Step 2 of 3 — Restraining orders and description of abuse

This is the most important part of the form. The orders you check and the description you write go directly onto the DV-100. Write in your own words — the court will read exactly what you enter here.

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Temporary Restraining Orders

Check every order you are asking for. You can ask for more than one type.

Personal Conduct Order (§4)

I ask the court to order the restrained person not to contact, harass, attack, strike, threaten, assault, follow, stalk, molest, destroy personal property, or disturb my peace.

Stay-Away Order (§5)

I ask the court to order the restrained person to stay at least ___ yards away from me, my home, my workplace, and my children's school. Set the distance below.

Move-Out Order (§6)

I ask the court to order the restrained person to move out and not return to: [residence]. A judge can issue this even if their name is on the lease or mortgage.

Stay-away distance (yards)

100 yards is standard. You may request more.

Date of most recent incident

Must be today or earlier. The Translate button explains how to describe the date to the court.

Personal Conduct Orders — prohibited conduct (§4)

Check all conduct you are asking the court to prohibit. Your selections will compose the order description below, which you can then edit.

No calls, texts, or messages

No contact through phone, text, email, social media, or through other people.

Stay away from my home

No coming near my residence, my vehicle, or my workplace.

Stay away from my children's school

No approaching the school, childcare, or any location where my children are.

No threatening, harassing, or stalking

No conduct that disturbs my peace or causes fear, by any method.

Surrender firearms and ammunition

Any guns or other weapons must be surrendered and not acquired during the order.

Other orders: I ask the court to order (§7)

Your checked selections are composed above automatically. This field goes directly onto the form — the Translate button explains what to include.

Description of most recent incident of abuse or harassment (§11)

Check all types of conduct that occurred. Then describe the incident in your own words below — the court reads your exact description.

Physical

Hit, pushed, grabbed, choked, or injured me.

Threats

Threatened to hurt me, my children, or others.

Stalking or following

Followed me, tracked my location, monitored my devices.

Property damage

Destroyed, took, or damaged my property.

Harassment or emotional

Repeated unwanted contact, intimidation, isolation.

Weapon involved

Used or displayed a weapon during the incident.

Describe the most recent incident of abuse or harassment (give date)

This goes directly onto the DV-100. Use the Translate button on the label to see a plain-English guide for what courts look for.

Prior incidents of abuse or harassment (§12)

If there has been a history of abuse, describe any previous incidents. Approximate dates are acceptable. Leave blank if this is the first incident.

If there has been a history of abuse, describe any other incident(s)

Include approximate dates, any injuries or police reports, and any pattern of escalation you have observed.

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