DV-170

Notice of Order Protecting 
Information of Minor

Clerk stamps date here when form is filed.

1

Confidential Information
The court has made some information in this case confidential.  
Details of the order for confidentiality are in form DV-165, Order on 
Request to Keep Minor's Information Confidential. Confidential 
information may be given only to law enforcement to enforce the 
restraining order.

2

Documents Attached to This Notice
The following documents contain confidential information:

a.
b.
c.

d.
e.
f.

g.

h.

Form DV-100, Request for Domestic Violence Restraining Order
Form DV-109, Notice of Court Hearing
Form DV-110, Temporary Restraining Order
Form DV-130, Restraining Order After Hearing
Form DV-160, Request to Keep Minor's Information Confidential
Form DV-165, Order on Request to Keep Minor's Information 
Confidential

Form DV-175, Cover Sheet for Confidential Information (leave 
blank)

Other:

Fill in court name and street address:
Superior Court of California, County of

Court fills in case number when form is filed.

Case Number:

Instructions to Clerk 
When providing copies of  
unredacted filed documents to any 
party, you must attach this cover 
sheet on top of the document or set 
of documents. Complete item       to 
indicate the forms that are attached.

2

3

Filing Documents
If you file any document that contains any confidential information in this case, other family law case, or other civil 
case with the same parties, you must also use form DV-175 as a cover sheet. See form DV-165, item       for all 
information made confidential by the court.  

7

4

To person receiving this notice: 

Unless authorized by the court or by law, you may be sanctioned up to $1,000 or face other court penalties if you 
misuse or disclose the information that is confidential in this case to anyone other than law enforcement. See Family 
Code section 6301.5(c)(2) for the limited situations in which disclosures can be made without the court's permission. 

Judicial Council of California, www.courts.ca.gov  
Rev. September 1, 2020, Mandatory Form 
Family Code, § 6301.5

Notice of Order Protecting Information of Minor

DV-170, Page 1 of 1