SUPERIOR COURT OF CALIFORNIA, COUNTY OF

STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PEOPLE OF THE STATE OF CALIFORNIA 
v.

DEFENDANT:

FOR COURT USE ONLY

CR-162

ORDER TO SURRENDER FIREARMS IN DOMESTIC VIOLENCE CASE  
(CLETS-CPO)  
(Penal Code, § 136.2(a)(1)(G)(ii))

CASE NUMBER:

 PERSON TO SURRENDER FIREARMS (complete name):
F

Nonbinary

M

Wt.:

Race:
Hair color:

Date of birth:
Eye color:

1.  This proceeding was heard on (date):

at (time):

in Dept.:

Gender:
 Ht.:

Room: 

by judicial officer (name):

2. This order expires on    (date): 

. If no date is listed, this order remains in effect until further court order. 

To terminate, courts must use Notice of Termination of Protective Order in Criminal Proceeding (form CR-165).

3.

Defendant was personally served with a copy of this order at the court hearing, and no additional proof of service of this   
order is required.

4. GOOD CAUSE APPEARING, THE COURT ORDERS THAT THE ABOVE-NAMED DEFENDANT

a. Must not own, possess, buy or try to buy, receive or try to receive, or in any other way get any firearms, 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), or 
ammunition. Possession of firearms, firearm parts, or ammunition while this order is in effect may subject the defendant to state 
or federal prosecution, and may include jail or prison time and/or a fine.

b. Within 24 hours of receiving this order the defendant must turn in to local law enforcement, or sell to or store with a licensed 
gun dealer, any firearms or firearm parts owned by the defendant or within the defendant's immediate possession or control. 

c. Within 48 hours of receiving this order the defendant must file a receipt with the court showing that all firearms or firearm parts 

have been turned in, sold, or stored.

The court finds good cause to believe that the defendant has a firearm or firearm parts within their immediate possession   
(time):

or control and sets a review hearing for (date):
to ascertain whether the defendant has complied with the firearm and firearm parts relinquishment requirements of Code Civ. 
Proc., § 527.9. (Cal. Rules of Court, rule 4.700.)

(dept.):

Limited exemption: The court has made the necessary findings to grant an exemption under Code Civ. Proc., § 527.9(f). 
Under California law, the defendant is not required to relinquish this firearm (specify make, model, and serial number of 
firearm):                                                                                                                                                                                     
but must only have it during scheduled work hours and to and from their place of work. Even if exempt under California 
law, the defendant may be subject to federal prosecution for possessing or controlling a firearm. 

Executed on:  

(DATE)

(SIGNATURE OF JUDICIAL OFFICER)

NOTICES

This order is effective as of the date it was issued by the judicial officer and expires as ordered in item 2. 
This order is to be used ONLY when the court orders firearms relinquishment but does not make any other protective or 
restraining  orders.  Do NOT use in conjunction with other criminal protective orders (form CR-160 or CR-161).

Specified defendants may request an exemption from the firearm relinquishment requirements stated in item 4 of this order. 
The court must check the box under item 4 to order an exemption from the firearm relinquishment requirements. If the 
defendant can show that the firearm is necessary as a condition of continued employment, the court may grant an exemption 
for a particular firearm to be in the defendant's possession only during work hours and while traveling to and from work. If a 
peace officer's employment and personal safety depend on the ability to carry a firearm, a court may grant an exemption that 
allows the officer to carry a firearm on or off duty, but only if the court finds, after a mandatory psychological examination of 
the peace officer, that the officer does not pose a threat of harm. (Code Civ. Proc., § 527.9(f).) 

d.

e.

• 
• 

• 

Form Adopted for Mandatory Use  
Judicial Council of California  
CR-162 [Rev. March 1, 2023] 
Approved by Department of Justice

ORDER TO SURRENDER FIREARMS IN DOMESTIC VIOLENCE CASE 
(CLETS-CPO)

Page 1 of 1

Penal Code, §§ 136.2, 166 
www.courts.ca.gov