Blank California Wv 100 PDF Form

Blank California Wv 100 PDF Form

The California Wv 100 form is a legal document used to petition for a restraining order against workplace violence. It allows employers to seek protection for their employees from individuals who pose a threat. Understanding how to properly complete this form is essential for ensuring a safe work environment.

To get started on your petition, fill out the form by clicking the button below.

The California Wv 100 form is an essential tool for employers seeking to protect their employees from workplace violence. This petition allows employers to request restraining orders against individuals who pose a threat to their employees' safety. Before filling out the form, it's crucial to review the accompanying informational guide, WV-100-INFO, which outlines the necessary steps and requirements. Only employers with standing under the California Code of Civil Procedure section 527.8 can file this petition. The form requires detailed information about the employee in need of protection, the respondent from whom protection is sought, and any additional individuals who may also require safeguarding. Employers must provide a thorough account of the respondent's conduct, including any threats or acts of violence that have occurred. Furthermore, the form includes sections for requesting personal conduct orders and stay-away orders, ensuring that the court understands the specific protections needed. Completing the Wv 100 form accurately is vital, as it sets the stage for legal intervention aimed at maintaining a safe workplace environment.

Document Sample

 

Petition for Workplace Violence

Clerk stamps date here when form is filed.

WV-100

 

 

Restraining Orders

 

 

 

Read How Do I Get an Order to Prohibit Workplace Violence (form

WV-100-INFO) before completing this form. NOTE: Petitioner must

be an employer with standing to bring this action under Code of

Civil Procedure section 527.8. Also fill out Confidential CLETS Information (form CLETS-001) with as much information as you know.

1Petitioner (Employer) a. Name:

is a

corporation

sole proprietorship

(specify):

and is filing this suit on behalf of the employee identified in item 2 .

b. Lawyer for Petitioner (if any for this case)

 

 

 

Name:

State Bar No.:

 

 

 

 

 

 

 

Firm Name:

 

 

 

 

 

 

 

 

 

Fill in court name and street address:

Superior Court of California, County of

Court fills in case number when form is filed.

Petitioner’s Address (If the petitioner has a lawyer, give the lawyer’s information.)

c. Address:

City:

State:

 

Zip:

 

 

 

 

 

 

 

 

 

 

Telephone:

Fax:

 

 

 

 

 

 

 

 

 

 

 

 

E-Mail Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case Number:

2Employee in Need of Protection

Full Name:

Sex: M

F

Age:

3Respondent (Person From Whom Protection Is Sought)

Full Name:

 

 

 

 

Age:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address (if known):

 

 

 

 

 

 

 

 

 

City:

 

State:

 

Zip:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4Additional Protected Persons

a.Are you asking for protection for any family or household members of the employee or for any other employees at the employee’s workplace or at other workplaces of the petitioner?

Yes No (If yes, list them):

Full Name

Sex

Age Household Member? Relationship to Employee

Yes No

Yes Yes

No

No

Additional protected persons are listed in Attachment 4a.

This is not a Court Order.

Judicial Council of California, www.courts.ca.gov Revised January 1, 2018, Mandatory Form Code of Civil Procedure, §§ 527.8 and 527.9

Petition for Workplace Violence Restraining Orders

WV-100, Page 1 of 6

 

(Workplace Violence Prevention)

Case Number:

4b. Why do these people need protection? (Explain):

Response is stated in Attachment 4b.

5Relationship of Employee and Respondent

a. How does the employee know the respondent? (Describe):

Response is stated in Attachment 5a.

b. Respondent

is

is not a current employee of petitioner. (Explain any decision to retain, terminate,

 

or otherwise discipline the respondent):

Response is stated in Attachment 5b.

 

 

 

 

 

 

 

 

 

 

6Venue

Why are you filing in this county? (Check all that apply):

a. The respondent lives in this county.

b. The respondent has caused physical or emotional injury to the petitioner’s employee in this county.

c. Other (specify):

7Other Court Cases

a. Has the employee or any of the persons named in 4 been involved in another court case with the respondent?

No

Yes If yes, check each kind of case and indicate where and when each was filed:

 

Kind of Case

Filed in (County/State)

Year Filed Case Number (if known)

(1) Workplace Violence

(2) Civil Harassment

(3) Domestic Violence

(4) Divorce, Nullity, Legal Separation

(5) Paternity, Parentage, Child Support

(6) Eviction

(7) Guardianship

(8) Small Claims

(9) Postsecondary School Violence

(10) Criminal

(11) Other (specify):

b. Are any restraining orders or criminal protective orders now in effect relating to the employee or any of the

persons in 4 and the respondent?

No

Yes (If yes, attach a copy if you have one.)

This is not a Court Order.

Revised January 1, 2018

Petition for Workplace Violence Restraining Orders

WV-100, Page 2 of 6

(Workplace Violence Prevention)

Case Number:

8Description of Respondent's Conduct

a.Respondent has (check one or more):

(1) Assaulted, battered, or stalked the employee

(2) Made a credible threat of violence against the employee by making knowing or willful statements or engaging in a course of conduct that would place a reasonable person in fear for his or her safety or the safety of his or her immediate family.

b.One or more of these acts (check either or both):

(1) Took place at the employee’s workplace

(2)

Can reasonably be construed to be carried out in the future at the employee’s workplace

Address of workplace:

c.Describe what happened. (Provide details; include the dates of all incidents beginning with the most recent; tell who did what to whom; identify any witnesses):

Response is stated in Attachment 8c.

d. Was the employee harmed or injured?

Yes

No (If yes, describe harm or injuries):

 

Response is stated in Attachment 8d.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

e. Did the respondent use or threaten to use a gun or any other weapon?

Yes

Response is stated in Attachment 8e.

 

No (If yes, describe):

This is not a Court Order.

Revised January 1, 2018

Petition for Workplace Violence Restraining Orders

WV-100, Page 3 of 6

(Workplace Violence Prevention)

Case Number:

8 f. For any of the incidents described above, did the police come?

Yes

No

I don’t know

 

 

 

 

 

 

If yes, did the employee or the respondent receive an Emergency Protective Order?

 

Yes No

I don’t know

 

 

 

 

 

If yes, the order protects (check all that apply):

 

 

 

 

 

the employee

the respondent

one or more of the persons in

4 .

(Attach a copy of the order if you have one.)

 

 

 

 

 

Check the orders you want ￿

9 Personal Conduct Orders

I ask the court to order the respondent not to do any of the following things to the employee or to any person to be protected listed in 4 :

a. Harass, intimidate, molest, attack, strike, stalk, threaten, assault (sexually or otherwise), hit, abuse, destroy personal property of, or disturb the peace of the person.

b. Commit acts of unlawful violence on or make threats of violence to the person.

c. Follow or stalk the person during work hours or to or from the place of work.

d. Contact the person, either directly or indirectly, by any means, including, but not limited to, in person, by telephone, in writing, by public or private mail, by interoffice mail, by e-mail, by text message, by fax, or by other electronic means.

e. Enter the person’s workplace.

f. Other (specify):

As stated in Attachment 9f.

The respondent will be ordered not to take any action to get the addresses or locations of any protected person unless the court finds good cause not to make the order.

10Stay-Away Order

a. I ask the court to order the respondent to stay at least

 

yards away from (check all that apply):

(1)

(2)

(3)

(4)

(5)

(6)

(7)

The employee.

(8)

The employee’s vehicle.

The other persons listed in 4 .

(9)

Other (specify):

The employee’s workplace.

The employee’s home.

The employee’s school.

The school of the employee’s children.

The place of child care of the employee’s children.

This is not a Court Order.

Revised January 1, 2018

Petition for Workplace Violence Restraining Orders

WV-100, Page 4 of 6

(Workplace Violence Prevention)

Case Number:

10b. If the court orders the respondent to stay away from all the places listed above, will he or she still be able to get

to his or her home, school, or job?

Yes No

(If no, explain):

Response is stated on Attachment 10b.

 

 

 

 

 

 

 

 

11Guns or Other Firearms and Ammunition

Does the respondent own or possess any guns or other firearms? Yes

No I don’t know

If the judge grants a protective order, the respondent will be prohibited from owning, possessing, purchasing, receiving, or attempting to purchase or receive a gun, other firearm, and ammunition while the protective order is in effect. The respondent will also be ordered to turn in to law enforcement, or sell to or store with a licensed gun dealer, any guns or firearms within his or her immediate possession or control.

12 Temporary Restraining Order

I request that a Temporary Restraining Order (TRO) be issued against the Respondent to last until the hearing. I am presenting form WV-110, Temporary Restraining Order, for the court’s signature together with this Petition.

Has the Respondent been told that you were going to go to court to seek a TRO against him/her?

Yes No (If you answered no, explain why below):

Reasons are stated in Attachment 12.

13 Request for Less Than Five Days' Notice of Hearing

You must have your papers personally served on the respondent at least five days before the hearing, unless the court orders a shorter time for service. (Form WV-200-INFO explains what is proof of personal service. Form WV-200, Proof of Personal Service, may be used to show the court that the papers have been served.)

If you want there to be fewer than five days between service and the hearing, explain why: Reasons are stated in Attachment 13.

14 No Fee for Filing

I ask that there be no filing fee because the respondent has threatened violence against the employee, or stalked the employee, or acted or spoken in a manner that has placed the employee in reasonable fear of violence.

This is not a Court Order.

Revised January 1, 2018

Petition for Workplace Violence Restraining Orders

WV-100, Page 5 of 6

(Workplace Violence Prevention)

Case Number:

15

16

17

18

No Fee to Serve Orders

I ask the court to order the sheriff or marshal to serve the respondent with the others for free because this request for orders is based on a credible threat of violence or stalking.

Court Costs

I ask the court to order the respondent to pay my court costs.

Additional Orders Requested

I ask the court to make the following additional orders (specify):

Additional orders requested are stated in Attachment 17.

Number of pages attached to this form, if any:

Date:

Lawyer’s name (if any)

 

Lawyer’s signature

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

Date:

Name of petitioner

 

Signature

Title

This is not a Court Order.

Revised January 1, 2018

Petition for Workplace Violence Restraining Orders

WV-100, Page 6 of 6

(Workplace Violence Prevention)

File Specifics

Fact Name Description
Governing Law The California Wv 100 form is governed by the Code of Civil Procedure sections 527.8 and 527.9.
Eligibility The petitioner must be an employer with standing to bring this action on behalf of an employee.
Confidential Information Petitioners are required to complete the Confidential CLETS Information form (CLETS-001) with available information.
Temporary Restraining Order A request for a Temporary Restraining Order (TRO) can be made to protect the employee until the hearing.

How to Use California Wv 100

Filling out the California WV-100 form involves providing detailed information about the petitioner, the employee in need of protection, and the respondent. Follow these steps carefully to ensure that all necessary information is included and accurately presented.

  1. Identify the Petitioner: Write the name of the employer (corporation or sole proprietorship) filing the petition. Indicate if the petitioner is a corporation or sole proprietorship.
  2. Lawyer Information: If applicable, fill in the lawyer's name, State Bar number, and firm name.
  3. Fill in Court Information: Enter the name and address of the Superior Court of California in the appropriate fields.
  4. Petitioner’s Address: Provide the address, city, state, zip code, telephone number, fax number, and email address of the petitioner. If a lawyer is involved, include their information.
  5. Employee Information: Enter the full name, sex, and age of the employee who needs protection.
  6. Respondent Information: Fill in the full name, age, and address (if known) of the person from whom protection is sought.
  7. Additional Protected Persons: Indicate if you are requesting protection for any family or household members or other employees. If yes, list their names, sex, age, and relationship to the employee.
  8. Reason for Protection: Explain why the additional protected persons need protection in Attachment 4b.
  9. Relationship Details: Describe how the employee knows the respondent and whether the respondent is a current employee.
  10. Venue Justification: Check the reasons for filing in this county, such as the respondent's residence or incidents occurring in this county.
  11. Other Court Cases: Indicate if there have been any other court cases involving the employee or additional protected persons and provide relevant details.
  12. Description of Conduct: Check all applicable behaviors of the respondent and provide detailed descriptions of incidents, including dates and witnesses in Attachment 8c.
  13. Injury Information: Indicate if the employee was harmed or injured and describe any harm in Attachment 8d.
  14. Weapon Use: State whether the respondent used or threatened to use a weapon.
  15. Police Involvement: Indicate if the police were called and whether an Emergency Protective Order was issued.
  16. Personal Conduct Orders: List the actions you want the court to order the respondent to refrain from, including harassment and contact.
  17. Stay-Away Order: Specify the distances the respondent should maintain from the employee and other protected persons.
  18. Firearm Information: Indicate whether the respondent owns or possesses any firearms.
  19. Temporary Restraining Order: Request a Temporary Restraining Order and indicate if the respondent has been informed about the court action.
  20. Notice of Hearing: If requesting less than five days' notice for the hearing, provide reasons in Attachment 13.
  21. Fee Waiver Request: State the reason for requesting a waiver of the filing fee due to threats of violence against the employee.

After completing the form, gather any necessary attachments and submit the form to the appropriate court. Ensure all information is accurate and complete to avoid delays in processing your request.

Your Questions, Answered

What is the California Wv 100 form?

The California Wv 100 form is a legal document used to petition for a workplace violence restraining order. It allows employers to seek protection for their employees from individuals who have threatened or committed acts of violence in the workplace. This form must be filled out completely and filed with the appropriate court.

Who can file the Wv 100 form?

Only an employer with standing can file the Wv 100 form. This means the employer must have a legitimate reason under California law, specifically Code of Civil Procedure section 527.8, to bring this action on behalf of an employee who is in need of protection.

What information do I need to provide on the form?

You will need to provide several details, including:

  1. The name and address of the employer.
  2. The name and details of the employee needing protection.
  3. Information about the respondent (the person from whom protection is sought).
  4. Any additional protected persons, if applicable.
  5. A description of the respondent's conduct that necessitates the restraining order.

Can I request protection for others besides the employee?

Yes, you can request protection for family or household members of the employee, as well as for other employees at the workplace. You will need to list these individuals on the form and explain why they need protection.

What happens after I file the Wv 100 form?

Once you file the form, the court will review your petition. If the court finds sufficient evidence, it may issue a temporary restraining order (TRO) until a hearing can be held. During this time, the respondent will be prohibited from contacting or coming near the employee or any additional protected persons.

Is there a fee to file the Wv 100 form?

Generally, there is no filing fee for the Wv 100 form if the respondent has threatened violence against the employee or has engaged in conduct that has caused reasonable fear of violence. You can request a fee waiver on the form.

How long does a restraining order last?

The duration of a restraining order can vary. A temporary restraining order typically lasts until the hearing, which is usually scheduled within a few weeks. If the court issues a permanent restraining order, it can last for several years, depending on the circumstances of the case.

What should I do if the respondent violates the restraining order?

If the respondent violates the restraining order, you should contact law enforcement immediately. Violating a restraining order is a serious offense and can result in criminal charges against the respondent. Keep a record of any violations, as this may be important for future legal actions.

Common mistakes

Completing the California WV-100 form accurately is crucial for ensuring that workplace violence petitions are processed effectively. However, individuals often make common mistakes that can hinder this process. Below is a list of four frequent errors made when filling out this form:

  1. Incomplete Information:

    Many people fail to provide all necessary details about the petitioner, employee, and respondent. Omitting critical information, such as the full names, addresses, and relationships, can lead to delays or rejections of the petition.

  2. Incorrect Venue Selection:

    Choosing the wrong county to file the petition is another mistake. It’s essential to check that the venue aligns with the requirements, such as where the respondent resides or where the incidents occurred.

  3. Failure to Attach Required Documents:

    Individuals often neglect to attach necessary documents, such as the Confidential CLETS Information form or any existing restraining orders. These attachments are vital for the court’s understanding of the situation.

  4. Inadequate Description of Incidents:

    Providing vague or insufficient descriptions of the respondent's conduct can weaken the case. Detailed accounts, including dates, specific actions, and any witnesses, are essential for the court to grasp the gravity of the situation.

By avoiding these common pitfalls, petitioners can enhance their chances of successfully obtaining a workplace violence restraining order.

Documents used along the form

The California WV-100 form is essential for employers seeking protection against workplace violence. In addition to this form, several other documents are commonly used to support the petition process. Each of these documents serves a specific purpose and helps ensure that all relevant information is presented to the court.

  • WV-110, Temporary Restraining Order: This document requests a temporary restraining order against the respondent. It is intended to provide immediate protection until a court hearing can take place. The petitioner must present this form alongside the WV-100.
  • CLETS-001, Confidential CLETS Information: This form collects confidential information regarding the parties involved, which is crucial for law enforcement and court records. It helps ensure that the protective order can be effectively enforced.
  • WV-200, Proof of Personal Service: This document verifies that the respondent has been personally served with the necessary court papers. It is important for demonstrating compliance with legal requirements regarding notification.
  • WV-200-INFO, Information on Proof of Personal Service: This informational guide outlines the requirements and procedures for serving the respondent. It provides essential details to ensure that the service is conducted correctly.

Utilizing these forms in conjunction with the WV-100 can significantly enhance the chances of obtaining the necessary protections for employees facing workplace violence. Each document plays a vital role in ensuring the safety and well-being of individuals in the workplace.

Similar forms

The California Form WV-100 is similar to the Domestic Violence Restraining Order (DV-100) in that both forms are designed to protect individuals from threats and violence. While the WV-100 specifically addresses workplace violence, the DV-100 focuses on domestic situations. Both forms require the petitioner to provide details about the respondent’s conduct and the relationship between the parties involved. In both cases, the petitioner can request various protective measures, including stay-away orders and restrictions on contact, ensuring the safety of the individual seeking protection.

Another document that shares similarities with the WV-100 is the Civil Harassment Restraining Order (CH-100). This form is used when an individual seeks protection from harassment by someone who is not a family member or intimate partner. Like the WV-100, the CH-100 requires the petitioner to describe the incidents of harassment and provide information about the respondent. Both forms allow for the inclusion of additional protected persons and can lead to court orders that restrict the respondent’s behavior to ensure the safety of the petitioner and any other individuals named in the request.

The Workplace Violence Prevention Order (WV-110) is also closely related to the WV-100. This form is often filed alongside the WV-100 to request a temporary restraining order that provides immediate protection until a hearing can be held. Both documents address similar issues of safety in a workplace setting, but the WV-110 specifically seeks urgent relief, while the WV-100 serves as the initial petition. The process of gathering evidence and detailing the respondent's actions is common to both forms, ensuring that the court has a comprehensive understanding of the situation.

In addition, the Emergency Protective Order (EPO) is another document that aligns with the WV-100. An EPO is typically issued by law enforcement in urgent situations where immediate protection is necessary. While the WV-100 is a formal request submitted to the court, the EPO provides temporary relief until a more permanent solution can be established through the court system. Both forms aim to address immediate threats and ensure the safety of individuals, but the EPO is often a quicker, more immediate response to a crisis.

Lastly, the Restraining Order After Hearing (ROAH) form is similar to the WV-100 in that it is used to establish long-term protection after a court hearing. Following the initial filing of the WV-100, if a judge finds sufficient evidence of workplace violence, a ROAH may be issued to provide ongoing protection. Both forms require detailed accounts of the respondent's behavior and the impact it has had on the petitioner, ensuring that the court can make informed decisions regarding the need for continued protection.

Dos and Don'ts

When filling out the California WV-100 form, there are several important steps to follow to ensure accuracy and compliance. Below are four things you should do and should not do during this process.

  • Do read the accompanying instructions carefully before starting the form. Understanding the requirements will help you complete it correctly.
  • Do provide complete and accurate information for both the petitioner and the employee in need of protection. Missing details can delay the process.
  • Do check all applicable boxes and ensure that any additional protected persons are clearly listed. This helps the court understand the full scope of your request.
  • Do submit the Confidential CLETS Information form along with the WV-100. This is essential for the protection order process.
  • Don't leave any sections blank unless instructed. Incomplete forms may be rejected or cause delays.
  • Don't provide false or misleading information. This can have serious legal consequences.
  • Don't forget to sign and date the form. An unsigned form may not be considered by the court.
  • Don't hesitate to seek assistance if you're unsure about any part of the form. Proper guidance can prevent mistakes.

Misconceptions

Understanding the California WV-100 form is crucial for employers seeking to protect their employees from workplace violence. However, several misconceptions often arise regarding this form. Below are six common misunderstandings, along with clarifications to help demystify the process.

  • Misconception 1: Only employees can file the WV-100 form.
  • This is not accurate. The form can be filed by an employer on behalf of an employee who is experiencing workplace violence. The employer must have standing to bring the action under California law.

  • Misconception 2: The WV-100 form is a court order.
  • It is essential to note that the WV-100 form itself is not a court order. It is a petition requesting the court to issue a restraining order. The actual court order is issued only after a hearing.

  • Misconception 3: The form must be filed in the employee's home county.
  • While it may seem logical to file in the employee's home county, the form can be filed in the county where the respondent lives or where the alleged violence occurred. This flexibility allows for better access to justice.

  • Misconception 4: The employer must have evidence of physical harm to file the form.
  • Although evidence of physical harm can strengthen the case, it is not a requirement to file the WV-100. The employer can file if there are credible threats or a pattern of behavior that places the employee in fear for their safety.

  • Misconception 5: There are fees associated with filing the WV-100 form.
  • Employers can request a fee waiver when filing the form. If the petition involves threats of violence, the court typically waives the filing fee, making the process more accessible.

  • Misconception 6: The WV-100 form guarantees immediate protection.
  • Filing the WV-100 does not guarantee immediate protection. A temporary restraining order (TRO) may be issued, but it requires a hearing for a permanent order. The timeline for this can vary depending on the court's schedule.

By understanding these misconceptions, employers can better navigate the process of seeking protection for their employees and ensure a safer workplace environment.

Key takeaways

Here are some key takeaways regarding the California WV-100 form for workplace violence restraining orders:

  • Eligibility: Only an employer can file this petition on behalf of an employee who is experiencing workplace violence.
  • Complete Required Forms: Along with the WV-100, you must fill out the Confidential CLETS Information form (CLETS-001).
  • Petitioner's Information: Include the name, address, and contact details of the employer filing the petition.
  • Employee Details: Provide full details about the employee in need of protection, including their age and gender.
  • Respondent Information: Identify the person from whom protection is sought, including their address if known.
  • Additional Protected Persons: You can request protection for family members or other employees if they are at risk.
  • Incident Description: Clearly describe the incidents of violence or threats, including dates and any witnesses.
  • Temporary Restraining Order: You may request a Temporary Restraining Order to provide immediate protection until the hearing.
  • No Filing Fee: There is typically no filing fee if the employee has been threatened or stalked, which can ease the process for employers.

Filling out the WV-100 form accurately is crucial for ensuring the safety of employees and obtaining the necessary legal protection.