EA-110

Temporary Restraining Order

Clerk stamps date here when form is filed.

Person in       must complete items       ,       and        only.

1

2

1

3

1 Protected Elder or Dependent Adult

a.

Full Name:

Person requesting protection for the elder or dependent adult, if 
different (person named in item      of form EA-100):

3

Lawyer for person named above (if any, for this case):
Name:

State Bar No.:

Fill in court name and street address:

Superior Court of California, County of

Your Address (If you have a lawyer, give your lawyer’s information. 
If you do not have a lawyer and want to keep your home address 
private, you may give a different mailing address instead. You do not 
have to give telephone, fax, or email.):
Address:

State:

Fax:

Zip:

Court fills in case number when form is filed.

Case Number:

Full Name:

Firm Name:

b.

City:

Telephone:

Email Address:

2 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:

*Race:

City:

*Gender:

M

F

Nonbinary

Home Address:

State:

Zip:

Height:

Weight:

Hair Color:

Eye Color:

*Age:

Date of Birth:

Relationship to Protected Person:

3

Additional Protected Persons

In addition to the elder or dependent adult named in      , the following family or household members or 
conservator of that person are protected by the temporary orders indicated below:

1

Full Name

Gender Age Household Member? Relation to Protected Person

Yes

Yes

No

No

Check here if there are additional protected persons. List them on an attached sheet of paper and write 
“Attachment 3—Additional Protected Persons” as a title. You may use form MC-025, Attachment.

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,   
Rev. January 1, 2023, Mandatory Form 
Code of Civil Procedure, § 527.9; 
Welfare and Institutions Code, § 15657.03 
Approved by DOJ

Temporary Restraining Order 
(CLETS-TEA or TEF) 
(Elder or Dependent Adult Abuse Prevention)

EA-110, Page 1 of 6

(1)

(2)

(3)

(1)

(2)

(3)

(4)

Case Number:

To the Person in     :2
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 must not do the following things to the elder or dependent adult named in  1

  and to the other protected persons listed in      : 3

Physically abuse, financially abuse, intimidate, molest, attack, strike, stalk, threaten, assault (sexually or 
otherwise), hit, harass, destroy personal property of, or disturb the peace of the person.

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 interoffice mail, by email, by text messages, by fax, 
or by other electronic means. 

Take any action to obtain the person’s address or location. If this item       is not checked, the court has  
found good cause not to make this order.

3

(4)

Other (specify):

Other personal conduct orders are attached at the end of this Order on Attachment 5a(4).

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 person in      .1

6

Stay-Away Orders
Not Requested

Denied Until the Hearing

Granted as Follows:

a. You must stay at least                         yards away from (check all that apply):

The elder or dependent adult in 1

The vehicle of the person in  1

(5)

(6)

Other (specify):

Each person in 

3

The home of the elder or 
dependent adult

The job or workplace of the elder 
or dependent adult

b.

This stay-away order does not prevent you from going to or from your home or place of employment.

7 Move-Out Order

Not Requested

Denied Until the Hearing

Granted as Follows:

You must immediately move out from and not return to (address):

Rev. January 1, 2023

Temporary Restraining Order (CLETS-TEA or TEF) 
(Elder or Dependent Adult Abuse Prevention)

EA-110, Page 2 of 6

This is a Court Order.

Case Number:

8 No Firearms (Guns), Firearm Parts, or Ammunition

Not Issued (financial abuse only)

Granted as Follows:

This order must be granted unless only financial abuse is alleged.

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 below.

b. Prohibited items are:

(1)

Firearms (guns);

(3)

Ammunition.

c. You must:

(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

(1)

(2)

Sell to or store with a licensed gun dealer, or turn in to a law enforcement agency, any firearms (guns) and 
firearm parts in your immediate possession or control. This must be done within 24 hours of being served 
with this Order. 
File a receipt with the court within 48 hours of receiving this Order that proves that your firearms (guns) 
and firearm parts have been turned in, sold, or stored. (You may use form EA-800, Receipt for Firearms 
and Firearm Parts, for the receipt.) 

d.

The court has received information that you own or possess a firearm (gun), firearm parts, or ammunition.

9

Financial Abuse
does not
This case                                              involve solely financial abuse unaccompanied by force, threat, harassment, 
intimidation, or any other form of abuse.

does

10 Possession and Protection of Animals

Not Requested

Denied Until the Hearing

Granted as Follows (specify):

1

The person in       is given the sole possession, care, and control of the animals listed below, which are 
owned, possessed, leased, kept, or held by him or her, or reside in his or her household. 
(Identify animals by, e.g., type, breed, name, color, sex.)

The person in      must stay at least           yards away from, and not take, sell, transfer, encumber, conceal, 
molest, attack, strike, threaten, harm, or otherwise dispose of, the animals listed above.

2

Rev. January 1, 2023

Temporary Restraining Order (CLETS-TEA or TEF) 
(Elder or Dependent Adult Abuse Prevention)

EA-110, Page 3 of 6

This is a Court Order.

a.

b.

Case Number:

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 Person in     :1

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.

b.

c.

The clerk will enter this Order and its proof of service form into CARPOS.

The clerk will transmit this Order and its proof of service form to a law enforcement agency to be entered  
into CARPOS.

By the close of business on the date that this Order is made, the petitioner or the petitioner’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.

13 No Fee to Serve (Notify) Restrained Person

If the sheriff or marshal serves this Order, he or she will do it for free.

14

Number of pages attached to this Order, if any:

Date:

Judicial Officer

Rev. January 1, 2023

Temporary Restraining Order (CLETS-TEA or TEF) 
(Elder or Dependent Adult Abuse Prevention)

EA-110, Page 4 of 6

This is a Court Order.

Case Number:

Warnings and Notices to the Restrained Person in 2

You Cannot Have Firearms (Guns), Firearm Parts, or Ammunition 

If the court grants the orders in item      , you cannot own, have, possess, buy or try to buy, receive or try to receive, or 
otherwise get any prohibited items listed in item 8b 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) and firearm parts that you have or control as stated in item      . The court will require you to prove that 
you did so.

8

8

Notice Regarding Nonappearance at Hearing and Service of Order
If you have been personally served with this Temporary Restraining Order and form EA-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 does not differ from this 
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 item      .

2

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.

After You Have Been Served With a Restraining Order

Obey all the orders.

Read form EA-120-INFO, How Can I Respond to a Request for Elder or Dependent Adult Abuse Retraining Orders?, 
to learn how to respond to this Order.

If you want to respond, fill out form EA-120, Response to Request for Elder or Dependent Adult Abuse Restraining 
Orders, and file it with the court clerk. You do not have to pay any fee to file your response.
You must have form EA-120 served on the person in       (the person asking the court for protection of the elder or 
dependent adult or the elder or dependent adult if no other person is named in that item), or that person’s attorney, by 
mail. You cannot do this yourself. The person who does the mailing should complete and sign form EA-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.

1

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 www.courts.ca.gov/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 five years. Tell the judge why you 
disagree with the orders requested.

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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 Order System (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.

Rev. January 1, 2023

Temporary Restraining Order (CLETS-TEA or TEF) 
(Elder or Dependent Adult Abuse Prevention)

EA-110, Page 5 of 6

This is a Court Order.

Case Number:

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 item       on 
page 1.

4

Arrest Required if Order Is Violated
If an officer has probable cause to believe that the restrained person had notice of the order and has disobeyed the order, 
the officer must arrest the restrained person. (Pen. Code, §§ 836(c)(1), 13701(b).) A violation of the order may be a 
violation of Penal Code section 166 or 273.6. Agencies are encouraged to enter violation messages into CARPOS.

Notice/Proof of Service
The law enforcement agency must first determine if the restrained person had notice of the order. Consider the restrained 
person “served” (given notice) if (Pen. Code, § 836(c)(2)):
•  The officer sees a copy of the proof of service or confirms that the proof of service is on file; or
•  The restrained person was informed of the order by an officer.
An officer can obtain information about the contents of the order and proof of service in CARPOS. If proof of service on 
the restrained person cannot be verified, the agency must advise the restrained person of the terms of the order and  then 
enforce it.

If the Protected Person Contacts the Restrained Person
Even if the 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).)

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

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 be enforced.  

2.  No-Contact Order: If a restraining/protective order includes a no-contact order, the no-contact order must be  

enforced. Item 5a(2) is an example of a no-contact order. 

3.  Criminal Protective Order (CPO): If none of the orders include an EPO or a no-contact order, the most recent 

CPO must be enforced. (Fam. Code, §§ 6383(h)(2) and 6405(b).) 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 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 be enforced.

(Clerk will fill out this part.)

—Clerk's Certificate—

Clerk’s Certificate
[seal]

I certify that this Temporary Restraining Order is a true and correct copy of the  
original on file in the court. 

Date:

Clerk, by

, Deputy

This is a Court Order.

Rev. January 1, 2023

Temporary Restraining Order (CLETS-TEA or TEF) 
(Elder or Dependent Adult Abuse Prevention)

EA-110, Page 6 of 6