Step 1 of 5 — quick basics

We need a few details to fill in the top of the form. None of this is sent anywhere — it stays on your device until you print.

SharpeSystem helps you fill out this form correctly — it is not a lawyer and does not give legal advice. What you do with the completed form is your decision.

National DV Hotline: 1-800-799-7233 — 24/7, free, confidential

Your information (Petitioner — you)

Your full legal name

Full legal name — exactly as it appears on your birth certificate or Social Security card. This is how it will appear on every court document.

Your date of birth Your phone number Your street address Your city, state, and ZIP

Keep my address confidential

If checked, your address will not appear on the form given to the restrained person. The court will keep it on file. Check this if you are concerned for your safety.

Person to be restrained (Respondent)

Their full legal name

Their full legal name — exactly as it appears on their birth certificate or Social Security card.

Their date of birth (if known) Their phone number (if known) Their street address (if known) Their city, state, and ZIP (if known)

What is your relationship to this person?

This matches Section 2 of the DV-100 exactly. Choose the option that best describes how you know them.

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