Santa Clara — FM-1124*

Source: https://santaclara.courts.ca.gov/system/files/forms/fm-1124_rem.pdf

ATTACHMENT FM-1124 SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA FOR COURT USE ONLY STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PROTECTED PERSON:

RESTRAINED PERSON:

FINDINGS RE NON-COMPLIANCE WITH ORDER TO RELINQUISH CASE NUMBER: GUNS, FIREARMS OR AMMUNITION

This form is related to: DV-110/130 CH-110/130 EA-110/130 WV-110/130 JV-250/255 Other:

1. The above matter came before the Court on in Department of the

   Superior Court, the Honorable , presiding.

2. The Court makes ALL the following findings by a preponderance of the evidence:

   a. The Restrained Person received proper notice of the hearing.

   b. The Restrained Person appeared did not appear for the hearing.

   c. The Court issued a restraining order against the Restrained Person on (date) ,

   which prohibits possession and requires the relinquishment of guns, firearms or ammunition, by surrender to Law Enforcement, or sale to or storage with a licensed gun dealer, as required by law.

   d. The Restrained Person owns or has access to guns, firearms or ammunition, as indicated by:

   Pretrial Service report showing registered weapons Protected Person’s testimony that:

   ______________________________________________________________________________.

   e. The Restrained Person has failed to offer satisfactory proof that he or she has relinquished the following guns, firearms or ammunition as required by law: _________________________________________________________________________________.

3. Allegations by Protected Person:

   Physical abuse Threats Sexual assault Suicidal ideation Strangulation

   Coercive control Stalking Substance abuse Weapon involved

   Other _______________________________________________________________________.

4. The Court will submit this form to the Santa Clara County District Attorney’s Office at prohibitedpersons@dao.sccgov.org and court at AB178@scscourt.org along with a copy of the restraining order within two (2) business days fromthe date of the hearing referenced above in paragraph 1 in compliance with Fam. Code §6389(c)(4).

Date: Judicial Officer

FM-1124 REV 07/26/2023 FINDINGS RE NONCOMPLIANCE WITH ORDER TO RELINQUISH Page 1 of 1For Mandatory Use GUNS, FIREARMS OR AMMUNITION