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 fill out this form is crucial for ensuring a safe work environment.
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The California Wv 100 form, officially known as the Petition for Workplace Violence Restraining Orders, serves as a crucial tool for employers seeking to protect their employees from potential harm in the workplace. This form enables an employer to initiate legal action against an individual who poses a threat of violence, thereby fostering a safer work environment. To complete the Wv 100, the employer, referred to as the petitioner, must establish their standing under California's Code of Civil Procedure section 527.8. 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. Key sections include descriptions of the respondent's conduct, the relationship between the employee and the respondent, and the reasons for seeking a restraining order. The form also addresses the need for a temporary restraining order (TRO) and outlines the procedures for filing, including the request for a waiver of filing fees under specific circumstances. By providing a structured approach to addressing workplace violence, the Wv 100 form not only empowers employers but also reinforces the importance of a secure and supportive workplace culture.
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)
Address (if known):
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
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)
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?
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?
Yes (If yes, attach a copy if you have one.)
Revised January 1, 2018
WV-100, Page 2 of 6
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?
Response is stated in Attachment 8e.
No (If yes, describe):
WV-100, Page 3 of 6
8 f. For any of the incidents described above, did the police come?
I don’t know
If yes, did the employee or the respondent receive an Emergency Protective Order?
Yes ✖ No
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)
(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.
WV-100, Page 4 of 6
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?
(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.
WV-100, Page 5 of 6
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.
Name of petitioner
Signature
Title
WV-100, Page 6 of 6
Filling out the California WV-100 form is an important step for employers seeking to protect their employees from workplace violence. It is essential to provide accurate information and to complete each section carefully. The following steps outline how to fill out the form correctly.
What is the California WV-100 form?
The California WV-100 form is a legal document used to petition for a restraining order against workplace violence. It is specifically designed for employers who are seeking protection for their employees from individuals who may pose a threat. The form must be completed carefully, and it requires detailed information about the employee in need of protection, the respondent, and the nature of the threats or violence. Additionally, a Confidential CLETS Information form must be filled out alongside the WV-100.
Who can file the WV-100 form?
Only employers have the standing to file the WV-100 form. This includes corporations and sole proprietorships. The employer must be acting on behalf of an employee who is experiencing threats or violence in the workplace. It is essential for the employer to have sufficient grounds under California's Code of Civil Procedure section 527.8 to initiate this action.
What information is required on the WV-100 form?
The WV-100 form requires various details, including the name and address of the petitioner (employer), information about the employee needing protection, and details about the respondent (the individual posing the threat). The form also asks for descriptions of the incidents that occurred, any witnesses, and whether the police were involved. Additionally, it allows for the inclusion of other individuals who may need protection and details about their relationship to the employee.
What happens after the WV-100 form is filed?
Once the WV-100 form is filed, the court will review it and may issue a temporary restraining order (TRO) until a hearing is scheduled. The employer must ensure that the respondent is served with the petition and notified of the hearing date. The court will ultimately decide whether to grant a permanent restraining order based on the evidence presented during the hearing.
Filling out the California WV-100 form, which is a petition for workplace violence restraining orders, can be a daunting task. Many people make common mistakes that can hinder the process. One frequent error is failing to read the accompanying instructions carefully. The form references the WV-100-INFO guide, which provides essential information on how to complete the petition correctly. Skipping this step can lead to incomplete or incorrect submissions, delaying the process of obtaining protection.
Another common mistake is not providing accurate information about the petitioner. The form requires the petitioner to be an employer with standing to bring the action under specific legal codes. Omitting details about the employer's status, such as whether they are a corporation or sole proprietorship, can lead to complications. Ensuring that the employer's name and relevant details are correctly filled out is crucial.
Additionally, some individuals neglect to include necessary contact information. The form asks for the petitioner’s address, telephone number, and email address. Failing to provide this information can create barriers in communication between the court and the petitioner. This oversight may result in missed notifications regarding hearings or other important updates.
People also often forget to specify the relationship between the employee and the respondent. This section is vital, as it helps the court understand the context of the request for protection. Providing a vague or incomplete description can lead to confusion and may weaken the case. Clear and detailed explanations are essential for the court to assess the situation accurately.
Another mistake involves not including all protected persons. If the petitioner is seeking protection for family members or other employees, it is important to list them clearly. Failing to do so can limit the scope of the protection order. The form allows for additional protected persons to be listed, and utilizing this option can enhance the safety of those involved.
In some cases, individuals do not provide sufficient details regarding the respondent's conduct. The form asks for a description of incidents that occurred, including dates and any witnesses. Providing vague or incomplete descriptions can weaken the case significantly. Clear and detailed accounts of the events help the court understand the severity of the situation.
Another common oversight is neglecting to check whether there are existing court cases involving the respondent. This section is crucial as it provides the court with background information that may be relevant to the current petition. If there are any previous cases, listing them accurately can help the court make informed decisions.
Lastly, some people may overlook the requirement for a temporary restraining order (TRO). If the petitioner believes immediate protection is necessary, they should request a TRO in conjunction with the petition. Not doing so can delay the process and leave the employee vulnerable during the interim. Understanding the importance of this step can significantly impact the outcome of the petition.
The California WV-100 form is essential for employers seeking protection against workplace violence. When filing this form, several additional documents may also be required to support the case. Below is a list of other forms and documents that are often used alongside the WV-100, along with a brief description of each.
These documents help to create a comprehensive case for workplace violence protection. Having all necessary forms and attachments ready can streamline the process and ensure that the court has all the information needed to make informed decisions. Proper preparation is key to achieving the desired outcome.
The California WV-100 form, which is used to petition for workplace violence restraining orders, shares similarities with several other legal documents. Here are five documents that are comparable and how they relate to the WV-100:
When filling out the California WV-100 form, it is important to follow specific guidelines to ensure accuracy and compliance. Here is a list of things to do and avoid:
This form can only be filed by employers who have the legal standing to bring such actions under California law. The employer acts on behalf of the employee in need of protection.
The form addresses various forms of workplace violence, including emotional harm and credible threats. It encompasses a broad range of behaviors that may place an employee in fear for their safety.
While there are several steps involved, the process can be relatively quick. Courts prioritize cases involving workplace violence, and temporary restraining orders can often be issued swiftly.
Any employer, regardless of size, can file this form if they have a legitimate reason to seek protection for their employees. Small businesses are equally eligible to utilize this legal resource.
It is advisable to gather as much information as possible before completing the form. This includes details about the incidents and any existing protective orders, as this information strengthens the case.
The form allows for multiple employees or household members to be included as additional protected persons. This flexibility is essential for addressing broader safety concerns within the workplace.
While having legal representation can be beneficial, it is not a requirement to file the Wv 100 form. Employers can complete and submit the form on their own.
Filing the Wv 100 form is just one part of the process. Following the submission, a court hearing will take place, and additional forms, such as the Temporary Restraining Order (TRO), may also be necessary.