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Here is the text we could read:

CH-800

Receipt for Firearms and Firearm
Parts

Clerk stamps date here when form is filed.

1 Petitioner
Name:

2 Restrained Person

a. Your Name:

Your Lawyer (if you have one for this case):
Name:

State Bar No.:

Firm Name:

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.)

Fill in court name and street address:

Superior Court of California, County of

Address:

City:

Telephone:
Email Address:

State:

Fax:

Zip:

Court fills in case number when form is filed.

Case Number:

To the Restrained Person:
If a judge has ordered you to turn in, sell, or store your firearms (guns) and 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)—
use this form to prove to the judge that you have obeyed their orders. Take this form to a law enforcement officer or
a licensed gun dealer to complete item or . For more information on how to properly turn in your items, read
form CH-800-INFO, How Do I Turn In, Sell, or Store My Firearms and Firearm Parts?

(Complete the section below. Keep a copy and give the original to the person in .)2

To Law Enforcement

Name of Law Enforcement Agency:

Name of Law Enforcement Agent:
Address:

Telephone:

Email Address:

Items Surrendered
a. Firearms and firearm parts transferred on:

Date:

Time:

a.m.

p.m.

b. List of items (List all the items surrendered by the person in . You may attach a separate form from your
agency (e.g., a property report), use item , or both. Check below if you have attached a separate form):

Separate form is attached. (If it does not include all surrendered items, list additional items in item .)

I declare under penalty of perjury under the laws of the State of California that the information above is
true and correct.

Signature of law enforcement agent:

Judicial Council of California,
Rev. January 1, 2023, Optional Form
Code of Civil Procedure, §§ 527.6 and 527.9;
Penal Code, § 29830

Receipt for Firearms and Firearm Parts
(Civil Harassment Prevention)

CH-800, Page 1 of 3

Case Number:

To Licensed Gun Dealer

(Complete the section below. Keep a copy and give the original to the person in .)2

Name of Licensed Gun Dealer:

License number:

Address:
Telephone:

Email Address:

Items Stored or Sold
a. Firearms and firearm parts transferred on:

Date:

Time:

a.m.

p.m.

b. List of items (List all the items surrendered by the person in . You may attach a separate form (e.g.,

Department of Justice’s Report of Firearms Acquisition) or you may use item . Check below if you have
attached a separate form):

Separate form is attached. (If it does not include all surrendered items, list additional items in item .)

I declare under penalty of perjury under the laws of the State of California that the information above is
true and correct.

Signature of licensed gun dealer:

List of Items Surrendered

Firearms and firearm parts

Make

Model

Serial Number,
if there is one

Sold

Stored

To be
destroyed

(1)
(2)
(3)
(4)
(5)

(6)

Check here if there is not enough space above for your answer. Use a separate sheet of paper to list other items.
Write “CH-800, item 6” at the top, and attach it to this form.

Rev. January 1, 2023

Receipt for Firearms and Firearm Parts
(Civil Harassment Prevention)

CH-800, Page 2 of 3

Case Number:

7 To the Restrained Person:

Besides the items listed on page 2 or in an attached form, do you have or own any other firearms (guns) or firearm
parts?

Yes

(If yes, check one of the boxes below):

I filed a Receipt for Firearms and Firearm Parts (form CH-800) or other proof for those items with the
court on (date):

I am filing the proof for those firearms (guns) and firearm parts along with this proof.

I have not yet filed the proof for the other firearms (guns) and firearm parts.
(Explain why not):

I declare under penalty of perjury under the laws of the State of California that the information above is true and
correct.

Type or print your name

Sign your name

After the form is complete, make two additional copies. Take the copies and original to the court clerk to file.

Your signature

Date:

Your Next Steps

Keep a copy for yourself.

Note that failure to file a receipt with the court is a violation of the court's order.

Rev. January 1, 2023

Receipt for Firearms and Firearm Parts
(Civil Harassment Prevention)

CH-800, Page 3 of 3

Proof of Firearms Turned In, Sold, or Stored

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the California state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from selfhelp.courts.ca.gov (2023-03)
Page(s): 3
Fields(s): 83
Average fields per page: 27
Reading Level: Grade 6
LIST Grouping(s): Unknown

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

c_h_page_p_county_info was CH-800[0].Page1[0].P1Caption[0].County[0].CourtInfo_ft[0] (0.50 conf)
c_h_page_p_case_number__1 was CH-800[0].Page1[0].P1Caption[0].CaseNumber[0].CaseNumber_ft[0] (0.42 conf)
c_page_list_item_full_name was CH-800[0].Page1[0].List1[0].Item1[0].ProtectedFullName_ft[0] (0.36 conf)
c_h_page_list_li_respondent_full_name_ft was CH-800[0].Page1[0].List2[0].Li2A[0].RespondentFullName_ft[0] (0.35 conf)
c_h_page_list_li_respondent_lawyer_name_ft was CH-800[0].Page1[0].List2[0].Li2A[0].RespondentLawyerName_ft[0] (0.36 conf)
c_h_page_list_respondent_lawyer was CH-800[0].Page1[0].List2[0].Li2A[0].RespondentLawyerBar_no[0] (0.33 conf)
c_h_page_list_li_respondent_lawyer_firm_ft was CH-800[0].Page1[0].List2[0].Li2A[0].RespondentLawyerFirm_ft[0] (0.35 conf)
c_h_page_list_li_b_respondent_street_ft was CH-800[0].Page1[0].List2[0].Li2B[0].RespondentStreet_ft[0] (0.33 conf)
c_h_page_list_li_b_respondent_city_ft was CH-800[0].Page1[0].List2[0].Li2B[0].RespondentCity_ft[0] (0.36 conf)
c_h_page_list_li_b_respondent_state_ft was CH-800[0].Page1[0].List2[0].Li2B[0].RespondentState_ft[0] (0.37 conf)
c_h_page_list_li_b_respondent_zip_ft was CH-800[0].Page1[0].List2[0].Li2B[0].RespondentZip_ft[0] (0.31 conf)
c_h_page_list_li_b_respondent_phone_ft was CH-800[0].Page1[0].List2[0].Li2B[0].RespondentPhone_ft[0] (0.33 conf)
c_h_page_list_li_b_respondent_fax_ft was CH-800[0].Page1[0].List2[0].Li2B[0].RespondentFax_ft[0] (0.37 conf)
c_h_page_list_b_e_mail was CH-800[0].Page1[0].List2[0].Li2B[0].RestrainedE-Mail_ft[0] (0.40 conf)
c_h_page_list_section_agency was CH-800[0].Page1[0].List4[0].LESection[0].Agency[0] (0.35 conf)
c_h_page_list_section_agent was CH-800[0].Page1[0].List4[0].LESection[0].Agent[0] (0.35 conf)
c_h_page_list_section_address was CH-800[0].Page1[0].List4[0].LESection[0].LEAddress[0] (0.30 conf)
c_h_page_le_section_l was CH-800[0].Page1[0].List4[0].LESection[0].LEphone[0] (0.32 conf)
c_page_list_le_section_l_email was CH-800[0].Page1[0].List4[0].LESection[0].LEmail[0] (0.32 conf)
c_h_page_section_sold_dt was CH-800[0].Page1[0].List4[0].LESection[0].Sublist4[0].Li4A[0].SoldDate_dt[0] (0.40 conf)
c_h_page_section_time_dt was CH-800[0].Page1[0].List4[0].LESection[0].Sublist4[0].Li4A[0].SoldTime_dt[0] (0.39 conf)
c_h_page_list_le_section__1 was CH-800[0].Page1[0].List4[0].LESection[0].Sublist4[0].Li4A[0].ampm[0] (0.36 conf)
c_h_page_list_le_section__2 was CH-800[0].Page1[0].List4[0].LESection[0].Sublist4[0].Li4A[0].ampm[1] (0.36 conf)
page_section_check_box_right was CH-800[0].Page1[0].List4[0].LESection[0].Sublist4[0].CheckBoxRightCaption[0] (0.35 conf)
c_h_page_p_case_number__2 was CH-800[0].Page2[0].P2Caption[0].CaseNumber_ft[0] (0.36 conf)
c_h_page_list_item_dealer__1 was CH-800[0].Page2[0].List5[0].Item5[0].Dealer[0] (0.40 conf)
c_h_page_list_item_license was CH-800[0].Page2[0].List5[0].Item5[0].License[0] (0.40 conf)
c_h_page_list_item_dealer__2 was CH-800[0].Page2[0].List5[0].Item5[0].DealerAddress[0] (0.34 conf)
c_h_list_item_dealer_phone was CH-800[0].Page2[0].List5[0].Item5[0].DealerPhone[0] (0.34 conf)
c_h_list_item_dealer_email was CH-800[0].Page2[0].List5[0].Item5[0].DealerEmail[0] (0.34 conf)
c_list_item_sold_date_dt was CH-800[0].Page2[0].List5[0].Item5[0].Sublist5[0].Li5a[0].SoldDate_dt[0] (0.36 conf)
c_h_item_sold_time_dt was CH-800[0].Page2[0].List5[0].Item5[0].Sublist5[0].Li5a[0].SoldTime_dt[0] (0.37 conf)
c_h_page_list_item_sublist_li_timeapm__1 was CH-800[0].Page2[0].List5[0].Item5[0].Sublist5[0].Li5a[0].timeapm[0] (0.39 conf)
c_h_page_list_item_sublist_li_timeapm__2 was CH-800[0].Page2[0].List5[0].Item5[0].Sublist5[0].Li5a[0].timeapm[1] (0.39 conf)
c_item_b_check_box_right was CH-800[0].Page2[0].List5[0].Item5[0].Sublist5[0].Li5b[0].CheckBoxRightCaption1[0] (0.40 conf)
c_page_item_check_box_right was CH-800[0].Page2[0].List6[0].Item6[0].CheckBoxRightCaption[0] (0.35 conf)
c_h_page_list_item_firearm__1 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm1[0].TextField1[0] (0.42 conf)
c_h_page_list_item_firearm__2 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm1[0].TextField11[0] (0.42 conf)
c_h_page_list_item_firearm__3 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm1[0].TextField111[0] (0.42 conf)
c_h_list_item_firearm_choice__1 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm1[0].Choice[0] (0.38 conf)
c_h_list_item_firearm_choice__2 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm1[0].Choice[1] (0.38 conf)
c_h_list_item_firearm_choice__3 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm1[0].Choice[2] (0.38 conf)
c_h_page_list_item_firearm__4 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm2[0].TextFieldm[0] (0.42 conf)
c_h_page_list_item_firearm__5 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm2[0].TextFieldn[0] (0.42 conf)
c_h_page_list_item_firearm__6 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm2[0].TextFieldo[0] (0.42 conf)
c_h_list_item_firearm_choice__4 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm2[0].Choice[0] (0.38 conf)
c_h_list_item_firearm_choice__5 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm2[0].Choice[1] (0.38 conf)
c_h_list_item_firearm_choice__6 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm2[0].Choice[2] (0.38 conf)
c_h_page_list_item_firearm__7 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm3[0].TextField3[0] (0.42 conf)
c_h_page_list_item_firearm__8 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm3[0].TextField33[0] (0.42 conf)
c_h_page_list_item_firearm__9 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm3[0].TextField333[0] (0.42 conf)
c_h_list_item_firearm_choice__7 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm3[0].Choice[0] (0.38 conf)
c_h_list_item_firearm_choice__8 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm3[0].Choice[1] (0.38 conf)
c_h_list_item_firearm_choice__9 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm3[0].Choice[2] (0.38 conf)
c_h_page_list_item_firearm__10 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm4[0].TextField4[0] (0.42 conf)
c_h_page_list_item_firearm__11 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm4[0].TextField44[0] (0.42 conf)
c_h_page_list_item_firearm__12 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm4[0].TextField444[0] (0.42 conf)
c_h_list_item_firearm_choice__10 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm4[0].Choice[0] (0.38 conf)
c_h_list_item_firearm_choice__11 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm4[0].Choice[1] (0.38 conf)
c_h_list_item_firearm_choice__12 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm4[0].Choice[2] (0.38 conf)
c_h_page_list_item_firearm__13 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm5[0].TextField5[0] (0.42 conf)
c_h_page_list_item_firearm__14 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm5[0].TextField55[0] (0.42 conf)
c_h_page_list_item_firearm__15 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm5[0].TextField555[0] (0.42 conf)
c_h_list_item_firearm_choice__13 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm5[0].Choice[0] (0.38 conf)
c_h_list_item_firearm_choice__14 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm5[0].Choice[1] (0.38 conf)
c_h_list_item_firearm_choice__15 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm5[0].Choice[2] (0.38 conf)
c_h_page_list_item_firearm__16 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm6[0].TextField6[0] (0.42 conf)
c_h_page_list_item_firearm__17 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm6[0].TextField66[0] (0.42 conf)
c_h_page_list_item_firearm__18 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm6[0].TextField666[0] (0.42 conf)
c_h_list_item_firearm_choice__16 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm6[0].Choice[0] (0.38 conf)
c_h_list_item_firearm_choice__17 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm6[0].Choice[1] (0.38 conf)
c_h_list_item_firearm_choice__18 was CH-800[0].Page2[0].List6[0].Item6[0].FirearmTable[0].Firearm6[0].Choice[2] (0.38 conf)
c_h_page_list_item_proof_f was CH-800[0].Page2[0].List6[0].Item6[0].ProofWhyNotOF_cb[0] (0.36 conf)
c_h_page_p_case_number__3 was CH-800[0].Page3[0].P3Caption[0].CaseNumber_ft[0] (0.36 conf)
c_h_page_list_filingbbb was CH-800[0].Page3[0].List7[0].#subform[0].Filingbbb[0] (0.38 conf)
c_h_page_list_subform_filingc was CH-800[0].Page3[0].List7[0].#subform[1].Filingc[0] (0.38 conf)
c_h_page_list_excuse_ft was CH-800[0].Page3[0].List7[0].#subform[1].Excuse_ft[0] (0.33 conf)
c_h_page_list_subform_turned_date_dt was CH-800[0].Page3[0].List7[0].#subform[2].TurnedInDate_dt[0] (0.37 conf)
c_page_list_check_box_right was CH-800[0].Page3[0].List7[0].#subform[2].CheckBoxRightCaption[0] (0.34 conf)
c_h_page_list_firearm__1 was CH-800[0].Page3[0].List7[0].firearm[0] (0.33 conf)
c_h_page_list_firearm__2 was CH-800[0].Page3[0].List7[0].firearm[1] (0.33 conf)
c_h_page_sign_sig_date was CH-800[0].Page3[0].Sign[0].SigDate[0] (0.34 conf)
c_h_page_sign_name_tf was CH-800[0].Page3[0].Sign[0].YourName_tf[0] (0.37 conf)

We've done our best to group similar variables togther to avoid overwhelming the user.

Suggested Screen 0:

c_h_page_p_county_info
c_h_page_p_case_number__1
c_page_list_item_full_name
c_h_page_list_li_respondent_full_name_ft
c_h_page_list_li_respondent_lawyer_name_ft
c_h_page_list_respondent_lawyer
c_h_page_list_li_respondent_lawyer_firm_ft
c_h_page_list_li_b_respondent_street_ft
c_h_page_list_li_b_respondent_city_ft
c_h_page_list_li_b_respondent_state_ft
c_h_page_list_li_b_respondent_zip_ft
c_h_page_list_li_b_respondent_phone_ft
c_h_page_list_li_b_respondent_fax_ft
c_h_page_list_b_e_mail
c_h_page_list_section_agency
c_h_page_list_section_agent
c_h_page_list_section_address
c_h_page_le_section_l
c_page_list_le_section_l_email
c_h_page_section_sold_dt
c_h_page_section_time_dt
c_h_page_list_le_section__1
c_h_page_list_le_section__2
page_section_check_box_right
c_h_page_p_case_number__2
c_h_page_list_item_dealer__1
c_h_page_list_item_license
c_h_page_list_item_dealer__2
c_h_list_item_dealer_phone
c_h_list_item_dealer_email
c_list_item_sold_date_dt
c_h_item_sold_time_dt
c_h_page_list_item_sublist_li_timeapm__1
c_h_page_list_item_sublist_li_timeapm__2
c_item_b_check_box_right
c_page_item_check_box_right
c_h_page_list_item_firearm__1
c_h_page_list_item_firearm__2
c_h_page_list_item_firearm__3
c_h_list_item_firearm_choice__1
c_h_list_item_firearm_choice__2
c_h_list_item_firearm_choice__3
c_h_page_list_item_firearm__4
c_h_page_list_item_firearm__5
c_h_page_list_item_firearm__6
c_h_list_item_firearm_choice__4
c_h_list_item_firearm_choice__5
c_h_list_item_firearm_choice__6
c_h_page_list_item_firearm__7
c_h_page_list_item_firearm__8
c_h_page_list_item_firearm__9
c_h_list_item_firearm_choice__7
c_h_list_item_firearm_choice__8
c_h_list_item_firearm_choice__9
c_h_page_list_item_firearm__10
c_h_page_list_item_firearm__11
c_h_page_list_item_firearm__12
c_h_list_item_firearm_choice__10
c_h_list_item_firearm_choice__11
c_h_list_item_firearm_choice__12
c_h_page_list_item_firearm__13
c_h_page_list_item_firearm__14
c_h_page_list_item_firearm__15
c_h_list_item_firearm_choice__13
c_h_list_item_firearm_choice__14
c_h_list_item_firearm_choice__15
c_h_page_list_item_firearm__16
c_h_page_list_item_firearm__17
c_h_page_list_item_firearm__18
c_h_list_item_firearm_choice__16
c_h_list_item_firearm_choice__17
c_h_list_item_firearm_choice__18
c_h_page_list_item_proof_f
c_h_page_p_case_number__3
c_h_page_list_filingbbb
c_h_page_list_subform_filingc
c_h_page_list_excuse_ft
c_h_page_list_subform_turned_date_dt
c_page_list_check_box_right
c_h_page_list_firearm__1
c_h_page_list_firearm__2
c_h_page_sign_sig_date
c_h_page_sign_name_tf

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Proof of Firearms Turned In, Sold, or Stored

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The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02