Form DV-805 "Proof of Enrollment for Batterer Intervention Program" - California

What Is Form DV-805?

This is a legal form that was released by the California Superior Court - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2016;
  • The latest edition provided by the California Superior Court;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DV-805 by clicking the link below or browse more documents and templates provided by the California Superior Court.

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Download Form DV-805 "Proof of Enrollment for Batterer Intervention Program" - California

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Clerk stamps date here when form is filed.
Proof of Enrollment for
DV-805
Batterer Intervention Program
Protected Person
1
Name:
2
Restrained Person
Your Name:
a.
Your Lawyer (if you have one for this case):
Name:
State Bar No.:
Firm Name:
Fill in court name and street address:
Superior Court of California, County of
.
Address (If you have a lawyer, give your lawyer’s information. If you
b
do not have a lawyer and want to keep your home address private,
you may give a different mailing address instead. You do not have to
give your telephone, fax, or e-mail.):
Address:
City:
State:
Zip:
Court fills in case number when form is filed.
Telephone:
Fax:
Case Number:
E-mail Address:
3
To the Restrained Person:
If the court has ordered you to complete a 52-week batterer intervention program, you must complete and file this
form to prove to the court that you have obeyed its orders. After the order is made, you must enroll in a program by
the date ordered by the judge. If the judge did not order you to enroll by a certain date, then you must enroll no later
than 30 days after the judge made the order.
I,
, declare as follows:
Type or print your name
a.
I have enrolled in a batterer intervention program that is approved by the probation department under Penal Code
section 1203.097.
Name of provider:
Address:
Telephone number:
b.
I have signed all necessary forms with the program, allowing the program to release proof of enrollment,
attendance records, and completion or termination reports to the court and the protected party, or his or her
attorney.
My first class
is/was on (date):
c.
Other (list any other order made by the court that you have completed):
d.
4
You must provide the protected party with the information listed in 3a. Have someone else mail a copy of this form
to the protected person. The person who mails it must complete
Form
DV-250. File Form DV-250 with the
clerk and keep a copy for yourself.
I declare under penalty of perjury under the laws of the State of California that the information above is true and correct.
Date:
Sign your name
Judicial Council of California, www.courts.ca.gov
DV-805,
Proof of Enrollment for
Page 1 of 1
New July 1, 2016, Mandatory Form
Family Code, § 6343
Batterer Intervention Program
For your protection and privacy, please press the Clear
This Form button after you have printed the form.
Print this form
Save this form
Clear this form
Clerk stamps date here when form is filed.
Proof of Enrollment for
DV-805
Batterer Intervention Program
Protected Person
1
Name:
2
Restrained Person
Your Name:
a.
Your Lawyer (if you have one for this case):
Name:
State Bar No.:
Firm Name:
Fill in court name and street address:
Superior Court of California, County of
.
Address (If you have a lawyer, give your lawyer’s information. If you
b
do not have a lawyer and want to keep your home address private,
you may give a different mailing address instead. You do not have to
give your telephone, fax, or e-mail.):
Address:
City:
State:
Zip:
Court fills in case number when form is filed.
Telephone:
Fax:
Case Number:
E-mail Address:
3
To the Restrained Person:
If the court has ordered you to complete a 52-week batterer intervention program, you must complete and file this
form to prove to the court that you have obeyed its orders. After the order is made, you must enroll in a program by
the date ordered by the judge. If the judge did not order you to enroll by a certain date, then you must enroll no later
than 30 days after the judge made the order.
I,
, declare as follows:
Type or print your name
a.
I have enrolled in a batterer intervention program that is approved by the probation department under Penal Code
section 1203.097.
Name of provider:
Address:
Telephone number:
b.
I have signed all necessary forms with the program, allowing the program to release proof of enrollment,
attendance records, and completion or termination reports to the court and the protected party, or his or her
attorney.
My first class
is/was on (date):
c.
Other (list any other order made by the court that you have completed):
d.
4
You must provide the protected party with the information listed in 3a. Have someone else mail a copy of this form
to the protected person. The person who mails it must complete
Form
DV-250. File Form DV-250 with the
clerk and keep a copy for yourself.
I declare under penalty of perjury under the laws of the State of California that the information above is true and correct.
Date:
Sign your name
Judicial Council of California, www.courts.ca.gov
DV-805,
Proof of Enrollment for
Page 1 of 1
New July 1, 2016, Mandatory Form
Family Code, § 6343
Batterer Intervention Program
For your protection and privacy, please press the Clear
This Form button after you have printed the form.
Print this form
Save this form
Clear this form