 Caregiver Information Form (Vietnamese)

JV-290-INFO 10/1/2007 Instruction Sheet for Caregiver Information Form

JV-290-INFO C 10/1/2007 Instruction Sheet for Caregiver Information Form (Chinese)

JV-290-INFO K 10/1/2007 Instruction Sheet for Caregiver Information Form (Korean)

JV-290-INFO S 10/1/2007 Instruction Sheet for Caregiver Information Form (Spanish)

JV-290-INFO V 10/1/2007 Instruction Sheet for Caregiver Information Form (Vietnamese)

JV-291-INFO 9/1/2020 Information on Requesting Access to Records for Persons With a


Limited Right to Appeal

JV-291-INFO C 9/1/2020 Information on Requesting Access to Records for Persons With a


Limited Right to Appeal (Chinese)

JV-291-INFO K 9/1/2020 Information on Requesting Access to Records for Persons With a


Limited Right to Appeal (Korean)

* Adopted for Mandatory Use. Page 80 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

JV-291-INFO S 9/1/2020 Information on Requesting Access to Records for Persons With a


Limited Right to Appeal (Spanish)

JV-291-INFO V 9/1/2020 Information on Requesting Access to Records for Persons With a


Limited Right to Appeal (Vietnamese)

JV-295* 9/1/2020 De Facto Parent Request

JV-295 S 1/1/2007 De Facto Parent Request (Spanish)

JV-296* 1/1/2007 De Facto Parent Statement

JV-296 S 1/1/2007 De Facto Parent Statement (Spanish)

JV-297* 9/1/2019 De Facto Parent Order

JV-297 S 9/1/2019 De Facto Parent Order (Spanish)

JV-298* 1/1/2007 Order Ending De Facto Parent Status

JV-298 S 1/1/2007 Order Ending De Facto Parent Status (Spanish)

JV-299 9/1/2019 De Facto Parent Pamphlet

JV-299 C 9/1/2019 De Facto Parent Pamphlet (Chinese)

JV-299 K 9/1/2019 De Facto Parent Pamphlet (Korean)

JV-299 S 9/1/2019 De Facto Parent Pamphlet (Spanish)

JV-299 V 9/1/2019 De Facto Parent Pamphlet (Vietnamese)

JV-300* 7/1/2010 Notice of Hearing on Selection of a Permanent Plan

JV-300 S 7/1/2010 Notice of Hearing on Selection of a Permanent Plan (Spanish)

JV-305* 1/1/2007 Citation for Publication Under Welfare and Institutions Code Section
294

JV-305 S 1/1/2007 Citation for Publication Under Welfare and Institutions Code Section
294 (Spanish)

JV-310* 1/1/2019 Proof Of Service Under Section 366.26 of the Welfare And Institutions
Code

JV-310 S 1/1/2019 Proof Of Service Under Section 366.26 of the Welfare And Institutions
Code (Spanish)

JV-320* 1/1/2023 Orders Under Welfare and Institutions Code Sections 366.24, 366.26,
727.3, 727.31

JV-321* 9/1/2020 Request for Prospective Adoptive Parent Designation

JV-322* 1/1/2007 Confidential Information—Prospective Adoptive Parent

JV-323* 1/1/2008 Notice of Intent to Remove Child

JV-324* 1/1/2008 Notice of Emergency Removal

JV-325* 9/1/2020 Objection to Removal

* Adopted for Mandatory Use. Page 81 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

JV-326* 1/1/2019 Proof of Notice

JV-326-INFO 1/1/2019 Instructions for Notice of Prospective Adoptive Parent Hearing

JV-327* 7/1/2010 Prospective Adoptive Parent Designation Order

JV-328* 1/1/2008 Prospective Adoptive Parent Order After Hearing

JV-330* 9/1/2019 Letters of Guardianship

JV-330 C 9/1/2019 Letters of Guardianship (Chinese)

JV-330 K 9/1/2019 Letters of Guardianship (Korean)

JV-330 S 9/1/2019 Letters of Guardianship (Spanish)

JV-330 V 9/1/2019 Letters of Guardianship (Vietnamese)

JV-350-INFO* 1/1/2023 Information on Juvenile Court Guardianship

JV-350-INFO C 9/1/2019 Information on Juvenile Court Guardianship (Chinese)

JV-350-INFO K 9/1/2019 Information on Juvenile Court Guardianship (Korean)

JV-350-INFO S 9/1/2019 Information on Juvenile Court Guardianship (Spanish)

JV-350-INFO V 9/1/2019 Information on Juvenile Court Guardianship (Vietnamese)

GC-207-INFO/JV- 1/1/2023 Comparison of Guardians With Other Nonparent Caregivers


352-INFO*

GC-207-INFO/JV- 1/1/2023 Comparison of Guardians With Other Nonparent Caregivers (Spanish)


352-INFO S

JV-356* 1/1/2016 Request for Special Immigrant Juvenile Findings

FL-357/GC-224/JV- 7/1/2016 Special Immigrant Juvenile Findings


357*

FL-357/GC-224/JV- 7/1/2016 Special Immigrant Juvenile Findings (Spanish)


357 S

JV-361* 1/1/2021 First Review Hearing After Youth Turns 16 Years of


Age—Information, Documents, and Services

JV-362* 1/1/2023 Review Hearing for Youth Approaching 18 Years of Age—Information,


Documents, and Services

JV-363* 1/1/2023 Review Hearing for Youth 18 Years of Age or Older—Information,


Documents, and Services

JV-364* 1/1/2020 Termination of Dependency for Adoption

JV-364 S 1/1/2020 Termination of Dependency for Adoption (Spanish)

JV-365* 1/1/2023 Termination of Juvenile Court Jurisdiction—Nonminor

JV-365 S 1/1/2017 Termination of Juvenile Court Jurisdiction—Nonminor (Spanish)

* Adopted for Mandatory Use. Page 82 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

JV-367* 1/1/2021 Findings and Orders After Hearing to Consider Termination of


Juvenile Court Jurisdiction Over a Nonminor

JV-400 1/1/2007 Visitation Attachment: Parent, Legal Guardian, Indian Custodian,


Other Important Person

JV-401 1/1/2015 Visitation Attachment: Sibling

JV-402 1/1/2007 Visitation Attachment: Grandparent

JV-403 1/1/2016 Sibling Attachment: Contact and Placement

JV-405 1/1/2020 Continuance—Dependency Detention Hearing

JV-406 7/1/2011 Continuance—Dependency General

JV-410 1/1/2023 Findings and Orders After Detention Hearing (Welf. & Inst. Code, §
319)

JV-412 1/1/2020 Findings and Orders After Jurisdictional Hearing (Welf. & Inst. Code,
§ 356)

JV-415 1/1/2020 Findings and Orders After Dispositional Hearing (Welf. & Inst. Code, §
361 et seq.)

JV-416 7/1/2011 Dispositional Attachment: Dismissal of Petition With or Without


Informal Supervision

JV-417 7/1/2011 Dispositional Attachment: In-Home Placement With Formal


Supervision

JV-418 1/1/2021 Dispositional Attachment: Appointment of Guardian (Welf. & Inst.


Code, § 360(a))

JV-419 1/1/2007 Guardianship—Consent and Waiver of Rights

JV-419A 1/1/2007 Guardianship—Child's Consent and Waiver of Rights

JV-420 7/1/2011 Dispositional Attachment: Removal From Custodial


Parent—Placement With Previously Noncustodial Parent

JV-421 1/1/2023 Dispositional Attachment: Removal From Custodial


Parent—Placement With Nonparent (Welf. & Inst. Code, §§ 361,
361.2)

JV-425 7/1/2011 Findings and Orders After In-Home Status Review Hearing

JV-426 7/1/2011 Findings and Orders After In-Home Status Review Hearing—Child
Placed With Previously Noncustodial Parent

JV-430 1/1/2023 Findings and Orders After Six-Month Status Review Hearing (Welf. &
Inst. Code, § 366.21(e))

JV-431 7/1/2011 Six-Month Prepermanency Attachment: Child Reunified

JV-432 1/1/2023 Six-Month Permanency Attachment: Reunification Services Continued


(Welf. & Inst. Code, § 366.21(e))

* Adopted for Mandatory Use. Page 83 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

JV-433 1/1/2023 Six-Month Permanency Attachment: Reunification Services


Terminated (Welf. & Inst. Code, § 366.21(e))

JV-435 1/1/2023 Findings and Orders After 12-Month Permanency Hearing (Welf. &
Inst. Code, § 366.21(f))

JV-436 7/1/2011 Twelve-Month Permanency Attachment: Child Reunified

JV-437 1/1/2023 Twelve-Month Permanency Attachment: Reunification Services


Continued (Welf. & Inst. Code, § 366.21(f))

JV-438 1/1/2023 Twelve-Month Permanency Attachment: Reunification Services


Terminated (Welf. & Inst. Code, § 366.21(f))

JV-440 1/1/2023 Findings and Orders After 18-Month Permanency Hearing (Welf. &
Inst. Code, § 366.22)

JV-441 7/1/2011 Eighteen-Month Permanency Attachment: Child Reunified

JV-442 1/1/2023 Eighteen-Month Permanency Attachment: Reunification Services


Terminated (Welf. & Inst. Code, § 366.22)

JV-443 1/1/2023 Eighteen-Month Permanency Attachment: Reunification Services


Continued (Welf. & Inst. Code, § 366.22)

JV-445 1/1/2023 Findings and Orders After Postpermanency Hearing—Parental Rights


Terminated; Permanent Plan of Adoption (Welf. & Inst. Code, § 366.3)

JV-446 1/1/2023 Findings and Orders After Postpermanency Hearing—Permanent


Plan Other than Adoption (Welf. & Inst. Code, § 366.3)

JV-448 1/1/2006 Order Granting Authority to Consent to Medical, Surgical, and Dental
Care

JV-450* 1/1/2012 Order for Prisoner's Appearance at Hearing Affecting Parental Rights

JV-451* 1/1/2012 Prisoner's Statement Regarding Appearance at Hearing Affecting


Parental Rights

JV-455 1/1/2023 Findings and Orders After 24-Month Permanency Hearing (Welf. &
Inst. Code, § 366.25)

JV-456 7/1/2011 Twenty-four-Month Permanency Attachment: Child Reunified

JV-457 1/1/2023 Twenty-four-Month Permanency Attachment: Reunification Services


Terminated (Welf. & Inst. Code, § 366.25)

JV-459(A) 1/1/2023 Status Review Attachment: Sexual and Reproductive Health Services
(Welf. & Inst. Code, §§ 366(a)(1)(F), 727.2(e)(7))

JV-460 1/1/2021 Attachment: Additional Findings and Orders For Child Approaching
Majority—Dependency

JV-461* 1/1/2021 Findings and Orders After Nonminor Disposition Hearing

JV-461(A)* 1/1/2023 Dispositional Attachment: Nonminor Dependent

JV-462 1/1/2023 Findings and Orders After Nonminor Dependent Status Review
Hearing

* Adopted for Mandatory Use. Page 84 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

JV-463* 1/1/2021 Nonminor's Informed Consent to Hold Disposition Hearing

JV-463 S 1/1/2021 Nonminor's Informed Consent to Hold Disposition Hearing (Spanish)

JV-464-INFO* 1/1/2019 How to Ask to Return to Juvenile Court Jurisdiction and Foster Care

JV-464-INFO C 1/1/2019 How to Ask to Return to Juvenile Court Jurisdiction and Foster Care
(Chinese)

JV-464-INFO K 1/1/2019 How to Ask to Return to Juvenile Court Jurisdiction and Foster Care
(Korean)

JV-464-INFO S 1/1/2019 How to Ask to Return to Juvenile Court Jurisdiction and Foster Care
(Spanish)

JV-464-INFO V 1/1/2019 How to Ask to Return to Juvenile Court Jurisdiction and Foster Care
(Vietnamese)

JV-466* 1/1/2019 Request to Return to Juvenile Court Jurisdiction and Foster Care

JV-468* 7/1/2012 Confidential Information—Request to Return to Juvenile Court


Jurisdiction and Foster Care

JV-469* 4/1/2023 Petition and Order To Exit and Reenter Jurisdiction—Nonminor


Dependent

JV-470 1/1/2019 Findings and Orders Regarding Prima Facie Showing on Nonminor's
Request to Reenter Foster Care

JV-471* 9/1/2022 Findings and Orders Regarding Exit and Reentry Of


Jurisdiction—Nonminor Dependent

JV-472 1/1/2019 Findings and Order After Hearing to Consider Nonminor's Request to
Reenter Foster Care

JV-474 1/1/2019 Nonminor Dependent—Consent to Copy and Inspect Nonminor


Dependent Court File

JV-475 10/25/2013 Agreement of Adoption of Nonminor Dependent

JV-477 10/25/2013 Consent of Spouse or Registered Partner to Adoption of Nonminor


Dependent

JV-479 10/25/2013 Order of Adoption of Nonminor Dependent

JV-500* 1/1/2007 Parentage Inquiry

JV-500 S 1/1/2007 Parentage Inquiry (Spanish)

JV-501* 1/1/2007 Parentage—Finding and Judgment

JV-501 S 1/1/2007 Parentage—Finding and Judgment (Spanish)

JV-505* 1/1/2008 Statement Regarding Parentage

JV-505 S 1/1/2008 Statement Regarding Parentage (Spanish)

JV-510* 1/1/2019 Proof of Service—Juvenile

* Adopted for Mandatory Use. Page 85 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

JV-510(A) 1/1/2019 Attachment to Proof of Service-Juvenile (Additional Person Served)

JV-520* 1/1/2007 Fax Filing Cover Sheet

JV-520 S 1/1/2007 Fax Filing Cover Sheet (Spanish)

CR-125/JV-525* 7/1/2007 Order to Attend Court or Provide Documents (For


Subpoena/Subpoena Duces Tecum)

JV-530* 7/1/2002 Certified Request for Pupil Records—Truancy

JV-530 S 7/1/2002 Certified Request for Pupil Records—Truancy (Spanish)

JV-531* 7/1/2002 Local Educational Agency Response to JV-530

JV-531 S 7/1/2002 Local Educational Agency Response to JV-530 (Spanish)

JV-535* 1/1/2021 Order Designating Educational Rights Holder

JV-535 S 1/1/2021 Order Designating Educational Rights Holder (Spanish)

JV-535(A)* 9/1/2021 Attachment to Order Designating Educational Rights Holder

JV-535(A) S 9/1/2021 Attachment to Order Designating Educational Rights Holder (Spanish)

JV-535-INFO 9/1/2020 Information on Educational Rights Holders

JV-535-INFO S 9/1/2020 Information on Educational Rights Holders (Spanish)

JV-536* 1/1/2014 Local Educational Agency Response to JV-535—Appointment of


Surrogate Parent

JV-536 S 1/1/2014 Local Educational Agency Response to JV-535—Appointment of


Surrogate Parent (Spanish)

JV-537 1/1/2014 Educational Rights Holder Statement

JV-537 S 1/1/2014 Educational Rights Holder Statement (Spanish)

JV-538 1/1/2014 Findings and Orders Regarding Transfer from School of Origin

JV-539 1/1/2014 Request for Hearing Regarding Child’s Access to Services

JV-539 S 1/1/2014 Request for Hearing Regarding Child’s Access to Services (Spanish)

JV-540* 1/1/2014 Notice of Hearing on Joinder—Juvenile

JV-540 S 1/1/2014 Notice of Hearing on Joinder—Juvenile (Spanish)

JV-548* 1/1/2017 Motion for Transfer Out

JV-550* 1/1/2017 Juvenile Court Transfer-Out Orders

JV-550 S 1/1/2007 Juvenile Court Transfer-Out Orders (Spanish)

JV-552* 1/1/2017 Juvenile Court Transfer-Out Orders—Nonminor Dependent

JV-552 S 1/1/2017 Juvenile Court Transfer-Out Orders—Nonminor Dependent (Spanish)

JV-555 1/1/2020 Notice of Intent to Place Child Out of County

* Adopted for Mandatory Use. Page 86 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

JV-556 1/1/2019 Objection to Out-of-County Placement


and Notice of Hearing

JV-565 1/1/2013 Request for Assistance with Expedited Placement Under the
Interstate Compact on the Placement of Children

JV-567* 1/1/2013 Expedited Placement Under the Interstate Compact on the Placement
of Children: Findings and Orders

JV-569* 9/1/2020 Proof of Service—Petition for Access to Juvenile Case File

JV-570* 9/1/2020 Petition for Access to Juvenile Case File

JV-570 S 1/1/2009 Petition for Access to Juvenile Case File (Spanish)

JV-571* 9/1/2020 Notice of Petition for Access to Juvenile Case File

JV-572* 9/1/2020 Objection to Release of Juvenile Case File

JV-573* 1/1/2021 Order on Petition for Access to Juvenile Case File

JV-574* 1/1/2021 Order After Judicial Review on Petition for Access to Juvenile Case
File

JV-575* 1/1/2007 Petition to Obtain Report of Law Enforcement Agency

JV-575 S 1/1/2007 Petition to Obtain Report of Law Enforcement Agency (Spanish)

JV-580* 1/1/2006 Notice to Child and Parent/Guardian RE: Release of Juvenile Police
Records and Objection

JV-580 S 1/1/2006 Notice to Child and Parent/Guardian RE: Release of Juvenile Police
Records and Objection (Spanish)

JV-581 1/1/2022 Law Enforcement Notice on Sealing of Records (Welf. & Inst. Code, §
827.95)

JV-582 1/1/2022 Petition to Seal Juvenile Police Records

JV-589 1/1/2022 Acknowledgment of Juvenile Diversion Record Sealed (Welf. & Inst.
Code, § 786.5)

JV-590* 9/1/2018 Order to Seal Juvenile Records—Welfare and Institutions Code


Section 781

JV-591 7/1/2016 Acknowledgment of Juvenile Record Sealed

JV-592 1/1/2021 Prosecutor Request for Access to Sealed Juvenile Case File

JV-593 1/1/2021 Notice of Prosecutor Request for Access to Sealed Juvenile Case File

JV-594 1/1/2021 Response to Prosecutor Request for Access to Sealed Juvenile Case
File

JV-595 1/1/2021 Request to Seal Juvenile Records

JV-595-INFO* 1/1/2022 How to Ask the Court to Seal Your Records

JV-595-INFO S 1/1/2022 How to Ask the Court to Seal Your Records (Spanish)

* Adopted for Mandatory Use. Page 87 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

JV-596 9/1/2018 Dismissal and Sealing of Records—Welfare and Institutions Code


Section 786

JV-596-INFO* 1/1/2022 Sealing of Records for Satisfactory Completion of Probation

JV-596-INFO S 1/1/2020 Sealing of Records for Satisfactory Completion of Probation (Spanish)

JV-597 1/1/2022 Probation Department Notice on Sealing of Records After Diversion


Program (Welf. & Inst. Code, § 786.5)

JV-598 9/1/2018 Petition to Review Denial of Sealing of Records After Diversion


Program

JV-599 1/1/2021 Order on Prosecutor Request for Access to Sealed File

JV-600 1/1/2020 Juvenile Wardship Petition

JV-600 S 1/1/2020 Juvenile Wardship Petition (Spanish)

JV-610 1/1/2007 Child Habitually Disobedient

JV-610 S 1/1/2007 Child Habitually Disobedient (Spanish)

JV-611 1/1/2007 Child Habitually Truant

JV-611 S 1/1/2007 Child Habitually Truant (Spanish)

JV-615* 1/1/2012 Deferred Entry of Judgment Notice of Noncompliance

JV-615 S 1/1/2012 Deferred Entry of Judgment Notice of Noncompliance (Spanish)

JV-618 1/1/2020 Waiver of Rights—Juvenile Justice

JV-618 S 1/1/2020 Waiver of Rights—Juvenile Justice (Spanish)

JV-620* 1/1/2007 Violation of Law By Child

JV-622 1/1/2006 Informal Probation Agreement

JV-624 1/1/2012 Terms and Conditions

JV-625 9/1/2018 Notice of Hearing—Juvenile Delinquency Proceeding

JV-625 S 9/1/2018 Notice of Hearing—Juvenile Delinquency Proceeding (Spanish)

JV-635* 5/22/2017 Promise to Appear—Juvenile Delinquency (Juvenile 14 Years or


Older)

JV-635 S 5/22/2017 Promise to Appear—Juvenile Delinquency (Juvenile 14 Years or


Older) (Spanish)

JV-640 1/1/2012 Delinquency Court Proceeding Findings and Orders

JV-642 2/1/2023 Initial Appearance Hearing—Juvenile Delinquency

JV-644 1/1/2012 Jurisdiction Hearing—Juvenile Delinquency

JV-665 1/1/2016 Disposition—Juvenile Delinquency

JV-667 1/1/2023 Custodial and Out-of-Home Placement Disposition Attachment

* Adopted for Mandatory Use. Page 88 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

JV-672 1/1/2023 Findings and Orders After Six-Month Prepermanency


Hearing—Delinquency (Welf. & Inst. Code, § 727.2)

JV-674 1/1/2023 Findings and Orders After Permanency Hearing—Delinquency (Welf.


& Inst. Code, § 727.3)

JV-678 1/1/2023 Findings and Orders After Postpermanency Hearing—Delinquency


(Welf. & Inst. Code, § 727.3)

JV-680 1/1/2021 Findings and Orders for Child Approaching Majority—Delinquency

JV-681 7/1/2012 Attachment: Hearing for Dismissal—Additional Findings and


Orders—Foster Care Placement—Delinquency

JV-682 3/15/2019 Findings and Orders After Hearing to Modify Delinquency Jurisdiction
to Transition Jurisdiction for Child Younger Than 18 Years of Age

JV-683 3/15/2019 Findings and Orders After Hearing to Modify Delinquency Jurisdiction
to Transition Jurisdiction for Ward Older Than 18 Years of Age

JV-688 1/1/2014 Continuance—Juvenile Delinquency

JV-690 1/1/2019 School Notification of Court Adjudication

JV-692 1/1/2012 Notification to Sheriff of Juvenile Delinquency Felony Adjudication

JV-700 7/1/2016 Declaration of Eligibility for Appointment to Represent Youth in


Delinquency Court

JV-710 1/1/2023 Order to Transfer Juvenile to Criminal Court Jurisdiction (Welfare and
Institutions Code, § 707)

JV-710 S 5/22/2017 Order to Transfer Juvenile to Criminal Court Jurisdiction (Welfare and
Institutions Code, § 707) (Spanish)

JV-732* 9/1/2017 Commitment to the California Department of Corrections and


Rehabilitation, Division of Juvenile Facilities

JV-732 S 9/1/2017 Commitment to the California Department of Corrections and


Rehabilitation, Division of Juvenile Facilities (Spanish)

JV-735 5/22/2017 Juvenile Notice of Violation of Probation

JV-735 S 5/22/2017 Juvenile Notice of Violation of Probation (Spanish)

JV-740 1/1/2012 Petition to Modify, Change, or Set Aside Previous Orders—Change of


Circumstances

JV-740 S 1/1/2012 Petition to Modify, Change, or Set Aside Previous Orders—Change of


Circumstances (Spanish)

JV-742 1/1/2019 Request to Vacate Disposition and Dismiss Penal Code Section 647f
Adjudication

JV-743 1/1/2019 Order after Request to Vacate Disposition and Dismiss Penal Code
Section 647f Adjudication

JV-744 7/1/2017 Request to Reduce Juvenile Marijuana Offense

* Adopted for Mandatory Use. Page 89 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

JV-744A 7/1/2017 Attachment to Request to Reduce Juvenile Marijuana Offense (Health


and Safety Code, § 11361.8(m))

JV-745 1/23/2017 Juvenile Order After Request to Reduce Marijuana Offense

JV-746 7/1/2017 Order After Request to Reduce Juvenile Marijuana Offense (Health
and Safety Code, § 11361.8(m))

JV-748 1/1/2019 Request to Expunge Arrest or Vacate Adjudication (Human


Trafficking Victim) (Penal Code, § 236.14)

JV-749 1/1/2019 Order After Request to Expunge Arrest or Vacate Adjudication (Penal
Code, § 236.14)

JV-750* 9/1/2018 Determination of Eligibility—Deferred Entry of Judgment—Juvenile

JV-750 S 9/1/2018 Determination of Eligibility—Deferred Entry of Judgment—Juvenile


(Spanish)

JV-751* 7/1/2010 Citation and Written Notification for Deferred Entry of


Judgment—Juvenile

JV-755 1/1/2012 Deferred Entry of Judgment—Dismissal and Sealing of Juvenile


Records

JV-755 S 1/1/2012 Deferred Entry of Judgment—Dismissal and Sealing of Juvenile


Records (Spanish)

JV-760 1/1/2012 Deferred Entry of Judgment Order

CR-110/JV-790 1/1/2023 Order for Victim Restitution

CR-111/JV-791 7/1/2015 Abstract of Judgment—Restitution

CR-112/JV-792 1/1/2023 Instructions: Order for Victim Restitution

CR-113/JV-793 1/1/2014 Instructions: Abstract of Judgment—Restitution

JV-794 9/1/2017 Petition to Terminate Wardship and Order

CR-185/JV-796 1/1/2009 Petition for Expungement of DNA Profiles and Samples (Pen. Code, §
299)

CR-186/JV-798 1/1/2009 Order for Expungement of DNA Profiles and Samples (Pen. Code, §
299)

JV-800 1/1/2023 Notice of Appeal—Juvenile

JV-800 C 9/1/2020 Notice of Appeal—Juvenile (Chinese)

JV-800 K 9/1/2020 Notice of Appeal—Juvenile (Korean)

JV-800 S 9/1/2020 Notice of Appeal—Juvenile (Spanish)

JV-800 V 9/1/2020 Notice of Appeal—Juvenile (Vietnamese)

JV-805-INFO 1/1/2020 Information Regarding Appeal Rights

JV-810 1/1/2021 Recommendation for Appointment of Appellate Attorney for Child

* Adopted for Mandatory Use. Page 90 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

JV-816 1/1/2017 Application for Extension of Time to File Brief (Juvenile Delinquency
Case)

JV-817 1/1/2017 Application for Extension of Time to File Brief (Juvenile Dependency
Case)

JV-820 9/1/2020 Notice of Intent to File Writ Petition and Request for Record to Review
Order Setting a Hearing Under Welfare and Institutions Code Section
366.26 (California Rules of Court, Rule 8.450)

JV-820 C 9/1/2020 Notice of Intent to File Writ Petition and Request for Record to Review
Order Setting a Hearing Under Welfare and Institutions Code Section
366.26 (California Rules of Court, Rule 8.450) (Chinese)

JV-820 K 9/1/2020 Notice of Intent to File Writ Petition and Request for Record to Review
Order Setting a Hearing Under Welfare and Institutions Code Section
366.26 (California Rules of Court, Rule 8.450) (Korean)

JV-820 S 9/1/2020 Notice of Intent to File Writ Petition and Request for Record to Review
Order Setting a Hearing Under Welfare and Institutions Code Section
366.26 (California Rules of Court, Rule 8.450) (Spanish)

JV-820 V 9/1/2020 Notice of Intent to File Writ Petition and Request for Record to Review
Order Setting a Hearing Under Welfare and Institutions Code Section
366.26 (California Rules of Court, Rule 8.450) (Vietnamese)

JV-822 9/1/2020 Notice of Intent to File Writ Petition and Request for Record to Review
Order Designating or Denying Specific Placement of a Dependent
Child After Termination of Parental Rights (California Rules of Court,
Rule 8.454)

JV-822 S 9/1/2020 Notice of Intent to File Writ Petition and Request for Record to Review
Order Designating or Denying Specific Placement of a Dependent
Child After Termination of Parental Rights (California Rules of Court,
Rule 8.454) (Spanish)

JV-825 1/1/2017 Petition for Extraordinary Writ

JV-826 1/1/2007 Denial of Petition

JV-826 S 1/1/2007 Denial of Petition (Spanish)

JV-828 7/1/2010 Notice of Action

Language Access
LA-350 9/1/2019 Notice of Available Language Assistance—Service Provider

LA-400 9/1/2019 Service Not Available in My Language:Request to Change Court


Order

LA-400 A 9/1/2019 Service Not Available in My Language:Request to Change Court


Order (Arabic)

LA-400 C 9/1/2019 Service Not Available in My Language:Request to Change Court


Order (Chinese)

* Adopted for Mandatory Use. Page 91 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

LA-400 F 9/1/2019 Service Not Available in My Language:Request to Change Court


Order (Farsi)

LA-400 K 9/1/2019 Service Not Available in My Language:Request to Change Court


Order (Korean)

LA-400 P 9/1/2019 Service Not Available in My Language:Request to Change Court


Order (Punjabi)

LA-400 R 9/1/2019 Service Not Available in My Language:Request to Change Court


Order (Russian)

LA-400 S 9/1/2019 Service Not Available in My Language:Request to Change Court


Order (Spanish)

LA-400 V 9/1/2019 Service Not Available in My Language:Request to Change Court


Order (Vietnamese)

LA-450 9/1/2019 Service Not Available in My Language: Order

LA-450 A 9/1/2019 Service Not Available in My Language: Order (Arabic)

LA-450 C 9/1/2019 Service Not Available in My Language: Order (Chinese)

LA-450 F 9/1/2019 Service Not Available in My Language: Order (Farsi)

LA-450 K 9/1/2019 Service Not Available in My Language: Order (Korean)

LA-450 P 9/1/2019 Service Not Available in My Language: Order (Punjabi)

LA-450 R 9/1/2019 Service Not Available in My Language: Order (Russian)

LA-450 S 9/1/2019 Service Not Available in My Language: Order (Spanish)

LA-450 V 9/1/2019 Service Not Available in My Language: Order (Vietnamese)

Menacing Dog
MD-100 9/1/2018 Petition to Determine if Dog is Potentially Dangerous or Vicious
(Menacing Dog)

MD-109 9/1/2018 Notice of Hearing (Menacing Dog)

MD-130 9/1/2018 Order After Hearing (Menacing Dog)

MD-140 9/1/2018 Notice of Appeal (Menacing Dog)

Military Service
MIL-010* 1/1/2012 Notice of Petition and Petition For Relief From Financial Obligation
During Military Service

MIL-015* 1/1/2012 Declaration in Support of Petition For Relief From Financial


Obligations During Military Service

MIL-020 1/1/2012 Order on Petition for Relief From Financial Obligations During Military
Service

MIL-100 1/1/2021 Notification of Military Veteran/Reserve/Active Status

* Adopted for Mandatory Use. Page 92 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

MIL-100 S 1/1/2021 Notification of Military Veteran/Reserve/Active Status (Spanish)

CR-183/MIL-183 1/1/2016 Petition for Dismissal (Military Personnel)

CR-184/MIL-184 1/22/2019 Order for Dismissal (Military Personnel)

Miscellaneous
GDC-001* 1/1/2019 Gender Discrimination Notice

GDC-001 C 1/1/2019 Gender Discrimination Notice (Chinese)

GDC-001 K 1/1/2019 Gender Discrimination Notice (Korean)

GDC-001 S 1/1/2019 Gender Discrimination Notice (Spanish)

GDC-001 V 1/1/2019 Gender Discrimination Notice (Vietnamese)

MC-010 9/1/2017 Memorandum of Costs (Summary)

MC-011 9/1/2017 Memorandum of Costs (Worksheet)

MC-012* 9/1/2018 Memorandum of Costs After Judgment, Acknowledgment of Credit,


and Declaration of Accrued Interest

MC-013-INFO 1/1/2018 Information Sheet for Calculating Interest and Amount Owed on a
Judgment

MC-020 1/1/1987 Additional Page [to be attached to any form]

MC-025 7/1/2009 Attachment to Judicial Council Form

MC-025 S 7/1/2009 Attachment to Judicial Council Form (Spanish)

MC-030 1/1/2006 Declaration

MC-031 7/1/2005 Attached Declaration

MC-040 1/1/2013 Notice of Change of Address or Other Contact Information

MC-050* 1/1/2009 Substitution of Attorney—Civil (Without Court Order)

MC-1000 1/1/2019 Petition for Review of Denial of Request to Remove Name From
Gang Database

MC-120 1/1/2017 Confidential Reference List of Identifiers

MC-125* 1/1/2019 Confidential Information Form Under Civil Code Section 1708.85

MC-200 1/1/2018 Claim Opposing Forfeiture

MC-201 1/1/2009 Claim Opposing Forfeiture of Vehicle

MC-202 2/1/1995 Petition for Forfeiture of Vehicle and Notice of Hearing

MC-350* 1/1/2021 Petition for Approval of Compromise of Claim or Action or Disposition


of Proceeds of Judgment for Minor or Person With A Disability

* Adopted for Mandatory Use. Page 93 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

MC-350(A-12b(5)) 1/1/2021 Additional Medical Service Providers Attachment to Petition for


Approval of Compromise of Claim or Action or Disposition of
Proceeds of Judgment

MC-350EX* 1/1/2021 Petition for Expedited Approval of Compromise of Claim or Action or


Disposition of Proceeds of Judgment for Minor or Person With a
Disability

MC-351* 1/1/2021 Order Approving Compromise of Claim or Action or Disposition of


Proceeds of Judgment for Minor or Person With a Disability

MC-355* 1/1/2021 Order to Deposit Funds in Blocked Account

MC-356* 1/1/2021 Acknowledgment of Receipt of Order and Funds for Deposit in


Blocked Account

MC-357* 1/1/2021 Petition to Withdraw Funds From Blocked Account

MC-358* 1/1/2021 Order Authorizing Withdrawal of Funds From Blocked Account

MC-410 1/1/2021 Disability Accommodation Request

MC-410 C 1/1/2021 Disability Accommodation Request (Chinese)

MC-410 K 1/1/2021 Disability Accommodation Request (Korean)

MC-410 S 1/1/2021 Disability Accommodation Request (Spanish)

MC-410 V 1/1/2021 Disability Accommodation Request (Vietnamese)

MC-410-INFO 1/1/2021 How to Request a Disability Accommodation for Court

MC-410-INFO C 1/1/2021 How to Request a Disability Accommodation for Court (Chinese)

MC-410-INFO K 1/1/2021 How to Request a Disability Accommodation for Court (Korean)

MC-410-INFO S 1/1/2021 How to Request a Disability Accommodation for Court (Spanish)

MC-410-INFO V 1/1/2021 How to Request a Disability Accommodation for Court (Vietnamese)

MC-500* 1/1/2007 Media Request to Photograph, Record, or Broadcast

MC-510* 1/1/2007 Order on Media Request to Permit Coverage

MC-800 1/1/2002 Court Clerks Office: Signage

Name Change
NC-100* 1/1/2023 Petition for Change of Name

NC-100-INFO 1/1/2023 Instructions for Filing a Petition for Change of Name

NC-110* 1/1/2023 NAME AND INFORMATION ABOUT THE PERSON WHOSE NAME
IS TO BE CHANGED
(Attachment to Petition for Change of Name)

NC-110G* 1/1/2001 Supplemental Attachment to Petition for Change of Name


(Declaration of Guardian)

* Adopted for Mandatory Use. Page 94 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

NC-120* 1/1/2023 ORDER TO SHOW CAUSE—CHANGE OF NAME

NC-121* 1/1/2019 Proof of Service of Order to Show Cause

NC-125* 1/1/2023 Order to Show Cause—Change of Name to Conform to Gender


Identity

NC-130* 9/1/2018 Decree Changing Name

NC-130G* 9/1/2018 Decree Changing Name of Minor (by Guardian)

NC-150 1/1/2023 Notice of Hearing on Petition

NC-300 1/1/2023 PETITION FOR RECOGNITION OF CHANGE OF GENDER AND


SEX IDENTIFIER, NAME CHANGE, AND ISSUANCE OF NEW
CERTIFICATES

NC-300-INFO 1/1/2023 Instructions For Filing Petition For Recognition Of Change Of Gender
And Sex Identifier, Name Change, And Issuance Of New Certificates

NC-311* 1/1/2023 Birth Certificate for Child of Petitioner—Attachment

NC-312* 1/1/2023 Marriage License and Certificate—Attachment

NC-325* 1/1/2023 Order to Show Cause—Issuance of New Marriage License and


Certificate

NC-330 1/1/2023 Order Recognizing Change Of Gender And Sex Identifier, For Name
Change, And For Issuance Of New Certificates

NC-400* 1/1/2019 Confidential Cover Sheet—Name Change Proceeding Under Address


Confidentiality Program (Safe at Home) (Change of Name)

NC-400-INFO 1/1/2019 Information Sheet for Name Change Proceedings Under Address
Confidentiality Program (Safe at Home)

NC-400-INFO C 1/1/2019 Information Sheet for Name Change Proceedings Under Address
Confidentiality Program (Safe at Home) (Chinese)

NC-400-INFO K 1/1/2019 Information Sheet for Name Change Proceedings Under Address
Confidentiality Program (Safe at Home) (Korean)

NC-400-INFO S 1/1/2019 Information Sheet for Name Change Proceedings Under Address
Confidentiality Program (Safe at Home) (Spanish)

NC-400-INFO V 1/1/2019 Information Sheet for Name Change Proceedings Under Address
Confidentiality Program (Safe at Home) (Vietnamese)

NC-410* 1/1/2010 Application to File Documents Under Seal in Name Change


Proceeding Under Address Confidentiality Program (Safe at Home)

NC-420* 1/1/2019 Declaration in Support of Application to File Documents Under Seal in


Name Change Proceeding Under Address Confidentiality Program
(Safe at Home)

NC-425 1/1/2010 Order on Application to File Documents Under Seal in Name Change
Proceeding Under Address Confidentiality Program (Safe at Home)

* Adopted for Mandatory Use. Page 95 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

NC-500* 1/1/2023 Petition For Recognition Of Minor's Change Of Gender And Sex
Identifier And For Issuance Of New Birth Certificate And Change Of
Name

NC-500-INFO 1/1/2023 Instructions for Filing Petition for Recognition of Minor's Change of
Gender and Sex Identifier

NC-510G* 1/1/2023 Declaration of Guardian or Juvenile Attorney (Attachment to form NC-


500)

NC-520* 1/1/2023 Order To Show Cause—Recognition Of Minor's Change Of Gender


And Issuance Of New Birth Certificate

NC-530* 1/1/2023 Order Recognizing Minor's Change of Gender and Sex Identifier and
for Issuance of New Birth Certificate

non-JC form
CP10 7/1/2017 Claim of Right to Possession and Notice of Hearing

CP10.5 6/15/2015 Prejudgment Claim of Right to Possession

Personal Injury, Property Damage,


Wrongful Death
PLD-PI-001 1/1/2007 Complaint—Personal Injury, Property Damage, Wrongful Death

PLD-PI-001(1) 1/1/2007 Cause Of Action—Motor Vehicle

PLD-PI-001(2) 1/1/2007 Cause of Action—General Negligence

PLD-PI-001(3) 1/1/2007 Cause of Action—Intentional Tort

PLD-PI-001(4) 1/1/2007 Cause of Action—Premises Liability

PLD-PI-001(5) 1/1/2007 Cause of Action—Products Liability

PLD-PI-001(6) 1/1/2007 Exemplary Damages Attachment

PLD-PI-002 1/1/2007 Cross-Complaint—Personal Injury, Property Damage, Wrongful Death

PLD-PI-003 1/1/2007 Answer—Personal Injury, Property Damage, Wrongful Death

Pleading - Contract
PLD-C-001 1/1/2007 Complaint—Contract

PLD-C-001(1) 1/1/2007 Cause Of Action—Breach of Contract

PLD-C-001(2) 1/1/2009 Cause of Action—Common Counts

PLD-C-001(3) 1/1/2007 Cause Of Action—Fraud

PLD-C-010 1/1/2007 Answer—Contract

PLD-C-500* 11/1/2021 Complaint—Recovery of COVID-19 Rental Debt

PLD-C-505* 11/1/2021 Answer—Recovery of COVID-19 Rental Debt

* Adopted for Mandatory Use. Page 96 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

PLD-C-520* 11/1/2021 Verification by Plaintiff Regarding Rental Assistance—Recovery of


COVID-19 Rental Debt

Pleading - General
PLD-050* 9/1/2021 General Denial

Proof of Service
POS-010* 1/1/2007 Proof of Service of Summons

POS-015* 1/1/2005 Notice And Acknowledgment of Receipt—Civil

POS-020 1/1/2005 Proof Of Personal Service—Civil

POS-020(D) 1/1/2005 Attachment To Proof Of Personal Service—Civil (Documents Served)

POS-020(P) 1/1/2005 Attachment To Proof Of Personal Service—Civil (Persons Served)

POS-030 1/1/2005 Proof of Service By First-Class Mail—Civil/Information Sheet for Proof


of Service By First-Class Mail—Civil

POS-030(D) 1/1/2005 Attachment to Proof of Service By First-Class Mail—Civil (Documents


Service)

POS-030(P) 1/1/2005 Attachment to Proof of Service By First-Class Mail—Civil (Persons


Served)

POS-040 1/1/2020 Proof of Service—Civil (Proof of Service)

POS-040(D) 1/1/2005 Attachment to Proof of Service—Civil (Documents Served)

POS-040(P) 2/1/2017 Attachment to Proof of Service—Civil (Persons Served)

POS-050/EFS-050 2/1/2017 Proof of Electronic Service

POS-050(D)/EFS- 1/1/2010 Attachment to Proof of Electronic Service (Documents Served)


050(D)

POS-050(P)/EFS- 2/1/2017 Attachment to Proof of Electronic Service (Persons Served)


050(P)

Receiverships
RC-200 1/1/2007 Ex Parte Order Appointing Receiver and Order to Show Cause and
Temporary Restraining Order—Rents, Issues, and Profits

RC-210 1/1/2007 Order Confirming Appointment of Receiver and Preliminary


Injunction—Rents, Issues, and Profits

RC-300 1/1/2007 Order to Show Cause and Temporary Restraining Order—Rents,


Issues, and Profits

RC-310 1/1/2007 Order Appointing Receiver After Hearing and Preliminary


Injunction—Rents, Issues, and Profits

Remote Appearance
RA-010* 1/1/2022 Notice of Remote Appearance

* Adopted for Mandatory Use. Page 97 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

RA-010 C 1/1/2022 Notice of Remote Appearance (Chinese)

RA-010 K 1/1/2022 Notice of Remote Appearance (Korean)

RA-010 S 1/1/2022 Notice of Remote Appearance (Spanish)

RA-010 V 1/1/2022 Notice of Remote Appearance (Vietnamese)

RA-015* 1/1/2022 Opposition to Remote Proceeding at Evidentiary Hearing or Trial

RA-015 C 1/1/2022 Opposition to Remote Proceeding at Evidentiary Hearing or Trial


(Chinese)

RA-015 K 1/1/2022 Opposition to Remote Proceeding at Evidentiary Hearing or Trial


(Korean)

RA-015 S 1/1/2022 Opposition to Remote Proceeding at Evidentiary Hearing or Trial


(Spanish)

RA-015 V 1/1/2022 Opposition to Remote Proceeding at Evidentiary Hearing or Trial


(Vietnamese)

RA-020 1/1/2022 Order Regarding Remote Appearance

RA-020 C 1/1/2022 Order Regarding Remote Appearance (Chinese)

RA-020 K 1/1/2022 Order Regarding Remote Appearance (Korean)

RA-020 S 1/1/2022 Order Regarding Remote Appearance (Spanish)

RA-020 V 1/1/2022 Order Regarding Remote Appearance (Vietnamese)

RA-025 1/1/2022 Request To Appear Remotely—Juvenile Dependency

RA-030 1/1/2022 Request To Compel Physical Presence—Juvenile Dependency

Safe at Home
SH-001* 9/1/2020 Confidential Information Form Under Code of Civil Procedure Section
367.3

SH-020* 1/1/2021 Motion to Place Documents Under Seal Under Code of Civil
Procedure Section 367.3

SH-020-INFO 1/1/2021 Instructions for Motion to Place Documents Under Seal Under Code
of Civil Procedure Section 367.3

SH-022* 1/1/2021 Declaration in Support of Motion to Place Documents Under Seal


Under Code of Civil Procedure Section 367.3

SH-025* 1/1/2021 Order on Motion to Place Documents Under Seal Under Code of Civil
Procedure Section 367.3

SH-030* 1/1/2021 Ex Parte Application for Order Shortening Time for Hearing on Motion
to Place Documents Under Seal Under Code of Civil Procedure
Section 367.3

* Adopted for Mandatory Use. Page 98 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

SH-032* 1/1/2021 Declaration Regarding Notice and Service of Ex Parte Application for
Order Shortening Time for Hearing on Motion to Place Documents
Under Seal Under Code of Civil Procedure Section 367.3

SH-035* 1/1/2021 Order on Ex Parte Application for Order Shortening Time for Hearing
on Motion to Place Documents Under Seal Under Code of Civil
Procedure Section 367.3

School Violence Prevention


SV-100* 1/1/2023 Petition for Private Postsecondary School Violence Restraining
Orders (Private Postsecondary School Violence Prevention)

SV-100-INFO 1/1/2023 How Do I Get an Order to Prohibit Private Postsecondary School


Violence? (Private Postsecondary School Violence Prevention)

SV-109* 1/1/2023 Notice of Court Hearing (Private Postsecondary School Violence


Prevention)

SV-110* 1/1/2023 Temporary Restraining Order (CLETS-TSV) (Private Postsecondary


School Violence Prevention)

SV-115* 1/1/2020 Request to Continue Court Hearing (Temporary Restraining Order)


(Private Postsecondary School Violence Prevention)

SV-115-INFO 1/1/2020 How to Ask for a New Hearing Date (Private Postsecondary School
Violence Prevention)

SV-116* 1/1/2020 Order on Request to Continue Hearing (Temporary Restraining


Order) (CLETS-TSV) (Private Postsecondary School Violence
Prevention)

SV-120* 1/1/2023 Response to Petition for Private Postsecondary School Violence


Restraining Orders (Private Postsecondary School Violence
Prevention)

SV-120-INFO 1/1/2023 How Can I Respond to a Petition for Private Postsecondary School
Violence Restraining Orders? (Private Postsecondary School
Violence Prevention)

SV-130* 1/1/2023 Private Postsecondary School Violence Restraining Order After


Hearing (CLETS-SVO) (Private Postsecondary School Violence
Prevention)

SV-200 1/1/2023 Proof of Personal Service (Private Postsecondary School Violence


Prevention)

SV-200-INFO 1/1/2012 What Is ''Proof of Personal Service''?

SV-250 1/1/2012 Proof of Service of Response by Mail

SV-260 1/1/2012 Proof of Service of Order After Hearing by Mail

SV-600* 1/1/2018 Request to Modify/Terminate Private Postsecondary School Violence


Restraining Order

SV-610* 1/1/2018 Notice of Hearing on Request to Modify/Terminate Private


Postsecondary School Violence Restraining Order

* Adopted for Mandatory Use. Page 99 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

SV-620* 1/1/2018 Response to Request to Modify/Terminate Private Postsecondary


School Violence Restraining Order

SV-630* 1/1/2018 Order on Request to Modify/Terminate Private Postsecondary School


Violence Restraining Order

SV-700* 1/1/2012 Request to Renew Restraining Order

SV-710* 1/1/2012 Notice of Hearing to Renew Restraining Order

SV-720* 1/1/2012 Response to Request to Renew Restraining Order

SV-730* 1/1/2012 Order Renewing Private Postsecondary School Violence Restraining


Order

SV-800 1/1/2023 Receipt for Firearms and Firearm Parts (Private Postsecondary
School Violence Prevention)

SV-800-INFO 1/1/2023 How Do I Turn In, Sell, or Store My Firearms and Firearm Parts?
(Private Postsecondary School Violence Prevention)

Small Claims
SC-100* 11/1/2021 Plaintiff’s Claim and ORDER to Go to Small Claims Court

SC-100A* 1/1/2017 Other Plaintiffs or Defendants (Attachment to Plaintiff's Claim and


ORDER to Go to Small Claims Court)

SC-100-INFO* 1/1/2020 Information for the Small Claims Plaintiff (Small Claims)

SC-100-INFO S 1/1/2020 Information for the Small Claims Plaintiff (Small Claims) (Spanish)

SC-101* 7/1/2007 Attorney Fee Dispute (After Arbitration) (Attachment to Plaintiff's


Claim and ORDER to Go to Small Claims Court)

SC-103 11/1/2021 Fictitious Business Name

SC-104 1/1/2009 Proof of Service

SC-104A 1/1/2006 Proof of Mailing (Substituted Service)

SC-104B 11/1/2021 What Is “Proof of Service”?

SC-104C 7/1/2017 How to Serve a Business or Public Entity

SC-105 1/1/2007 Request for Court Order and Answer

SC-105A 1/1/2007 Order on Request for Court Order

SC-107* 1/1/2000 Small Claims Subpoena for Personal Appearance and Production of
Documents at Trial or Hearing and Declaration

SC-108 7/1/2011 Request to Correct or Cancel Judgment and Answer

SC-108A 1/1/2007 Order on Request to Correct or Cancel Judgment

SC-109 1/1/2007 Authorization to Appear

SC-112A 7/1/2010 Proof of Service by Mail

* Adopted for Mandatory Use. Page 100 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

SC-113A 7/1/2010 Clerk’s Certificate of Mailing

SC-114 1/1/2004 Request to Amend Party Name Before Hearing

SC-120* 1/1/2011 Defendant’s Claim and ORDER to Go to Small Claims Court

SC-120A* 1/1/2007 Other Plaintiffs or Defendants (Attachment to Defendant's Claim and


ORDER to Go to Small Claims Court)

SC-130* 7/1/2010 Notice of Entry of Judgment

SC-132* 7/1/2010 Attorney-Client Fee Dispute (Attachment to Notice of Entry of


Judgment)

SC-133* 1/1/2011 Judgment Debtor's Statement of Assets

SC-134* 1/1/2017 Application and Order to Produce Statement of Assets and to Appear
for Examination

SC-135 1/1/2007 Notice of Motion to Vacate Judgment and Declaration

SC-140 1/1/2007 Notice of Appeal

SC-145* 1/1/2007 Request to Pay Judgment to Court

SC-150 7/1/2010 Request to Postpone Trial

SC-152 7/1/2010 Order on Request to Postpone Trial

SC-200* 7/1/2010 Notice of Entry of Judgment

SC-200-INFO 7/1/2010 What to Do After the Court Decides Your Small Claims Case

SC-200-INFO S 7/1/2010 What to Do After the Court Decides Your Small Claims Case
(Spanish)

SC-202A* 7/1/2010 Decision on Attorney-Client Fee Dispute

SC-220 7/1/2013 Request to Make Payments

SC-220-INFO 7/1/2013 Payments in Small Claims Cases

SC-221 7/1/2013 Response to Request to Make Payments

SC-222 7/1/2013 Order on Request to Make Payments

SC-223 7/1/2013 Declaration of Default in Payment of Judgment

SC-224 7/1/2013 Response to Declaration of Default in Payment of Judgment

SC-225 7/1/2013 Order on Declaration of Default in Payments

SC-225A 7/1/2013 Attachment to Order on Declaration of Default in Payments

SC-290 7/1/2010 Acknowledgment of Satisfaction of Judgment

SC-300 3/15/2019 Petition for Writ

SC-300-INFO 1/1/2016 Information on Writ Proceedings in Small Claims Cases

* Adopted for Mandatory Use. Page 101 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

SC-500* 11/1/2021 Plaintiff's Claim and ORDER to Go to Small Claims Court (COVID-19
Rental Debt)

SC-500A* 11/1/2021 Other Plaintiffs or Defendants (COVID-19 Rental Debt)

SC-500-INFO 10/15/2021 COVID-19 Rental Debt in Small Claims Court

SC-500-INFO S 10/15/2021 COVID-19 Rental Debt in Small Claims Court (Spanish)

Subpoena
SUBP-001* 1/1/2007 Civil Subpoena for Personal Appearance at Trial or Hearing

SUBP-002* 1/1/2012 Civil Subpoena (Duces Tecum) for Personal Appearance and
Production of Documents, Electronically Stored Information, and
Things at Trial or Hearing and Declaration

SUBP-010* 1/1/2012 Deposition Subpoena for Production of Business Records

SUBP-015* 1/1/2009 Deposition Subpoena for Personal Appearance

SUBP-020* 1/1/2009 Deposition Subpoena for Personal Appearance and Production of


Documents and Things

SUBP-025* 1/1/2008 Notice to Consumer or Employee and Objection

SUBP-030 1/1/2010 Application for Discovery Subpoena in Action Pending Outside


California

SUBP-035* 1/1/2012 Subpoena for Production of Business Records in Action Pending


Outside California

SUBP-040 1/1/2010 Deposition Subpoena for Personal Appearance in Action Pending


Outside California

SUBP-045* 1/1/2012 Deposition Subpoena for Personal Appearance and Production of


Documents, Electronically Stored Information, And Things in Action
Pending Outside California

SUBP-050* 1/1/2010 Subpoena for Inspection of Premises in Action Pending Outside


California

Summons
SUM-100* 7/1/2009 Summons

SUM-110* 7/1/2009 Summons—Cross-Complaint

SUM-120* 7/1/2009 Summons (Joint Debtor)

SUM-130* 1/1/2023 Summons—Unlawful Detainer—Eviction

SUM-145* 7/1/2009 Summons—Enforcement of State Housing Law

SUM-200(A)* 1/1/2007 Additional Parties Attachment (Attachment to Summons)

SUM-300* 1/1/2007 Declaration of Lost Summons After Service

* Adopted for Mandatory Use. Page 102 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

Traffic
TR-100* 1/1/2004 Notice of Correction and Proof of Service

TR-106 1/1/2004 Continuation of Notice to Appear

TR-108 1/1/2004 Continuation of Citation

TR-115 6/26/2015 Automated Traffic Enforcement System Notice to Appear

TR-120 6/26/2015 Nontraffic Notice to Appear

TR-130 6/26/2015 Traffic/Nontraffic Notice to Appear

TR-135 6/26/2015 Electronic Traffic/Nontraffic Notice to Appear (4" format)

TR-145 6/26/2015 Electronic Traffic/Nontraffic Notice to Appear (3" format)

TR-200* 1/1/1999 Instructions to Defendant

TR-200 C 1/1/1999 Instructions to Defendant (Chinese)

TR-200 K 1/1/1999 Instructions to Defendant (Korean)

TR-200 S 1/1/1999 Instructions to Defendant (Spanish)

TR-200 V 1/1/1999 Instructions to Defendant (Vietnamese)

TR-205* 1/1/1999 Request for Trial by Written Declaration (Trial by Written


Declaration—Traffic)

TR-210* 1/1/1999 Notice and Instructions to Arresting Officer

TR-215* 1/1/1999 Decision and Notice of Decision

TR-220* 1/1/1999 Request for New Trial (Trial de Novo)

TR-225* 1/1/1999 Order and Notice to Defendant of New Trial (Trial de Novo)

TR-235* 1/1/2000 Officer's Declaration

TR-300* 8/1/2022 Agreement to Pay and Forfeit Bail Installments

TR-300o* 8/1/2022 Online Agreement to Pay and Forfeit Bail in Installments

TR-310* 8/1/2022 Agreement to Pay Traffic Violator School Fees in Installments

TR-310o* 8/1/2022 Online Agreement to Pay Traffic Violator School Fees in Installments

TR-320/CR-320 4/1/2018 Can't Afford to Pay Fine: Traffic and Other Infractions

TR-320/CR-320 S 4/1/2018 Can't Afford to Pay Fine: Traffic and Other Infractions (Spanish)

TR-321/CR-321 4/1/2018 Can't Afford to Pay Fine: Traffic and Other Infractions (Court Order)

TR-321/CR-321 S 4/1/2018 Can't Afford to Pay Fine: Traffic and Other Infractions (Court Order)
(Spanish)

TR-INST 6/26/2015 Notice to Appear and Related Forms

* Adopted for Mandatory Use. Page 103 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

Transitional Housing Misconduct


TH-100* 9/1/2018 Petition for Order Prohibiting Abuse or Program Misconduct

TH-110* 9/1/2018 Order to Show Cause and Temporary Restraining Order

TH-120* 9/1/2018 Participant's Response

TH-130* 9/1/2018 Order After Hearing

TH-140* 9/1/2018 Proof of Personal Service

TH-190 9/1/2018 Restatement of Transitional Housing Misconduct Act

TH-200* 9/1/2018 Instructions for Program Operators

TH-210* 9/1/2018 Instructions for Participants

Unlawful Detainer
UD-100 9/1/2020 Complaint—Unlawful Detainer

UD-101* 7/16/2022 Plaintiff's Mandatory Cover Sheet and Supplemental


Allegations—Unlawful Detainer

UD-101 S 7/16/2022 Plaintiff's Mandatory Cover Sheet and Supplemental


Allegations—Unlawful Detainer (Spanish)

UD-104 10/5/2020 Cover Sheet for Declaration of Covid-19–Related Financial Distress

UD-104(A) 10/5/2020 Attachment—Declaration of Covid-19–Related Financial Distress

UD-105 4/14/2022 Answer—Unlawful Detainer

UD-105 S 10/1/2021 Answer—Unlawful Detainer (Spanish)

DISC-003/UD-106 1/1/2014 Form Interrogatories—Unlawful Detainer

UD-110 1/1/2003 Judgment—Unlawful Detainer

UD-110 S 1/1/2003 Judgment—Unlawful Detainer (Spanish)

UD-110S 1/1/2003 Judgment—Unlawful Detainer Attachment

UD-115 1/1/2003 Stipulation for Entry of Judgment

UD-116 7/1/2003 Declaration for Default Judgment by Court (Unlawful Detainer-Civ.


Proc., & 585(d))

UD-120* 7/16/2022 Verification by Landlord Regarding Rental Assistance—Unlawful


Detainer

UD-125* 10/1/2021 Application to Prevent Forfeiture Due to COVID-19 Rental Debt

UD-150* 1/1/2005 Request/Counter-Request to Set Case for Trial—Unlawful Detainer

WD-100 S 9/1/2020 Complaint—Unlawful Detainer (Spanish)

* Adopted for Mandatory Use. Page 104 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

Vexatious Litigants
VL-100* 9/1/2018 Prefiling Order—Vexatious Litigant

VL-110 9/1/2018 Request and Order to File New Litigation by Vexatious Litigant

VL-115 9/1/2018 Order to File New Litigation by Vexatious Litigant

VL-120 9/1/2018 Application for Order to Vacate Prefiling Order and Remove
Plaintiff/Petitioner From Judicial Council Vexatious Litigant List

VL-125 9/1/2018 Order on Application to Vacate Prefiling Order and Remove


Plaintiff/Petitioner From Judicial Council Vexatious Litigant List

Wage Garnishment
WG-001* 1/1/2012 Application For Earnings Withholding Order

WG-002* 7/1/2016 Earnings Withholding Order

WG-002 C 7/1/2016 Earnings Withholding Order (Chinese)

WG-002 K 7/1/2016 Earnings Withholding Order (Korean)

WG-002 S 7/1/2016 Earnings Withholding Order (Spanish)

WG-002 V 7/1/2016 Earnings Withholding Order (Vietnamese)

WG-003* 1/2/2012 Employee Instructions

WG-003 S 1/2/2012 Employee Instructions (Spanish)

WG-004* 1/1/2012 Earnings Withholding Order For Support

WG-004 C 1/1/2012 Earnings Withholding Order For Support (Chinese)

WG-004 K 1/1/2012 Earnings Withholding Order For Support (Korean)

WG-004 S 1/1/2012 Earnings Withholding Order For Support (Spanish)

WG-004 V 1/1/2012 Earnings Withholding Order For Support (Vietnamese)

WG-005* 9/1/2017 Employer's Return

WG-006 1/1/2009 Claim of Exemption

WG-007/EJ-165* 1/1/2007 Financial Statement

WG-008* 1/1/2007 Notice of Filing of Claim of Exemption

WG-009* 1/2/2012 Notice of Opposition to Claim of Exemption

WG-010/EJ-175 1/1/2007 Notice of Hearing on Claim of Exemption

WG-011* 1/1/2007 Order Determining Claim of Exemption

WG-012* 1/1/2012 Notice of Termination or Modification of Earnings Withholding Order

WG-020* 1/1/2007 Application For Earnings Withholding Order For Taxes (State Tax
Liability)

* Adopted for Mandatory Use. Page 105 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

WG-021* 1/1/2007 Confidential Supplement to Application For Earnings Withholding


Order For Taxes (State Tax Liability)

WG-022* 1/1/2007 Earnings Withholding Order For Taxes (State Tax Liability)

WG-023* 1/1/2007 Notice of Hearing—Earnings Withholding Order For Taxes (State Tax
Liability)

WG-024* 1/1/2007 Temporary Earnings Withholding Order For Taxes (State Tax Liability)

WG-025* 1/1/2007 Confidential Supplement to Temporary Earnings Withholding Order


For Taxes (State Tax Liability)

WG-026* 1/1/2007 Claim of Exemption and Financial Declaration (State Tax Liability)

WG-030* 7/1/2016 Earnings Withholding Order for Elder and Dependent Adult Financial
Abuse

WG-035* 1/1/2012 Confidential Statement of Judgment Debtor's Social Security Number

Workplace Violence Prevention


WV-100* 1/1/2023 Petition for Workplace Violence Restraining Orders

WV-100-INFO 1/1/2023 How Do I Get an Order to Prohibit Workplace Violence?

WV-109* 1/1/2023 Notice of Court Hearing

WV-110* 1/1/2023 Temporary Restraining Order (CLETS-TWH)

WV-115* 1/1/2020 Request to Continue Court Hearing (Temporary Restraining Order)


(Workplace Violence Prevention)

WV-115-INFO 1/1/2020 How to Ask for a New Hearing Date (Workplace Violence Prevention)

WV-116* 1/1/2020 Order on Request to Continue Hearing (CLETS-TWH) (Workplace


Violence Prevention)

WV-120* 1/1/2023 Response to Petition for Workplace Violence Restraining Orders

WV-120-INFO 1/1/2023 How Can I Respond to a Petition for Workplace Violence Restraining
Orders?

WV-130* 1/1/2023 Workplace Violence Restraining Order After Hearing (CLETS-WHO)

WV-200 1/1/2023 Proof of Personal Service (Workplace Violence Prevention)

WV-200-INFO 1/1/2012 What Is ''Proof of Personal Service''?

WV-250 1/1/2012 Proof of Service of Response by Mail

WV-260 1/1/2012 Proof of Service of Order After Hearing by Mail

WV-600* 1/1/2018 Request to Modify/Terminate Workplace Violence Restraining Order

WV-610* 1/1/2018 Notice of Hearing on Request to Modify/Terminate Workplace


Violence Restraining Order

* Adopted for Mandatory Use. Page 106 of 107


JUDICIAL COUNCIL FORMS
Form number Effective date Form title [Rev. May 1, 2023]

WV-620* 1/1/2018 Response to Request to Modify/Terminate Workplace Violence


Restraining Order

WV-630* 1/1/2018 Order on Request to Modify/Terminate Workplace Violence


Restraining Order

WV-700* 1/1/2012 Request to Renew Restraining Order

WV-710* 1/1/2012 Notice of Hearing to Renew Restraining Order

WV-720* 1/1/2012 Response to Request to Renew Restraining Order

WV-730* 1/1/2012 Order Renewing Workplace Violence Restraining Order

WV-800 1/1/2023 Receipt for Firearms and Firearm Parts (Workplace Violence
Prevention)

WV-800-INFO 1/1/2023 How Do I Turn In, Sell, or Store My Firearms and Firearm Parts?

* Adopted for Mandatory Use. Page 107 of 107

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