EA-610

Notice of Hearing on Request to  
                                               Elder or 
Terminate
Dependent Adult Abuse Restraining Order

Modify

Clerk stamps date here when form is filed.

Party seeking order  completes items       and       .

1

2

1

Party Seeking Modification/Termination
a.

Your Full Name:

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 e-mail.)

Fill in court name and street address:

Superior Court of California, County of

State:

Zip:

Fax:

Fill in case number:

Case Number:

Address:

City:

Telephone:

E-Mail Address:

2

Other Party

a.

Full Name:

b. Address (if known):

City:

3

Court Hearing 

State:

Zip:

The judge has set a court hearing date. Court will fill in box below.

The current restraining order stays in effect unless terminated by the court.

 Name and address of court if different from above:

Hearing  
Date

Ł Date:
Dept.:

Time:

Room:

EA-600, Request to Modify/Terminate Elder or Dependent Adult Abuse Restraining Order;
EA-610, Notice of Hearing on Request to Modify/Terminate Elder or Dependent Adult Abuse Restraining 
Order (this form);

EA-620, Response to Request to Modify/Terminate Elder or Dependent Adult Abuse Restraining Order (blank 
copy).

• •

•

The forms must be served on the other party                          before the hearing.

 days

a.

Someone age 18 or older—not you—must serve a copy of the following forms on the other party or parties:

4

Service on Other Party

Judicial Council of California, www.courts.ca.gov 
New January 1, 2018, Mandatory Form 
Welfare and Institutions Code, § 15657.03(i)

Notice of Hearing on Request to Modify/Terminate 
 Elder or Dependent Adult Abuse Restraining Order 
(Elder or Dependent Adult Abuse Prevention)

EA-610,  Page 1 of 2

Case Number:

b.

c.

d.

e.

If you are the restrained person: You must have the protected person personally 
served with these forms. This requirement of personal service on the protected person 
is not a justification for you to violate the terms of the civil harassment restraining 
order.  If the person who originally requested the restraining order was someone other than the protected 
person, you must also serve that person.  Service on that person may be by mail.

If you are the person who originally requested the order but not the protected person,  
and you are requesting modification or termination other than at the request of the 
protected person: You must have the protected person personally served with these 
forms. You must also serve the restrained person.  Service on the restrained person may be by mail.

If you are the protected person: The restrained person may be served with these forms by mail.

The person who serves the forms must fill out either form EA-200, Proof of Personal Service, or form EA-250, 
Proof of Service of Response by Mail (or both). Have the person who served sign the original. Take the signed 
original proof-of-service form back to the court clerk for filing or bring it with you to the hearing. For help with 
personal service, see form EA-200-INFO, What Is “Proof of Personal Service”?. 

Date:

Clerk, by

, Deputy

To the Other Party:

If you wish to make a written response to this request to modify or terminate the current civil harassment restraining 
order, you may fill out form EA-620, Response to Request to Modify/Terminate Elder or Dependent Adult Abuse 
Restraining Order. File the original with the court before the hearing and have someone age 18 or older—not you— mail 
a copy of it to the other party at the address in       at least                          before the hearing. Also file form EA-250, Proof 
of Service of Response by Mail, with the court before the hearing.

 days

1

Request for Accommodations 

Assistive listening systems, computer-assisted real-time captioning, or sign language interpreter services 
are available if you ask at least five days before the hearing. Contact the clerk’s office for Request for 
Accommodations by Persons With Disabilities and Response (form MC-410). (Civ. Code, § 54.8.)

(Clerk will fill out this part.)

—Clerk's Certificate—

I certify that this Notice of Hearing on Request to Modify/Terminate Elder or Dependent Adult Abuse 
Restraining Order is a true and correct copy of the original on file in the court. 

Clerk’s Certificate 
[seal]

 Date:

Clerk, by

, Deputy

New January 1, 2018

Notice of Hearing on Request to Modify/Terminate 
 Elder or Dependent Adult Abuse Restraining Order 
(Elder or Dependent Adult Abuse Prevention)

EA-610, Page 2 of 2