I agree to the relationship listed in item on Form DV-100.
I do not agree that the other party and I have or had the relationship listed in item on Form DV-100.
(Specify your reasons in item 24, page 4, of this form.)
Response to Request for Domestic
Violence Restraining Order
Name of Person Asking for Protection:
(See Form DV-100, item ):
Address (If you have a lawyer for this case, give your lawyer’s
information. If you do not have a lawyer and want to keep your home
address private, give a different mailing address instead. You do not
have to give your telephone, fax, or e-mail.):
Your lawyer in this case (if you have one):
Use this form to respond to the Request for Domestic
Violence Restraining Order (Form DV-100).
Fill out this form and take it to the court clerk.
Have the person in served by mail with a copy of this form and any attached pages. (See Form DV-250, Proof
of Service by Mail.)
For more information, read Form DV-120-INFO
, How Can I Respond to a Request for Domestic Violence
The judge will consider your Response at the hearing.
Write your hearing date, time, and place from Form DV-109, Notice of Court Hearing, item , here:
You must obey the orders in Form DV-110, Temporary Restraining Order, until the hearing. At the hearing,
the court may make restraining orders against you that could last up to five years and could be renewed.
Response to Request for Domestic Violence
(Domestic Violence Prevention)
Judicial Council of California, www.courts.ca.gov
Revised July 1, 2014, Mandatory Form
Family Code, § 6200 et seq.
DV-120, Page 1 of 4
Relationship to Person Asking for Protection
Other Protected People
Personal Conduct Orders
State Bar No.:
I agree to the order requested.
I do not agree to the order requested. (Specify your reasons in item 24, page 4, of this form.)
I do not agree to the orders requested. (Specify your reasons in item 24, page 4, of this form.)
I agree to the orders requested.
This is not a Court Order.
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California, County of
Court fills in case number: