Fillable Form 1: DV-140 Child Custody and Visitation Order (California)

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Form 1: DV-140 Child Custody and Visitation Order (California)

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Child Custody and Visitation Order
(Domestic Violence Prevention)
DV-140, Page 1 of 2
Judicial Council of California, www.courts.ca.gov
Rev. January 1, 2012, Mandatory Form
Family Code, §§ 3020,3022, 3040-3043, 3100, 6340, 7604
This is a Court Order.
DV-140
Child Custody and Visitation Order
Case Number:
The Court Orders:
Name of protected Person:
Physical Custody to:
(Person the child lives with.
Check at least one.)
Child’s Name
a.
This form is attached to (check one):
DV-110 DV-130
1
Mom Dad Other*
2
Other Parent's Name:
Mom Dad Other*
* If Other, specify relationship to child:
3
Child Custody is ordered as follows:
Legal Custody to: (Person
who makes decisions about
health, education. Check at
least one.)
Date of Birth Mom Dad Other*
b.
c.
Mom Dad Other*
If more children, check here. Attach a sheet of aper and write “DV-140, Child Custody” for a title.
* If Other, specify relationship to child and name of person:
4
Child Visitation is ordered as follows:
a.
b.
c.
No visitation to Mom Dad
(name):
Other
- page document,
See the attached
dated:
must go to mediation at:
The parties
d.
Until the next court order, visitation for
Mom Dad
(name):
Other
(1)
(starting):
Weekends
(The 1st weekend of the month is the 1st weekend with a Saturday.)
1st 2nd 3rd 4th 5th weekend of month
from at
a.m. p.m.
to
a.m. p.m.
at
(day of week)
(time)
(day of week)
(time)
(2)
(starting):
Weekdays
from at
a.m. p.m.
to
a.m. p.m.
at
(day of week)
(time)
(day of week)
(time)
(3)
Other Visitation
Check here and attach a sheet of paper if there are other visitation days and times, like holidays, birthdays,
sports events. List dates and times. Write “DV-140, Other Visitation” for a title.
5
Supervised Visitation or Exchange
Visits and/or exchanges of children are supervised as specified on Form DV-150, Supervised Visitation and
Exchange Order.
will be:
must have written permission from the
other parent, or a court order, to take the children outside of:
Case Number:
This is a Court Order.
DV-140, Page 2 of 2
Rev. January 1, 2012
Child Custody and Visitation Order
(Domestic Violence Prevention)
6
Responsibility for Transportation for Visitation
“Responsibility for transportation” means the parent will take or pick up the child or make arrangements for
someone else to do so.
a.
Mom Dad
(name):
Other
take children to the visits.
b.
Mom Dad
(name):
Other
pick up children from the visits.
c.
Drop-off / pick-up of children will be at
(address):
7
Travel with Children
Mom Dad
(name):
Other
a.
b.
c.
The State of California
The United State of America
(list):
Other place(s)
8
Child Abduction
9
Other Orders
Check here and attach any other orders to this form. Write "DV-140, Other Orders" as a title.
This court has jurisdiction to make child custody orders in this case under the Uniform Child Custody Jurisdiction
and Enforcement Act (part 3 of the California Family Code starting with § 3400).
10
Jurisdiction
The responding party was given reasonable notice and an opportunity to be heard as provided by the laws of the
State of California.
11
Notice and Opportunity to Be Heard
The country of habitual residence of the child or children in this case is
.
12
Country of Habitual Residence
The United States of America
(specify):
Other
If you violate this order, you may be subject to civil or criminal penalties, or both.
13
Penalties for Violating This Order
If this form is attached to Form DV-130 (Restraining Order After Hearing), the custody and visitation orders in this
form remain in effect after the restraining orders on For DV-130 end.
14
Duration of Child Custody, Visitation, and Support Orders
There is a risk that one of the parents will take the children out of California without the other parent's permission.
The orders in Form DV-145, Order: No Travel with Children, are attached and must be obeyed. (Fill out and
attach Form DV-145 to this form.)
or
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Form 1: DV-140 Child Custody and Visitation Order (California)

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Completed 20 November 2020

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