Form Crim 202 Protective And Restraining Order Worksheet (Rule 8.34)
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1Arrest Report No:
Case Number:
_________________________
___________________________
SUPERIOR COURT OF CALIFORNIA
COUNTY OF LOS ANGELES
Protective and Restraining Order Worksheet (Rule 8.34)
To: All Investigating and Filing Officers of domestic violence, child abuse, elder abuse, and sexual assault cases. In all domestic
violence cases (including intimate partner sexual assault and child sexual assault by a parent or guardian), Penal Code 273.75
requires the prosecuting agency to provide information to the court, at the time of arraignment, of any current civil or criminal
protective or restraining orders.
TO BE COMPLETED BY LAW ENFORCMENT AGENCY
Defendant’s Name: _________________________________________________________
Pursuant to Penal Code 273.75 and Los Angeles Superior Court Rule 8.34, on or about ___________________,
the following systems were checked for current criminal, civil or other court‐ordered protection orders:
G CII; G DVROS; G JAI; G ___________________________ Other CMS.
G No protective or restraining order was found.
G The following court case which may have a protective or restraining order was found:
Case Number: ________________________________ Court Location: ________________________________
Protected Person(s) Name(s): _________________________________________________________________
Issue Date: ____________________________________ Expiration Date: ______________________________
Attach additional pages if needed. Please attach copies of any available printouts of protective or restraining
orders to this form.
Agency: _________________Officer Name: __________________________ Serial/Employee No: __________
TO BE COMPLETED BY THE PROSECUTING AGENCY
Pursuant to Penal Code 273.75 and Los Angeles Superior Court Rule 8.34, on or about____________________,
The following systems were checked for current criminal, civil or other court‐ordered protection orders:
G CII; G DVROS*; G JAI*; G CIVIL INDEX*, G ______________ Other CMS. Probate and Family (No Access)
G No protective or restraining order was found.
G The following court case which may have a protective or restraining order was found:
Case Number: ________________________________ Court Location: ________________________________
Protected Person(s) Name(s): _________________________________________________________________
Issue Date: ____________________________________ Expiration Date: ______________________________
Attorney/Staff Name: ______________________________ Bar Number/Employee No: ___________________
*If not previously checked by law enforcement.
Note: The Investigating or Filing Officer must provide the prosecuting agency with a completed copy of the attached
Protective and Restraining Order Worksheet and include copies of all protective orders in civil, criminal and/or cases for
each of the filing packets.
Page____of____
Distribution: Original (White) ‐Court, Green‐Prosecutor, Blue‐LEA.
CRIM 202 (4/13)
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