Mendocino — WV-110

Source: http://www.courts.ca.gov/documents/wv110.pdf

WV-110 Temporary Restraining Order Clerk stamps date here when form is filed.

1 Petitioner (Employer or Collective Bargaining Representative) a. Name: Lawyer for Petitioner (if any, for this case): Name: State Bar No.: Firm Name:

b. Your Address (If you have a lawyer, give your lawyer’s information.):
Address: Fill in court name and street address:
Superior Court of California, County of City: State: Zip:
Telephone: Fax:
Email Address:

2 Protected Person or Persons Court fills in case number when form is filed. Full Name: Case Number: Full Name: Full Name: Full Name: Additional protected persons are listed at the end of this order on Attachment 2.

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.)

*Full Name: *Age: Date of Birth:
*Race: Height: Weight: Hair Color: Eye Color:
*Gender: M F Nonbinary Home Address:
City: State: Zip:
Relationship to Protected Person:

4 Expiration Date This order expires at the end of the hearing scheduled for the date and time below:

Date: Time: a.m. p.m.

This is a Court Order.

Judicial Council of California, courts.ca.gov WV-110, Page 1 of 7Rev. January 1, 2026, Mandatory Form Temporary Restraining Order (CLETS-TWH) Code Civ. Proc., §§ 527.8, 527.9, 527.11 (Workplace Violence Prevention)Approved by DOJ

Case Number:

To the Respondent:

The court has issued the temporary orders checked as granted below. 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. 5 Personal Conduct Orders Not Requested Denied Until the Hearing Granted as Follows: 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).

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 Granted as Follows: a. You must stay at least yards away from (check all that apply): (1) Each protected person listed in 2 (3) Other (specify): (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 b. This stay-away order does not prevent you from going to or from your home or place of employment. This is a Court Order.

Rev. January 1, 2026 Temporary Restraining Order (CLETS-TWH) WV-110, Page 2 of 7 (Workplace Violence Prevention)

Case Number:

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. 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.

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 Receipt for Firearms,
Firearm Parts, and Ammunition (form WV-800) for the receipt.)
d. The court has received information that you own or possess a firearm (gun), firearm parts, or ammunition.

8 Restrained Person Has Prohibited Items The court finds that you have the following prohibited items: a. Firearms and/or firearm parts Proof of compliance Description (include serial number, if known) Location, if known received by the court (1) (date): (2) (date): (3) (date): (4) (date):

b. Ammunition
Amount, if Proof of compliance
Description known Location, if known received by the court
(1) (date):
(2) (date):
(3) (date):
(4) (date):

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.

9 No Body Armor 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.

This is a Court Order.

Rev. January 1, 2026 Temporary Restraining Order (CLETS-TWH) WV-110, Page 3 of 7 (Workplace Violence Prevention)

Case Number:

10 Court Hearing to Review Firearms (Guns), Firearm Parts, and Ammunition Compliance In addition to the hearing listed on form WV-109, you must attend the court hearing listed below 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 . If you do not attend the court hearing listed below, a judge may find that you have violated the restraining order and notify law enforcement and a prosecuting attorney of the violation.

Name and address of court, if different than court
address listed on page 1:
Date: Dept.:
Time: Room:

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

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

To the Petitioner:

12 Mandatory Entry of Order Into CARPOS Through CLETS 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 below to enter into CARPOS: Name of Law Enforcement Agency Address (City, State, Zip)

Additional law enforcement agencies are listed at the end of this order on Attachment 12.

This is a Court Order.

Rev. January 1, 2026 Temporary Restraining Order (CLETS-TWH) WV-110, Page 4 of 7 (Workplace Violence Prevention)

Case Number:

13 No Fee to Serve (Notify) Restrained Person Ordered 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

Warnings and Notices to the Restrained Person in 3

You Cannot Have Firearms (Guns), Firearm Parts, or Ammunition You cannot own, have, possess, buy or try to buy, receive or try to receive, or otherwise get any prohibited items listed in 7 b on page 3 while this order is in effect. If you do, you can go to jail and pay a $1,000 fine. You must sell to or store with a licensed gun dealer, or turn in to a law enforcement agency, any firearms (guns), firearm parts, and ammunition that you have or control as stated in 7 above. The court will require you to prove that you did so.

Notice Regarding Nonappearance at Hearing and Service of Order If you have been personally served with this Temporary Restraining Order and form WV-109, Notice of Court Hearing, but you do not appear at the hearing either in person or by a lawyer, and a restraining order that is the same as this Temporary Restraining Order except for the expiration date is issued at the hearing, a copy of the order will be served on you by mail at the address in 3 . If this address is not correct or you wish to verify that the Temporary Restraining Order was converted into a restraining order at the hearing without substantive change, or to find out the duration of the order, contact the clerk of the court.

This is a Court Order.

Rev. January 1, 2026 Temporary Restraining Order (CLETS-TWH) WV-110, Page 5 of 7 (Workplace Violence Prevention)

Case Number:

After You Have Been Served With a Restraining Order Obey all the orders. Any intentional violation of this order is a misdemeanor punishable by a fine or by imprisonment in a county jail, or by both fine and imprisonment. (Pen. Code, § 273.6.) Read form WV-120-INFO, How Can I Respond to a Petition for Orders to Stop Workplace Violence?, to learn how to respond to this order. If you want to respond, fill out form WV-120, Response to Petition for Workplace Violence Restraining Orders, and file it with the court clerk. You do not have to pay any fee to file your response if the petition claims that you threatened violence against or stalked the employee, or placed the employee in reasonable fear of violence. You must have form WV-120 served on the petitioner or the petitioner’s attorney by mail. You cannot do this yourself. The person who does the service should complete and sign form WV-250 , Proof of Service of Response by Mail. File the completed proof of service with the court clerk before the hearing date or bring it with you to the hearing. In addition to the response, you may file and have declarations served, signed by you and other persons who have personal knowledge of the facts. You may use form MC-030, Declaration, for this purpose. It is available from the clerk’s office at the court shown on page 1 of this form or at courts.ca.gov/rules-forms/find-your-court-forms. If you do not know how to prepare a declaration, you should see a lawyer. Whether or not you file a response, you should attend the hearing. If you have any witnesses, they must also go to the hearing. At the hearing, the judge can make restraining orders against you that last for up to three years. Tell the judge why you disagree with the orders requested.

Instructions for Law Enforcement

Enforcing the Restraining Order This order is enforceable by any law enforcement agency that has received the order, is shown a copy of the order, or has verified its existence on the California Restraining and Protective Orders System (CARPOS). Agencies are encouraged to enter violation messages into CARPOS. If the law enforcement agency has not received proof of service on the restrained person, the agency must advise the restrained person of the terms of the order and then must enforce it. Violations of this order are subject to criminal penalties.

Start Date and End Date of Orders This order starts on the date next to the judge’s signature on page 4. The order ends on the expiration date in 4 on page 1.

If a Protected Person Contacts the Restrained Person Even if a protected person invites or consents to contact with the restrained person, this order remains in effect and must be enforced. The protected person cannot be arrested for inviting or consenting to contact with the restrained person. The order can be changed only by another court order. (Pen. Code, § 13710(b).)

This is a Court Order. Rev. January 1, 2026 Temporary Restraining Order (CLETS-TWH) WV-110, Page 6 of 7 (Workplace Violence Prevention)

Case Number:

Conflicting Orders—Priorities for Enforcement If more than one restraining order has been issued protecting a protected person from the restrained person, the orders must be enforced in the following priority (see Pen. Code, § 136.2; Fam. Code, §§ 6383(h)(2), 6405(b); Code Civ. Proc., § 527.12(d)(2)):

1. Emergency Protective Order (EPO): If one of the orders is an Emergency Protective Order (form EPO-001), provisions (e.g., stay-away order) that are more restrictive than in the other restraining/protective orders must be enforced. Provisions of another order that do not conflict with the EPO must also be enforced.

2. No-Contact Order: If a restraining/protective order includes a no-contact order, the no-contact order must be enforced. 5 a(4) is an example of a no-contact order.

3. Criminal Protective Order (CPO): If none of the orders includes an EPO or a no-contact order, the most recent CPO must be enforced. (Fam. Code, §§ 6383(h)(2), 6405(b); Code Civ. Proc., § 527.12(d)(2).) Additionally, a CPO issued in a criminal case involving charges of domestic violence, Penal Code sections 261, 261.5, or former 262, or charges requiring sex offender registration must be enforced over any civil court order. (Pen. Code, § 136.2(e)(2).) All provisions in the civil court order that do not conflict with the CPO must also be enforced.

4. Civil Restraining Orders: If there is more than one civil restraining order (e.g., domestic violence, juvenile, elder abuse, civil harassment), then the order that was issued last must be enforced. Provisions that do not conflict with the most recent civil restraining order must also be enforced.

   (Clerk will fill out this part.)

   —Clerk's Certificate—

Clerk’s Certificate I certify that this Temporary Restraining Order is a true and correct copy of the original on file in the court. [seal]

Date: Clerk, by , Deputy

This is a Court Order.

Rev. January 1, 2026 Temporary Restraining Order (CLETS-TWH) WV-110, Page 7 of 7 (Workplace Violence Prevention) For your protection and privacy, please press the Clear button after you have printed the form. Print Save Clear