Request for Elder or Dependent Adult Restraining Order
This document serves as a request for an Elder or Dependent Adult Restraining Order, allowing contact with a person over 65 or a dependent adult. It provides necessary instructions for completion and contact details for support services. This order is crucial for individuals seeking to maintain their relationships under specific legal circumstances.
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How do I fill this out?
To fill out this form, begin by ensuring you meet the eligibility criteria for requesting an Elder or Dependent Adult Restraining Order. Gather all necessary information related to the individuals involved and the nature of contact desired. Carefully follow the instructions for each section to complete the forms accurately.

How to fill out the Request for Elder or Dependent Adult Restraining Order?
1
Review the eligibility requirements for filing the order.
2
Gather all necessary documentation and information.
3
Complete the forms following the instructions provided.
4
Check for any specific requirements related to your case.
5
Submit your completed forms along with any necessary fees.
Who needs the Request for Elder or Dependent Adult Restraining Order?
1
An elderly individual who needs protection from harassment.
2
A dependent adult seeking to maintain contact with a family member.
3
Family members wanting to formally request permission for contact.
4
Caregivers who need legal clearance to assist in communications.
5
Legal representatives of elderly clients who need to file on their behalf.
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What are the instructions for submitting this form?
To submit this form, you can deliver it in person to the designated court at 3341 Power Inn Road, Sacramento, CA 95826 during office hours. Alternatively, forms can be submitted online through the court's e-Delivery system available on their website. Ensure that any required fees accompany your submission, and double-check that all fields are accurately filled out for processing.
What are the important dates for this form in 2024 and 2025?
Key dates to remember include January 1, 2023 for the effective date of the current regulations. Additionally, be aware of revision dates for updates to forms and processes. Future forms may be revised annually; check the court's website for updates.

What is the purpose of this form?
The purpose of the Elder or Dependent Adult Restraining Order is to facilitate safe and legal contact for individuals over 65 or dependent adults. This order serves as a protective measure, allowing specific relationships to continue while ensuring the safety and well-being of vulnerable individuals. Through this legal document, parties can establish boundaries and permissions that are recognized by the court.

Tell me about this form and its components and fields line-by-line.

- 1. Personal Information: Name, address, and contact details of the applicant.
- 2. Relationship to the Subject: Information regarding the relationship between the applicant and the elder or dependent adult.
- 3. Reason for Request: Details explaining why the restraining order allowing contact is necessary.
- 4. Court Information: Details of the court where the application will be filed.
- 5. Signature: The applicant's signature affirming the information is accurate.
What happens if I fail to submit this form?
Failure to submit this form may result in the denial of a request for contact. It could also lead to unresolved issues of harassment or isolation for the elder or dependent adult. Prompt submission is essential to ensure legal protections are in place.
- Denial of contact: Without proper submission, the requested contact relationship may be denied.
- Legal repercussions: Incomplete forms could result in legal issues or unfavorable outcomes.
- Lack of protection: Failing to submit may leave vulnerable individuals unprotected.
How do I know when to use this form?

- 1. Seeking Reconnection: Use this form to reconnect legally with an elder who may have been cut off.
- 2. Maintaining Family Ties: If family interactions have been limited, this form can assist in facilitating contact.
- 3. Legal Permission: Obtain legal permission to communicate with vulnerable individuals.
Frequently Asked Questions
What is the purpose of this form?
The form enables individuals to request a restraining order allowing contact with elderly or dependent adults.
Who can fill out this form?
Anyone over 18 on behalf of an elder or dependent adult can complete this form.
How do I submit this PDF?
You can submit the completed form electronically or deliver it in person to the court.
What should I do if I need help?
Contact the Self Help Center for assistance in completing the forms.
Is there a filing fee?
Yes, there may be a filing fee associated with this order.
How long does the process take?
Processing times may vary, but you can expect to hear back on the same day if submitted by 1 PM.
Can I edit this form?
Yes, you can edit the document using PrintFriendly's PDF editing tools.
What if I need an interpreter?
Contact the court at least 10 days prior to your hearing to arrange for an interpreter.
What happens after I submit this form?
You will be contacted with next steps and instructions for the hearing.
Where can I access my case information?
You can view court orders and case updates online via the Public Case Access System.