DV-610

Fax Transmission Cover
Sheet for Registration of 
Tribal Court Protective Order

Fill in court name and street address:

Superior Court of California, County of

1

Protected person (name or names):

2

Restrained person (name):

Fill in case number:
Case Number:

To:
From:

3

4

5

6

Please file the following transmitted form DV-600 and attached 
Tribal Court Protective Order issued by the tribal court.

This fax contains a total of                          pages, including the 
cover sheet.

Name and contact information of tribal court that issued order:

Date fax sent:

Name of court:

Mailing address:

Telephone number:   

Fax number:

Contact person:

E-mail (if the court has one):

Tribal Court case file number:

7

Please confirm receipt of this request by contacting: 

the tribal court contact person by telephone.

the tribal court contact person by e-mail.

other (describe):

8

Please process and send copies to 

 tribe at the address above or

protected person at the mailing address on the attached Tribal Court Protective Order

other (describe):

9

Other instructions:

If you do not receive all pages or have any other problems or questions about this transmission, please call 
(name):                                                                  at (telephone number):                                     .

Judicial Council of California, www.courts.ca.gov 
New July 1, 2012, Optional Form 
Cal. Rules of Court, rule 5.386

Fax Transmission Cover Sheet for 
Registration of Tribal Court Protective Order

DV-610, Page 1 of 1