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 |  | Case Number: Write in the case number. |
Request to Renew Restraining Order
| If you and the Restrained Person are joint parents of a child, use this form to tell the judge what you want him or her to decide about who will take care of the child, where the child will live, when the child will see the other parent, and if the Restrained Person should pay money for child support. This form ONLY applies to the child or children that you and the Restrained Person are the parents of together. Attach this form to the Request for Order (DV-100). |
1.
Write the name of the person who wants protection from the court. Check 
this box that tells if they are the child’s mother (Mom), father (Dad), or have some other relationship to the child. (Write that person’s name and his or her relationship to the child)
2.
Write the name of the Restrained Person and check this box that tells how he or she is related to the child.
3. Change of Current Court Orders:
Check this box only if you already have a court order for child custody and visitation and you want to change (modify) that order now. Write what the court order you already have says about child custody and visitation, then write why you think things should change.
If you checked this box, skip question 4. Go straight to question 5, then finish the rest of the form.
4.
Check this box only if you already have a court order for child custody, visitation and child support and you do not want to make any changes to that order. If you checked this box, you do not have to answer any more questions. DO attach a copy of the court order for child custody, visitation, and child support to this form.
5. Child Custody:
Check this box if you need to get your first court order regarding child custody, visitation, and child support.
Write each child’s name and date the child was born. Check
Check
6. Child’s Address:
Write the address for each place that the child has lived for the past five years UNLESS that address is private (if an address is private, leave that line blank).
Check this box under the person that the child lived with -- Mom (Mother), Dad (Father), or Other (write the name of the person the child lived with and his or her relationship to the child).
Write the dates that the child has lived at each address. Start with the place that the child is living now, and then list each place the child has lived before that in order (backwards in time from now to five years ago).
If the child lived with someone other than his or her mother or father, write the relationship (for example, Grandparent).
7. Other Children’s Addresses:
Check the first box if all the children listed on this form have lived together at the same addresses for the past five years.
Check the second box if the children listed on this form have lived at different addresses. Use a separate sheet of paper. At the top of the page write, “DV-105, Item 7 - Other Children’s Addresses.” Write the rest of the children’s names and dates of birth. Then, write the address where each child has lived, and who that child lived with (Mom, Dad, Other), and write the dates when the child lived at that address. Start with where the child lives now and then go back in order to where the child lived five years ago.
At the top of page 2, DV-105
 | Fill out the caption boxes as follows: | |
| Write your name. | |
 | Case Number: Write in the case number. - (the same number as on page 1) |
8. Other Custody Case:
Check this box (“No” or “Yes”) that tells whether there are any other court cases regarding child custody or visitation of a child listed on this form.
- If you already have an order about child custody and visitation from another court case, write the name of the child who is affected by that other court order. If you do not know of any other cases, skip the rest of this question and go to below.
- If there is another court case, check this box next to the word that tells the kind of court case that was about child custody or visitation.
- Check this box that tells how you participated in the other court case. Check this box next to witness if you just testified (gave information) in the court case. Check this box next to party if you were named in the lawsuit and participated in the proceedings as more than just a witness.
- Write the name and address of the court where this custody case was heard.
- Write the date that the other court order was issued. (The date of the court order is the date that the order was signed, or the date that the order was filed.)
9. Other People Claim to Have Custody:
Check this box next to “No” or “Yes” to tell if there is another person who is not involved in this court case that has, or says they have, custody or visitation rights with your child. Write that person’s name and address.
Check this box next to “Has custody” if the child is living with this other person now.
Check “Claims custody rights” if the other person says they have custody of the child,
or check “Claims visitation rights” if the other person says they have the right to visit with the child.
Write the name of the child (who the other person claims custody rights for) and the date they were born.
If you need more space, use a separate sheet of paper. At the top of the page write, “DV-105, Item 9 - Child Custody”. Then write the rest of the information.
10. Visitation:
Check this box if you want the judge to make an order about when the Restrained Person can visit with the child. You can check more than one box.
- Check this box if you want the Restrained Person not to be able to visit with the child at all until the court hearing.
- Check this box if you want the Restrained Person not to be able to visit with the child at all after the court hearing.
- Check this box if you want the Restrained Person to have some time visiting with the child before the hearing and after the hearing (you can check one or both boxes)
NOTE: Many parents find this section hard to fill out properly. Be sure to check what you write carefully with a lawyer, paralegal, or trusted friend.
- Check this box if you want the Restrained Person to be able to visit the child on the weekend. Write when you want this schedule to start. Check this box next to which weekend time or times you want, and write when the weekend begins (for example, you might write that the weekend begins on Friday at 5:00 p.m. and ends on Sunday at 5:00 p.m.)
- Check this box if you want the Restrained Person to be able to visit the child during the week. Write when you want this schedule to start. Check this box next to which weekday times you want, and write when the weekday begins (for example, you might write that the weekday begins at 8:00 a.m. and ends at 5:00 p.m.)
- Check this box if you want the Restrained Person to be able to visit the child at other times (such as holidays, birthdays, and sports events). If you check this box, write the rest of the information on a separate page. At the top of that sheet, write: “DV-105, Item 10 - Visitation.”
At the top of page 3, DV-105
 | Fill out the caption boxes as follows: | |
| Write your name. | |
| Case Number: Write in the case number. - (the same number as on page 1) |
11. Supervised Visitation:
Supervised Visitation means that an adult has to be with the Restrained Person and the child any time they are together to make sure the child is safe. Check this box if you think visits between the child and Restrained Person should include another adult.
- Write the name and telephone number of the person you want to be the supervisor.
- If the supervisor is a professional who will charge money, write who should pay the fees. If you want to split the fee, write what percentage of the fee you think Mom, Dad, or another person should pay. (For example, if you want each parent to pay one half of the visitation supervisor’s fee, you would write 50 % for each of the two parents, or one parent and another person).
12. Responsibility for Transportation for Visitation:
Check this box if you want the judge to include specific information about who will pick up and drop off the child for visits with the other parent.
- Check this box next to the name of the person (Mom, Dad, Other) you want to take the child TO visits with the Restrained Person.
- Check this box next to the name of the person (Mom, Dad, Other) you want to pick up the child FROM visits with the Restrained Person.
- Write the address where the child is to be dropped- off or picked-up for visits with the Restrained Person.
It is important to pick a place to have the child dropped off or picked up that the Restrained Person can go to without violating (going against) the Restraining Order.
If you think violence or other serious problems could happen when the child is being picked up or dropped off, you might think about doing this in a public place or in front of a police station.
13. Travel With Children:
Check this box if you want the judge to limit who can travel with the child, and where they can travel.
Check this box next to “Mom”, “Dad”, or “Other” if you want the judge to require the other parent to have your written permission to take the children outside of the areas specified in a or b below.
- Check this box if you do not want the other parent to take the child out of California.
- Check this box if you do not want the other parent to take the child other places (such as out of the country). If you mark this box, then you must say exactly where the other parent cannot travel with the child.
14. Child Abduction:
Check this box if you think the other parent might take the child out of the state of California without your permission.
If you check this box, you must fill out Request for Order: No Travel with Children (Form DV-108) and attach it to this form.
15. Child Support:
Check this box if you want the judge to make the Restrained Person pay child support.
- Check this box if you want child support. If you mark this box, you must also fill out, file, and serve an Income and Expense Declaration (Form FL-150) or a Financial Statement (Simplified) (Form FL-155) before your court hearing. (Read page 2 of Form FL-155 to learn if you can use it.)
- Check this box if you are getting or have applied for TANF, Welfare, CalWORKS, or Medi-Cal.
- Check this box if you already have a Child Support Order, but want it changed.
16. IMPORTANT!
This is a reminder that you must tell the court if you find out about any other child custody cases involving the children listed on these forms.
