Clerk stamps date here when form is filed.

Fill in court name and street address:

Superior Court of California, County of

Court fills in case number when form is filed.

Case Number:

GV-110

Temporary Gun Violence  
Restraining Order

Petitioner must complete items       and       only.

1

2

a. Your Full Name or Name of Law Enforcement Agency:

1 Petitioner

 I am:

A family member of the Respondent
An officer of a law enforcement agency
An employer of the Respondent 
A coworker of the Respondent
An employee or teacher of a secondary or postsecondary 
school that the Respondent has attended in the last 6 
months

b.

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

State Bar No.:

c. 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. Law enforcement officer, give agency 
information.) 

Address:

City:

Telephone:
Email Address:

2 Respondent

State:

Zip:

Fax:

(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:

*Gender: M

F

Home Address:

Height:
Nonbinary

City:
Relationship to Protected Person:

State:

Zip:

*Age:

Date of Birth:

Weight:

Hair Color:

Eye Color:

The court will complete the rest of this form.

3

Expiration Date
This Order expires at the end of the hearing scheduled for the date and time below: 

Date:

Time:

a.m.

p.m.

Judicial Council of California,   
Rev. January 1, 2023, Mandatory Form 
Penal Code, § 18150 et seq. 
Approved by DOJ

Temporary Gun Violence Restraining Order  
(CLETS-TGV) (Gun Violence Prevention)

GV-110, Page 1 of 5

This is a Court Order.

Case Number:

4

Findings

Having examined

Petitioner

and other witnesses

under oath,

Having considered the declarations of

Petitioner

and other witnesses

under penalty of perjury,

a. The court finds that there is a substantial likelihood that both of the following are true:

(1) Respondent poses a significant danger in the near future of causing personal injury to themself or another 

(2)

person by having in their custody or control, owning, purchasing, possessing, or receiving firearms, firearm  
parts (any receiver, frame, or unfinished receiver or frame as defined in Penal Code section 16531),  
ammunition, or magazines.
A temporary gun violence restraining order is necessary to prevent personal injury to Respondent or to 
another person because less restrictive alternatives either have been tried and found to be ineffective, or 
have been determined to be inadequate or inappropriate for the current circumstances.
The court has received credible information that Respondent owns or possesses one or more firearms, 
firearm parts, ammunition, or magazines. 

The facts as stated in the Petition and supporting documents, which are incorporated here by reference, 
establish sufficient grounds for the issuance of this Order.  And for the reasons stated below.

b.

c.

See the attached Attachment (form MC-025).

5 No Fee to Serve (Notify) Restrained Person  

If the sheriff or marshal serves this order, service will be free.

Rev. January 1, 2023

Temporary Gun Violence Restraining Order 
(CLETS-TGV) (Gun Violence Prevention)

GV-110, Page 2 of 5

This is a Court Order.

Case Number:

6 No Firearms (Guns), Firearm Parts, Ammunition, and Magazines

a. You cannot have in your custody or control, own, purchase, possess, or receive, or attempt to purchase or 

receive, any prohibited items listed below in b.

b. Prohibited items are:

(1)

Firearms (guns);

(3) Ammunition; and

(4) Magazines (ammunition feeding devices).

(2) Firearm parts (any receiver, frame, or unfinished receiver or frame as defined in Penal Code section 16531);

c. The court has received credible information that you own or possess one or more prohibited items that have not 
been turned in, sold, or stored. You must surrender (turn in, sell, or store) all prohibited items in your custody or 
control or that you possess or own. If a law enforcement officer asks you to turn over your prohibited items, you 
must do so immediately. If no request is made by a law enforcement officer, you must surrender all prohibited 
items within 24 hours of being served with this Order. You may surrender these items by turning them in to law 
enforcement, selling them to a licensed gun dealer, or storing them with a licensed gun dealer for as long as this 
Order or any more permanent order granted at the hearing in item      is in effect.

3

d.

Within 48 hours of receiving this Order, you must file a receipt with the court that proves that all your prohibited 
items have been turned in, sold, or stored. (You may use Receipt for Firearms, Firearm Parts, Ammunition, and 
Magazines (form GV-800) for the receipt.) You must also file a copy of the receipt with the law enforcement 
agency that served you with this order. FAILURE TO FILE THIS RECEIPT IS A VIOLATION OF THIS 
ORDER.

7 Number of pages attached to this Order, if any:

Date:

Warnings and Notices to the Respondent

Judicial Officer

To the restrained person: This Order is valid until the expiration date and time noted on page 
1. You are required to surrender all firearms, ammunition, and magazines that you own or 
possess in accordance with section 18120 of the Penal Code and you may not have in your 
custody or control, own, purchase, possess, or receive, or attempt to purchase or receive, any 
firearm, ammunition, or magazines while this order is in effect.  A hearing will be held on the 
date and at the time noted on Page 1 to determine if a more permanent gun violence 
restraining order should be issued. Failure to appear at the hearing may result in a court 
making an order against you that is valid for a period between one and five years. You may 
seek the advice of an attorney as to any matter connected with the order. The attorney should 
be consulted promptly so that the attorney may assist you in any matter connected with the 
order.
Violation of this Order is a misdemeanor. If you violate this Order, you will be prohibited from 
having in your custody or control, owning, purchasing, possessing, or receiving, or 
attempting to purchase or receive, any prohibited items listed in item 6b, above, for a period 
of five years. This Order must be enforced by any law enforcement officer in the state of 
California who is aware of or shown a copy of this Order. The Order remains enforceable 
regardless of the acts of the parties; it may be changed only by an order of the court.

This is a Court Order.

Rev. January 1, 2023

Temporary Gun Violence Restraining Order 
(CLETS-TGV) (Gun Violence Prevention)

GV-110, Page 3 of 5

Case Number:

After You Have Been Served With a Temporary Order

•

•

•

•

•

•

•

•

Obey the order by turning in all firearms (guns), firearm parts, ammunition, and magazines to a law enforcement 
agency or selling them to or storing them with a licensed gun dealer.

Read How Can I Respond to a Petition for Gun Violence Restraining Order? (form GV-120-INFO) to learn how to 
respond to this Order.
If you do not oppose the petition, fill out Consent to Gun Violence Restraining Order and Surrender of Firearms (form 
GV-125) and file it with the court clerk. 

If you disagree with the petition, fill out Response to Petition for Gun Violence Restraining Order (form GV-120) and 
file it with the court clerk. 

You must have form GV-120 served by mail on the Petitioner or the Petitioner’s attorney. You cannot do this yourself. 
The person who does the mailing should complete and sign Proof of Service by Mail (form GV-250). File the 
completed proof of service with the court clerk before the hearing date or bring it with you to the hearing.

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 Declaration (form MC-030) 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 attend the  
hearing. You and your witnesses may attend the hearing remotely (check with your court for instructions).

At the hearing, the judge can make a gun violence restraining order against you that lasts between one to five years. Tell 
the judge why you disagree with the order requested.

Instructions for Law Enforcement

Duties of Officer Serving This Order
The officer who serves this order on the Restrained Person must do the following:

•

Ask if the Restrained Person is in possession of any of the prohibited items listed in item 6b, above, or has 
custody or control of any that they have not already turned in.

•   Order the Restrained Person to immediately surrender to you all prohibited items.
•   Issue a receipt to the Restrained Person for all prohibited items that have been surrendered.
•   Complete a proof of personal service and file it with the court. You may use form GV-200 for this purpose. 
•   Within one business day of service, submit the proof of service directly into the California Restraining and 
Protective Order System (CARPOS), including the serving officer’s name and law enforcement agency.

Duties of Agency on Surrender of Firearms, Firearm Parts, Ammunition, or Magazines
The law enforcement agency that has received the surrendered prohibited items listed in item 6b, above, must do the 
following:

•  Retain the prohibited items until the termination or expiration of this Order or of any other gun violence restraining 

order issued by the court. 

•  On the expiration of this Order or of any later gun violence restraining order issued by the court, return the 

prohibited items to the respondent as provided by chapter 2 of division 11 of title 4 of the Penal Code (commencing 
with section 33850). Section 34000 provides for the sale or destruction of any unclaimed items.

Rev. January 1, 2023

Temporary Gun Violence Restraining Order 
(CLETS-TGV) (Gun Violence Prevention)

GV-110, Page 4 of 5

This is a Court Order.

Case Number:

Instructions for Law Enforcement
(continued)

•  If someone other than the Respondent claims title to any of the prohibited items surrendered, determine whether 

that person is the lawful owner. If so, return the prohibited items to that person as provided by chapter 2 of division 
11 of title 4 of the Penal Code (commencing with section 33850).

Enforcing This Order

The law enforcement officer should determine if the Respondent had notice of the order. Consider the Respondent 
“served” (given notice) if:

•  The officer sees a copy of the proof of service or confirms that the proof of service is on file; or
•  The Respondent was informed of the order by an officer; or
•  The officer sees a filed copy of form GV-125.

An officer can obtain information about the contents of the order and proof of service in CARPOS. If proof of service on 
the Respondent cannot be verified, the agency must advise the restrained person of the terms of the order and then enforce 
it (see above: Duties of Officer Serving This Order). 

The provisions in this Temporary Gun Violence Restraining Order do not affect those of any other protective or 
restraining order in effect, including a criminal protective order. The provisions in any other another existing protective 
order remain in effect. 

Clerk’s Certificate
[seal]

(Clerk will fill out this part.)
—Clerk's Certificate—

I certify that this Temporary Gun Violence Restraining Order (CLETS-TGV)
(form GV-110) is a true and correct copy of the  original on file in the court. 

Date:

Clerk, by

, Deputy

Rev. January 1, 2023

Temporary Gun Violence Restraining Order 
(CLETS-TGV) (Gun Violence Prevention)

GV-110, Page 5 of 5

This is a Court Order.