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Here is the text we could read:

ATTORNEY OR PARTY WITHOUT ATTORNEY:

STATE BAR NO.:

CR-110/JV-790

FOR COURT USE ONLY

STATE:

FAX NO.:

ZIP CODE:

SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:

NAME:

FIRM NAME:

STREET ADDRESS:

CITY:

TELEPHONE NO.:

EMAIL ADDRESS:

ATTORNEY FOR (name):

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

CASE NAME:

ORDER FOR VICTIM RESTITUTION 

CASE NUMBER:

1. a.  

On (date):
 was convicted of a crime that entitles the victim to restitution.

defendant (name): 

On (date):
was found to be a person described in Welfare and Institutions Code section 602, 
which entitles the victim to restitution.

Wardship is terminated.

child (name):

Parents or guardians jointly and severally liable (name each):

Co-offenders found jointly and severally liable  (name each):

2. Evidence was presented that the victim named below suffered losses as a result of defendant's/child's conduct. Defendant/child  

was informed of his or her right to a judicial determination of the amount of restitution and

a hearing was conducted.
stipulated to the amount of restitution to be ordered.
waived a hearing.

3. THE COURT ORDERS defendant/child to pay restitution to

the victim (name):  
the California Victim Compensation Board, to reimburse payments to the victim from the Restitution Fund, 
in the amount of:  $

in the amount of:  $

plus interest at 10 percent per year from the date of  
plus attorney fees and collection costs in the sum of:$

loss or  

sentencing.

b.

c.

d.

a.
b.
c.

a.

b.

c.
d.

Form Approved for Optional Use  
Judicial Council of California  
CR-110/JV-790  [Rev. January 1, 2023]

ORDER FOR VICTIM RESTITUTION 

Page 1 of 2

Penal Code, §§ 1202.4(f), 1214; 
Welfare and Institutions Code, § 730.6(h), (i), (q); 
 Civil Code, § 1714.1; Code of Civil Procedure, § 674(a)(7) 

www.courts.ca.gov

CASE NAME:

CASE NUMBER:

CR-110/JV-790

4. The amount of restitution includes

the value of property stolen or damaged.
medical expenses.
mental health counseling expenses.
lost wages or profits.

(1)   

incurred by the victim due to injury.

(2)            of the victim's parent(s) or guardian(s) (if victim is a child) incurred while caring for the injured child.
(3)            incurred by the victim due to time spent as a witness or in assisting police or prosecution.
(4)            of the victim's parent(s) or guardian(s) (if victim is a child) due to time spent as a witness or in assisting police  

or prosecution.

noneconomic losses (felony violations of Pen. Code, § 288, 288.5. and 288.7 only).
Other (specify):

JUDICIAL OFFICER

NOTICE TO VICTIMS

PENAL CODE SECTION 1214 PROVIDES THAT ONCE A DOLLAR AMOUNT OF RESTITUTION HAS BEEN ORDERED, THE  
ORDER IS THEN ENFORCEABLE AS IF IT WERE, AND IN THE SAME MANNER AS, A CIVIL JUDGMENT. ALTHOUGH THE 
CLERK OF THE COURT IS NOT ALLOWED TO GIVE LEGAL ADVICE, YOU ARE ENTITLED TO ALL RESOURCES 
AVAILABLE UNDER THE LAW TO OBTAIN OTHER INFORMATION TO ASSIST IN ENFORCING THE ORDER.  

HIS ORDER DOES NOT EXPIRE UNDER PENAL CODE SECTION 1214(d).  

OU MUST FILE A SATISFACTION OF JUDGMENT WITH THE COURT WHEN THIS ORDER IS SATISFIED, AS REQUIRED BY 

PENAL CODE SECTION 1214(b). 

OU ARE ENTITLED TO A CERTIFIED COPY OF THIS ORDER UPON REQUEST, AS REQUIRED BY PENAL CODE SECTION 

1214(b) AND WELFARE AND INSTITUTIONS CODE SECTION 730.7(c).

a.
b.
c.
d.

e.
f.

Date:

  T

  Y

  Y

CR-110/JV-790  [Rev. January 1, 2023]

ORDER FOR VICTIM RESTITUTION 

Page 2 of 2

Order for Victim Restitution

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): 2
Fields(s): 58
Average fields per page: 29
Reading Level: Grade 8
LIST Grouping(s): CO-07-00-00-00, CO-00-00-00-00.

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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.

cr_jv_page_std_p_header_sf_atty_info_state_ft was cr110jv790[0].Page1[0].StdP1Header_sf[0].AttyInfo[0].AttyState_ft[0] (0.58 conf)
page_std_p_header_sf_info_zip was cr110jv790[0].Page1[0].StdP1Header_sf[0].AttyInfo[0].AttyZip_ft[0] (0.38 conf)
cr_jv_page_std_p_header_sf_atty_info_city_ft was cr110jv790[0].Page1[0].StdP1Header_sf[0].AttyInfo[0].AttyCity_ft[0] (0.40 conf)
page_std_p_header_info_street was cr110jv790[0].Page1[0].StdP1Header_sf[0].AttyInfo[0].AttyStreet_ft[0] (0.38 conf)
cr_jv_page_std_p_header_sf_atty_info_firm_ft was cr110jv790[0].Page1[0].StdP1Header_sf[0].AttyInfo[0].AttyFirm_ft[0] (0.45 conf)
page_std_p_header_sf_info_name was cr110jv790[0].Page1[0].StdP1Header_sf[0].AttyInfo[0].AttyName_ft[0] (0.37 conf)
cr_jv_page_std_p_header_sf_atty_info_bar_dc was cr110jv790[0].Page1[0].StdP1Header_sf[0].AttyInfo[0].AttyBarNo_dc[0] (0.40 conf)
cr_jv_page_std_p_header_sf_atty_info_phone_ft was cr110jv790[0].Page1[0].StdP1Header_sf[0].AttyInfo[0].Phone_ft[0] (0.40 conf)
page_std_p_header_sf_info_ft__1 was cr110jv790[0].Page1[0].StdP1Header_sf[0].AttyInfo[0].Fax_ft[0] (0.42 conf)
page_std_p_header_info_email was cr110jv790[0].Page1[0].StdP1Header_sf[0].AttyInfo[0].Email_ft[0] (0.43 conf)
page_std_p_header_sf_info_ft__2 was cr110jv790[0].Page1[0].StdP1Header_sf[0].AttyInfo[0].AttyFor_ft[0] (0.40 conf)
page_std_p_sf_info_county was cr110jv790[0].Page1[0].StdP1Header_sf[0].CourtInfo[0].CrtCounty_ft[0] (0.38 conf)
cr_jv_page_std_p_header_sf_court_info_branch_ft was cr110jv790[0].Page1[0].StdP1Header_sf[0].CourtInfo[0].Branch_ft[0] (0.37 conf)
cr_jv_page_std_p_header_sf_court_info_city_zip_ft was cr110jv790[0].Page1[0].StdP1Header_sf[0].CourtInfo[0].CityZip_ft[0] (0.40 conf)
cr_jv_page_std_p_header_sf_court_info_street_ft was cr110jv790[0].Page1[0].StdP1Header_sf[0].CourtInfo[0].Street_ft[0] (0.42 conf)
cr_jv_page_std_p_header_sf_court_info_mailing_add_ft was cr110jv790[0].Page1[0].StdP1Header_sf[0].CourtInfo[0].MailingAdd_ft[0] (0.41 conf)
page_std_p_title_party_name was cr110jv790[0].Page1[0].StdP1Header_sf[0].TitlePartyName[0].CaseName_ft[0] (0.37 conf)
cr_jv_page_std_p_header_sf_case_number_ft was cr110jv790[0].Page1[0].StdP1Header_sf[0].CaseNumber[0].CaseNumber_ft[0] (0.40 conf)
cr_jv_page_list_li_c_b__1 was cr110jv790[0].Page1[0].List1[0].Li1a[0].CB1[0] (0.38 conf)
cr_jv_page_list_li_date was cr110jv790[0].Page1[0].List1[0].Li1a[0].on_date1[0] (0.35 conf)
cr_jv_page_list_li_defname was cr110jv790[0].Page1[0].List1[0].Li1a[0].defname[0] (0.35 conf)
cr_jv_page_list_li_b_c__1 was cr110jv790[0].Page1[0].List1[0].Li1b[0].CB2[0] (0.38 conf)
cr_jv_page_list_li_b_date was cr110jv790[0].Page1[0].List1[0].Li1b[0].on_date2[0] (0.35 conf)
cr_jv_page_list_li_b_child_name was cr110jv790[0].Page1[0].List1[0].Li1b[0].ChildName[0] (0.35 conf)
cr_jv_page_list_li_b_c__2 was cr110jv790[0].Page1[0].List1[0].Li1b[0].CB3[0] (0.38 conf)
cr_jv_page_list_li_c_b__2 was cr110jv790[0].Page1[0].List1[0].Li1c[0].CB4[0] (0.38 conf)
cr_jv_page_list_li_c_parent_guardian was cr110jv790[0].Page1[0].List1[0].Li1c[0].ParentOrGuardian[0] (0.41 conf)
jv_page_list_li_c_po_g was cr110jv790[0].Page1[0].List1[0].Li1c[0].POG2[0] (0.37 conf)
cr_jv_page_list_li_c_b__3 was cr110jv790[0].Page1[0].List1[0].Li1d[0].CB5[0] (0.38 conf)
jv_page_list_li_co_offenders was cr110jv790[0].Page1[0].List1[0].Li1d[0].CoOffenders[0] (0.38 conf)
cr_jv_page_list_li_co was cr110jv790[0].Page1[0].List1[0].Li1d[0].CoOff2[0] (0.38 conf)
cr_jv_page_list_li_c_b__4 was cr110jv790[0].Page1[0].List2[0].Li2a[0].CB6[0] (0.38 conf)
cr_jv_page_list_li_b_c__3 was cr110jv790[0].Page1[0].List2[0].Li2b[0].CB7[0] (0.38 conf)
cr_jv_page_list_li_c_b__5 was cr110jv790[0].Page1[0].List2[0].Li2c[0].CB8[0] (0.38 conf)
cr_jv_page_list_li_c_b__6 was cr110jv790[0].Page1[0].List3[0].Li3a[0].CB9[0] (0.38 conf)
cr_jv_page_list_li_victim_name was cr110jv790[0].Page1[0].List3[0].Li3a[0].VictimName[0] (0.37 conf)
cr_jv_page_list_li_amountof was cr110jv790[0].Page1[0].List3[0].Li3a[0].Amountof[0] (0.34 conf)
cr_jv_page_list_li_b_c__4 was cr110jv790[0].Page1[0].List3[0].Li3b[0].CB10[0] (0.38 conf)
cr_jv_page_list_li_b_amount was cr110jv790[0].Page1[0].List3[0].Li3b[0].Amount3b[0] (0.34 conf)
cr_jv_page_list_li_c_b__7 was cr110jv790[0].Page1[0].List3[0].Li3c[0].CB11[0] (0.38 conf)
cr_jv_page_list_li_c_loss__1 was cr110jv790[0].Page1[0].List3[0].Li3c[0].loss[0] (0.35 conf)
cr_jv_page_list_li_c_loss__2 was cr110jv790[0].Page1[0].List3[0].Li3c[0].loss[1] (0.35 conf)
cr_jv_page_list_li_c_b__8 was cr110jv790[0].Page1[0].List3[0].Li3d[0].CB14[0] (0.38 conf)
cr_jv_page_list_li_atty_fees was cr110jv790[0].Page1[0].List3[0].Li3d[0].AttyFees[0] (0.41 conf)
cr_jv_page_p_caption_case_name_ft was cr110jv790[0].Page2[0].P2Caption[0].CaseName[0].CaseName_ft[0] (0.39 conf)
cr_jv_page_p_caption_case_number_ft was cr110jv790[0].Page2[0].P2Caption[0].CaseNumber[0].CaseNumber_ft[0] (0.41 conf)
cr_jv_page_list_li_c_b__9 was cr110jv790[0].Page2[0].List4[0].Li4a[0].CB16[0] (0.38 conf)
cr_jv_page_list_li_b_c__5 was cr110jv790[0].Page2[0].List4[0].Li4b[0].CB17[0] (0.38 conf)
cr_jv_page_list_li_c_b__10 was cr110jv790[0].Page2[0].List4[0].Li4c[0].CB18[0] (0.38 conf)
cr_jv_page_list_li_c_b__11 was cr110jv790[0].Page2[0].List4[0].Li4d[0].CB19[0] (0.38 conf)
jv_list_li_sub_lid_c_b__1 was cr110jv790[0].Page2[0].List4[0].Li4d[0].SubList4[0].SubLid1[0].CB20[0] (0.36 conf)
jv_list_li_sub_lid_c_b__2 was cr110jv790[0].Page2[0].List4[0].Li4d[0].SubList4[0].SubLid2[0].CB21[0] (0.36 conf)
jv_list_li_sub_lid_c_b__3 was cr110jv790[0].Page2[0].List4[0].Li4d[0].SubList4[0].SubLid3[0].CB22[0] (0.36 conf)
jv_list_li_sub_lid_c_b__4 was cr110jv790[0].Page2[0].List4[0].Li4d[0].SubList4[0].SubLid4[0].CB23[0] (0.36 conf)
cr_jv_page_list_li_e_c_b was cr110jv790[0].Page2[0].List4[0].Li4e[0].CB24[0] (0.38 conf)
cr_jv_page_list_li_f_c_b was cr110jv790[0].Page2[0].List4[0].Li4f[0].CB25[0] (0.38 conf)
cr_jv_page_list_li_f_specify was cr110jv790[0].Page2[0].List4[0].Li4f[0].Specify[0] (0.34 conf)
cr_signature_date_time_field was cr110jv790[0].Page2[0].Signature[0].DateTimeField1[0] (0.39 conf)

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

Order for Victim Restitution

About This Form:

Identified Data Fields:

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