WV-110: California Temporary Restraining Order (Workplace Violence Prevention)

The Petitioner is the Employer or Collective Bargaining Representative: enter the Name.

For the Lawyer for Petitioner (if any, for this case), enter the Name, State Bar No. and Firm Name.

In b, Your Address: if you have a lawyer, give your lawyer's information. Enter the Address, City, State, Zip, Telephone, Fax and Email Address.

Fill in court name and street address (Superior Court of California, County of).

The Court fills in the Case Number, and the Clerk stamps the date, when the form is filed.

In 2 Protected Person or Persons, enter a Full Name on each Full Name line.

Check the box for: "Additional protected persons are listed at the end of this order on Attachment 2."

In 3 Respondent (Restrained Person), give all the information you know. Information with a star (*) is required to add this order to the California police database. If age is unknown, give an estimate. Enter the *Full Name, *Age, Date of Birth, *Race, Height, Weight, Hair Color and Eye Color. Check M, F or Nonbinary for *Gender. Enter the Home Address, City, State, Zip and the Relationship to Protected Person.

In 4 Expiration Date, this order expires at the end of the hearing scheduled for the date and time in Date and Time. Check p.m. or a.m.

To the Respondent: The court has issued the temporary orders checked as granted. If you do not obey these orders, you can be arrested and charged with a crime. You may have to go to jail for up to one year, pay a fine of up to $1,000, or both (checked October 19, 2026). 5 Personal Conduct Orders: Not Requested, Denied Until the Hearing or Granted as Follows.

In a, you are ordered not to do the following things to the protected person or persons listed in 2: (1) Harass, molest, strike, assault (sexually or otherwise), batter, abuse, destroy personal property of, or disturb the peace of the person. (2) Commit acts of violence or make threats of violence against the person. (3) Follow or stalk the person during work hours or to or from the place of work.

(4) Contact the person, either directly or indirectly, in any way, including, but not limited to, in person, by telephone, in writing, by public or private mail, by email, by fax, or by other electronic means. (5) Enter the workplace of the person.

(6) Take any action to obtain the person's address or locations. If this item is not checked, the court has found good cause not to make this order.

(7) Other (specify): Other personal conduct orders are attached at the end of this order on Attachment 5a(7).

In b, peaceful written contact through a lawyer or a process server or other person for service of legal papers related to a court case is allowed and does not violate this order. However, you may have your papers served by mail on the petitioner.

6 Stay-Away Order: Not Requested, Denied Until the Hearing or Granted as Follows.

In a, you must stay at least yards away from (check all that apply): (1) Each protected person listed in 2.

(2) For each protected person listed in 2: (a) The person's workplace (b) The person's home (c) The person's school (d) The person's children's school (e) The person's children's place of childcare (f) The person's vehicle.

(3) Other (specify).

In b, this stay-away order does not prevent you from going to or from your home or place of employment.

In 7 No Firearms (Guns), Firearm Parts, or Ammunition, a: you cannot own, possess, have, buy or try to buy, receive or try to receive, or in any other way get any prohibited items listed in b.

In b, prohibited items are: (1) Firearms (guns); (2) Firearm parts, meaning receivers, frames, or any item that may be used as or easily turned into a receiver or frame (see Penal Code section 16531); and (3) Ammunition.

In c, you must: (1) Sell to or store with a licensed gun dealer, or turn in to a law enforcement agency, any firearms (guns), firearm parts, and ammunition in your immediate possession or control. This must be done within 24 hours of being served with this order.

(2) File a receipt with the court within 48 hours of receiving this order that proves that all your firearms (guns), firearm parts, and ammunition have been turned in, sold, or stored. (You may use form WV-800 for the receipt.)

In d, the court has received information that you own or possess a firearm (gun), firearm parts, or ammunition.

In 8 Restrained Person Has Prohibited Items, the court finds that you have the following prohibited items:

In a. Firearms and/or firearm parts, the lines are Description (include serial number, if known), Location, if known, and the (date) of Proof of compliance received by the court.

In b. Ammunition, the lines are Description, Amount, if known, Location, if known, and the (date) of Proof of compliance received by the court.

Check here to list additional items: List them on a separate piece of paper, write “WV-110, Restrained Person Has Prohibited Items” at the top, and attach it to this form.

You cannot own, possess, or buy body armor (defined in Penal Code section 16288). You must relinquish any body armor you have in your possession.

In 10, in addition to the hearing listed on form WV-109, you must attend the court hearing to prove that you have properly turned in, sold, or stored all prohibited items (described in 7 b) you still have or own, including any items listed in 8.

The court hearing listed has a Name and address of court, if different than court address listed on page 1, and a Date, Dept., Time and Room. If you do not attend the court hearing listed, a judge may find that you have violated the restraining order and notify law enforcement and a prosecuting attorney of the violation.

11 Other Orders: Not Requested, Denied Until the Hearing or Granted as Follows (specify).

Additional orders are attached at the end of this order on Attachment 11.

To the Petitioner: in 12, this order must be entered into the California Restraining and Protective Order System (CARPOS) through the California Law Enforcement Telecommunications System (CLETS). Check one:

a. The clerk will enter this order and its proof-of-service form into CARPOS. b. The clerk will transmit this order and its proof-of-service form to a law enforcement agency to be entered into CARPOS.

c. By the close of business on the date that this order is made, the employer or the employer's lawyer should deliver a copy of the order and its proof-of-service form to the law enforcement agencies listed in Name of Law Enforcement Agency and Address (City, State, Zip) to enter into CARPOS.

13 No Fee to Serve (Notify) Restrained Person: Ordered or Not Ordered. The sheriff or marshal will serve this order without charge because: a. The order is based on a credible threat of violence or stalking. b. The petitioner is entitled to a fee waiver.

14 Number of pages attached to this order, if any.

Date: Judicial Officer.

The Clerk will fill out this part. In the Clerk's Certificate, the clerk certifies that this Temporary Restraining Order is a true and correct copy of the original on file in the court.