Epo 001 Form PDF Details

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QuestionAnswer
Form NameEpo 001 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namescalifornia emergency protective, ca epo, emergency protective order, ca emergency protective

Form Preview Example

YOU MUST
stay away at least:

EPO-001

ONE copy to court, ONE copy to restrained person, ONE copy to protected person, ONE copy to issuing agency

LAW ENFORCEMENT CASE NUMBER:

 

EMERGENCY PROTECTIVE ORDER (See reverse for important notices.)

1.PROTECTED PERSONS (insert names of all persons protected by this Order):

2.RESTRAINED PERSON (name):

Sex:

 

M

 

F Ht.:

 

Wt.:

 

Hair color:

 

Eye color:

 

Race:

 

Age:

 

Date of birth:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.TO THE RESTRAINED PERSON:

a.

b.

c.

YOU MUST NOT harass, attack, strike, threaten, assault (sexually or otherwise), hit, follow, stalk, molest, destroy any personal property of, disturb the peace of, keep under surveillance, or block the movements of each person named in item 1. YOU MUST NOT contact, either directly or indirectly, by any means, including but not limited to by telephone, mail, e-mail or other electronic means, any person named in item 1.

yards from each person named in item 1.

 

stay away at least:

 

yards from

 

move out immediately from

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(address):

d.YOU MUST NOT own, possess, purchase, receive, or attempt to purchase or receive any firearm or ammunition. If you have any firearms, you must turn them in to a law enforcement agency or sell them to, or store them with, a licensed gun dealer.

e.YOU MUST NOT take any action, directly or through others, to obtain the addresses or locations of any person named in item 1.

4.

 

 

(Name):

is given temporary care and control of the following

 

 

 

 

 

 

 

 

 

 

 

minor children of the parties (names and ages):

 

 

 

 

 

 

 

 

 

 

 

5.THIS ORDER WILL EXPIRE AT THE CLOSE OF THE COURT BUSINESS DAY ON:

6.TO THE PROTECTED PERSON: If you need protection for a longer period of time, you must request restraining orders from the court in the county where you live:

(Name and address of court):

INSERT DATE OF FIFTH COURT DAY OR SEVENTH CALENDAR DAY, WHICHEVER IS EARLIER; DO NOT COUNT DAY THE ORDER IS GRANTED

If you go to court to request restraining orders, take your copy of this form with you. If a juvenile petition is pending, file in that court.

7.Reasonable grounds for the issuance of this Order exist, and an emergency protective order is necessary to prevent the occurrence or recurrence of domestic violence, child abuse, child abduction, elder or dependent adult abuse, or stalking.

8. Judicial officer (name):

 

granted this Order on (date):

 

at (time):

APPLICATION

9.The events that caused the protected person to fear immediate and present danger of domestic violence, child abuse, child abduction, elder or dependent adult abuse (except solely financial abuse), or stalking are (give facts and dates; specify weapons):

10.

Firearms were:

observed

reported

searched for

seized

11.

12.

The person to be protected lives with the person to be restrained and requests an order that the restrained person move out immediately from the address in item 3c.

The person to be protected has minor children in common with the person to be restrained, and a temporary custody order is

requested because of the facts alleged in item 9. A custody order

 

does

 

does not exist.

By:

 

 

 

 

 

U

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(PRINT NAME OF LAW ENFORCEMENT OFFICER)

(SIGNATURE OF LAW ENFORCEMENT OFFICER)

Agency:

 

 

 

Telephone No.:

 

 

 

Badge No.:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PROOF OF SERVICE

 

 

 

 

 

 

 

 

 

 

 

 

13.

Person served (name):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14.

I personally delivered copies of this Order to the person served as follows:

Date:

 

 

 

 

Time:

 

Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15.

At the time of service, I was at least 18 years of age and not a party to this cause.

 

 

I am a California law enforcement officer.

 

 

16.

My name, address, and telephone number are (this does not have to be server's home telephone number or address):

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date:

U

 

(TYPE OR PRINT NAME OF SERVER)

 

(SIGNATURE OF SERVER)

Page 1 of 2

 

 

 

 

 

 

 

Form Adopted for Mandatory Use Judicial Council of California EPO-001 [Rev. January 1, 2014] Approved by DOJ

EMERGENCY PROTECTIVE ORDER (CLETS–EPO)

Family Code, §§ 6240-6275;

(Domestic Violence, Child Abuse, Elder or Dependent Adult Abuse, or Stalking)

Penal Code, § 646.91

www.courts.ca.gov

 

EMERGENCY PROTECTIVE ORDER

EPO-001

WARNINGS AND INFORMATION

TO THE RESTRAINED PERSON: VIOLATION OF THIS ORDER IS A MISDEMEANOR PUNISHABLE BY A $1,000 FINE, ONE YEAR IN JAIL, OR BOTH, OR IT MAY BE PUNISHABLE AS A FELONY. THIS PROTECTIVE ORDER SHALL BE ENFORCED BY ALL LAW ENFORCEMENT OFFICERS IN THE STATE OF CALIFORNIA WHO ARE AWARE OF OR SHOWN A COPY OF THE ORDER. THE TERMS AND CONDITIONS OF THIS ORDER REMAIN ENFORCEABLE REGARDLESS OF THE ACTS OF THE PARTIES; IT MAY BE CHANGED ONLY BY ORDER OF THE COURT (PENAL CODE SECTION 13710(b)).

YOU ARE PROHIBITED FROM OWNING, POSSESSING, PURCHASING, RECEIVING, OR ATTEMPTING TO PURCHASE OR RECEIVE A FIREARM OR AMMUNITION. (PENAL CODE SECTIONS 29825(a), 30305(a).) A VIOLATION IS SUBJECT TO A $1,000 FINE AND IMPRISONMENT OR BOTH. WITHIN 24 HOURS OF RECEIPT OF THIS ORDER, YOU MUST TURN IN YOUR FIREARMS TO A LAW ENFORCEMENT AGENCY, SELL THEM TO A LICENSED FIREARMS DEALER, OR STORE THEM WITH A LICENSED FIREARMS DEALER UNTIL THE EXPIRATION OF THIS ORDER. (PENAL CODE SECTION 29830.) PROOF OF SURRENDER, SALE, OR STORAGE MUST BE FILED WITH THE COURT WITHIN 48 HOURS OF RECEIPT OF THIS ORDER.

To the restrained person: This order will last until the date and time in item 5 on the reverse. The protected person may, however, obtain a more permanent restraining order from the court. You may seek the advice of an attorney on any matter connected with this order. The attorney should be consulted promptly so that the attorney may assist you in responding to the order.

A la persona bajo restricción judicial: Esta orden durará hasta la fecha y hora indicada en el punto 5 al dorso. La persona protegida puede, sin embargo, obtener una orden de entredicho (restricción judicial) más permanente de la corte. Usted puede consultar a un abogado en conexión con cualquier asunto relacionado con esta orden. Debe consultar al abogado inmediatamente para que él o ella le pueda ayudar a responder a la orden.

To the protected person: This order will last only until the date and time noted in item 5 on the reverse. If you wish to seek continuing protection, you will have to apply for an order from the court at the address in item 6. You may apply for a protective order free of charge. In the case of an endangered child, you may also apply for a more permanent order at the address in item 6, or if there is a juvenile dependency action pending, you may apply for a more permanent order under section 213.5 of the Welfare and Institutions Code. In the case of a child being abducted, you may apply for a Child Custody and Visitation Order from the court. You may seek the advice of an attorney on any matter connected with your application for any future court orders. The attorney should be consulted promptly so that the attorney may assist you in making your application. You do not have to have an attorney to get the protective order.

A la persona protegida: Esta orden durará sólo hasta la fecha y hora indicada en el punto 5 al dorso. Si usted desea que la protección continúe, tendrá que solicitar una orden de la corte en la dirección indicada en el punto 6. La solicitud de la orden de protección es gratis. En el caso de que un niño o una niña se encuentre en peligro, puede solicitar una orden más permanente en la dirección indicada en el punto 6, o si hay una acción legal pendiente de tutela juvenil, puede solicitar una orden más permanente conforme a la sección 213.5 del código titulado en inglés Welfare and Institutions Code. En el caso del secuestro de un niño o una niña, usted puede solicitar de la corte una orden para la guarda del niño o de la niña (Child Custody and Visitation Order). Puede consultar a un abogado en conexión con cualquier asunto relacionado con las solicitudes de órdenes de la corte que usted presente en el futuro. Debe consultar un abogado inmediatamente para que él o ella le pueda ayudar a presentar su solicitud. Para obtener la orden de protección no es necesario que un abogado le represente.

To law enforcement: The emergency protective order shall be served upon the restrained party by the officer, if the restrained party can reasonably be located, and a copy shall be given to the protected party. A copy shall be filed with the court as soon as practicable after issuance. Also, the officer shall have the order entered into the computer database system for protective and restraining orders maintained by the Department of Justice. The availability of an emergency protective order shall not be affected by the fact that the endangered person has vacated the household to avoid abuse. A law enforcement officer shall use every reasonable means to enforce an emergency protective order. A law enforcement officer who acts in good faith to enforce an emergency protective order shall not be held civilly or criminally liable.

If a child is in danger of being abducted: This order will last only until the date and time noted in item 5 on the reverse. You may apply for a child custody order from the court.

En el caso de peligro de secuestro de un niño o de una niña: Esta orden será válida sólo hasta la hora y fecha indicada en el punto 5 al dorso. Usted puede solicitar de la corte una orden para la guarda del niño o de la niña (Child Custody and Visitation Order).

This emergency protective order is effective when made. This order shall expire on the date and time specified in item 5 on the reverse. The provisions of this emergency protective order take precedence in enforcement over provisions of other existing protective orders between the same protected and restrained persons to the extent the provisions of this order are more restrictive. In other words, the provisions in this emergency protective order take precedence over the provisions in any other protective order, including a criminal protective order, if (1) the person to be protected is already protected by the other protective order, (2) the person to be restrained is subject to that other order, and (3) the provisions in this emergency order are more restrictive than the provisions in that other order. The provisions in another existing protective order remain in effect and take precedence if they are more restrictive than the provisions in this emergency protective order.

EPO-001 [Rev. January 1, 2014]

EMERGENCY PROTECTIVE ORDER (CLETS–EPO)

 

Page 2 of 2

(Domestic Violence, Child Abuse, Elder or Dependent Adult Abuse, or Stalking)

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1. To start with, while filling out the california emergency protective order, begin with the area containing subsequent fields:

Part no. 1 of filling out epo order

2. Once your current task is complete, take the next step – fill out all of these fields - THIS ORDER WILL EXPIRE AT THE, you must request restraining, INSERT DATE OF FIFTH COURT DAY OR, COUNT DAY THE ORDER IS GRANTED, Name and address of court, If you go to court to request, Reasonable grounds for the, or recurrence of domestic violence, Judicial officer name, granted this Order on date, at time, The events that caused the, abduction elder or dependent adult, APPLICATION, and observed with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

epo order completion process shown (portion 2)

3. This next stage is easy - fill out all of the form fields in Person served name, PROOF OF SERVICE, I personally delivered copies of, Date, Time, Address, At the time of service I was at, I am a California law enforcement, I declare under penalty of perjury, TYPE OR PRINT NAME OF SERVER, SIGNATURE OF SERVER, Form Adopted for Mandatory Use, EMERGENCY PROTECTIVE ORDER CLETSEPO, Domestic Violence Child Abuse, and Page of to finish this part.

Simple tips to prepare epo order part 3

4. Now fill out this next section! Here you will get all of these empty form fields to do.

epo order completion process outlined (stage 4)

Be extremely mindful when filling out this field and next field, as this is the part in which many people make mistakes.

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