Free DV-150 Supervised Visitation Order (Domestic Violence Prevention) - California

DV-150

COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Supervised Visitation Order : Plaintiff(s) : : : :

Case Number: Index No.

Calendar No.

This form is attached to Child Custody and Visitation Order (DV-140). 1 2 Protected person's name: -againstOther parent's name:

JUDICIAL SUBPOENA
Mom Mom Dad Dad Other Other

3 4

Defendant(s) : ......................................................

The Court Orders:

Parent to be supervised is:

Mom

Dad

Other (name):

Type of Visitation a. Supervised visitation TO b. Supervised exchange only c. Therapeutic visitation (licensed mental health professional)
THE PEOPLE OF THE STATE OF NEW YORK GREETINGS:

5

Type of Provider a. Professional (individual or supervised visitation center) WE COMMAND b. Nonprofessional YOU, that all business and excuses being laid aside, you and each of you attend before

, the Honorable at the Court located at County of Information 6 Provider's in room , on the day of , 20 , at o'clock in the noon, and at any recessed Name: or adjourned date, to testify and give evidence as a witness in this action on the part of the

Address: Phone #: Schedule of Visits -- see this subpoena or below. 7 the party on whose behalf Form DV-140 was issued for a maximum penalty of $50 and all damages sustained as a
result of your failure to comply. Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to

8

Costs will be paid as follows: Witness, Mom to pay: Honorable % CourtDad to pay: in County, % Other:

, one of the Justices of the day of , 20

9

Contact With Provider Mom to contact provider before (date): Dad to contact provider before (date): Other: The court also orders (specify):

(Attorney must sign above and type name below)

Attorney(s) for

10

Office and P.O. Address

Judicial Council of California, www.courtinfo.ca.gov Rev. July 1, 2003, Mandatory Form Family Code, § 3100, 3031

Supervised Visitation Order
(Domestic Violence Prevention)

Telephone No.: Facsimile No.: This is a Court Order. E-Mail Address: Mobile Tel. No.:

DV-150, Page 1 of 1
American LegalNet, Inc. www.USCourtForms.com