DV-105 - Request for Child Custody and Visitation Orders

Summary

Request for Child Custody and Visitation Orders

Text

Form ID: DV-105
Title: Request for Child Custody and Visitation Orders
Effective Date: 2026-01-01
Mandatory Form: yes
Languages: 汉语, 한국어, español, Tagalog, Tiếng Việt
Info Page: https://selfhelp.courts.ca.gov/jcc-form/DV-105
Primary Download URL: https://www.courts.ca.gov/documents/dv105.pdf
Alternate Download URLs: https://www.courts.ca.gov/documents/dv105c.pdf, https://www.courts.ca.gov/documents/dv105k.pdf, https://www.courts.ca.gov/documents/dv105s.pdf, https://www.courts.ca.gov/documents/dv105t.pdf, https://www.courts.ca.gov/documents/dv105v.pdf
Form Detail Page:
Request for Child Custody and Visitation Orders
(DV-105)
Ask the judge for custody orders if you have children with the person you want a restraining order against.
Get form DV-105
汉语
Get form DV-105 in Chinese Simplified
(Chinese Simplified)
한국어
Get form DV-105 in Korean
(Korean)
español
Get form DV-105 in Spanish
(Spanish)
Tagalog
Get form DV-105 in Tagalog
(Tagalog)
Tiếng Việt
Get form DV-105 in Vietnamese
(Vietnamese)
Effective: January 1, 2026
Go to
How-to instructions for Domestic Violence
Go to
Domestic Violence Form Packets
PDF Text:
Request for Child Custody and Visitation Orders 
(Domestic Violence Prevention)
DV-105, Page 1 of 6Judicial Council of California, courts.ca.gov 
Rev. January 1, 2026, Mandatory Form 
Fam. Code, §§ 3048, 3063, 6323, 6323.5
DV-105 Request for Child Custody and 
Visitation Orders
Case Number:
This form is attached to form DV-100.
2
1 Your Information 
Name:
Relationship to children: Parent Legal Guardian Other (describe):
2 Person You Want Protection From 
Name:
Relationship to children: Parent Legal Guardian Other (describe):
3 Children Under 18 Years Old (for children you have with the person in      , list from oldest to youngest)
a. Name: Date of birth:
(Check here if you need more space. Write “DV-105, Children” at the top and attach it to this form.)
b. Name: Date of birth:
c. Name: Date of birth:
d. Date of birth:Name:
4
a. Have all the children listed in        lived together for the last five years?3
No (If no, complete form DV-105(A). Do not complete the section below.)
(If yes, complete the section below.) Yes
City and State Where Children Lived (If you do not complete this section, the judge may not be able to 
b. List where the children have lived for the last five years. Start with their current location.
Children lived with (check all that apply):
Dates (month/year) City and State 
(include tribal land, if applies)
Me Person  
in 2
Other (relationship 
to child)
From:
Check here if this address is private 
(confidential). List the state only.
To present
From: Until:
From: Until:
From: Until:
From: Until:
From: Until:
make custody and visitation orders.)
This is not a Court Order.
Instructions: Use this form to request orders for children you have with the person in      . For more information on the 
orders you can request, read form DV-105-INFO, Asking for Child Custody and Visitation Orders.
2

Rev. January 1, 2026 Request for Child Custody and Visitation Orders 
(Domestic Violence Prevention)
DV-105, Page 2 of 6
Case Number:
5 History of Court Cases Involving Your Children
a. Do you know about any other case involving any child listed in      ?
No
Yes (If yes, complete the section below):
(Check all that apply. List where the case was filed (city, state, or tribe), year it was filed, and case number, 
if known.)
Custody 
Divorce 
Juvenile Court (child welfare, juvenile justice)
Guardianship
Criminal
Other (example: child support case)
3
b. Is there a current order for custody or visitation in effect?
No
Yes (If yes, complete the section below):
What did the judge order? (Examples: who has custody of the children and what the visitation schedule is)
(Attach a copy of the order, if you have one.)
Why do you want to change the order? 
c. If there is another parent or legal guardian besides you and the person in      , list their information below.2
Name: Parent Legal Guardian
This is not a Court Order.

Rev. January 1, 2026
Request for Child Custody and Visitation Orders 
(Domestic Violence Prevention)
DV-105, Page 3 of 6
Case Number:
Orders a Judge Can Make to Protect Your Children
To ask for orders to protect your children, answer the questions below.
6 Do you want to limit where the person in        can travel with your children?2
No
Yes (If yes, complete the section below):
I ask the judge to order that the person in       must have written permission from me, or a court order, to 
take the children outside:
The county of (list):
2
California
Other places (list):
7 Do you want the person in       to have access to the children's records or information?2
Yes
No (If no, complete the section below):
a. I ask the judge to order that the person in       not access or have access to the records or information for:2
All the children listed in      .3
Only the children listed here (names):
b. For the following records or information (check all that apply):
Medical, dental, and mental health 
School and daycare 
Extracurricular activity, including summer camps and sports teams
Other (describe): 
(If the judge makes this order, providers will not be able to release the protected information to the  
person in      .)    2
Child's employment (including volunteer and unpaid positions)
8 Do you believe the person in        might abduct (kidnap) your children?2
No
Yes (To ask for orders to help prevent abduction, you must complete form DV-108, Request for Orders to  
Prevent Child Abduction, and attach it to this form.)
This is not a Court Order.

Rev. January 1, 2026
Request for Child Custody and Visitation Orders 
(Domestic Violence Prevention)
DV-105, Page 4 of 6
Case Number:
Child Custody 
You can ask a judge to make custody orders for your children. There are two types of custody in California: legal and 
physical custody. For both types of custody, parents can share custody (joint) or one parent can have full custody (sole).
•
•
Legal custody means the person who makes decisions about the child's health, education, and welfare.  
Physical custody means the person who the child regularly lives with.
Any orders made by the judge now will last until your court date (about three weeks away). On your court date, 
the judge can change or extend the orders.
9 Do you want the judge to make child custody orders?
No
Yes (If yes, complete the section below):
Legal Custody (check one):
Sole to me
Sole to person in 2
Jointly (shared) by me and person in      2
Other (describe):
Physical Custody (check one):
Sole to me
Sole to person in 2
Jointly (shared) by me and person in      2
Other (describe):
Visitation (Parenting Time) with Children 
Visitation (parenting time) is the time each parent spends with the child. If a parent does not get custody, that parent 
can have visits, if a judge believes it is safe and in the child’s best interest. Visitation orders a judge can make include:
•No visits •Visits supervised (monitored) by a third party 
•Virtual or in-person visits •Visits not supervised  
Any orders made by the judge now will last until your court date (about three weeks away). On your court date, 
the judge can change or extend the orders. Answer the questions below to tell the judge what parenting time you 
want the person in       to have until your court date.
10 Do you want the person in        to have visits (parenting time) with the children?2
No, I ask the judge to order no visits for the person in       (Stop here. You have finished completing this form.)2
Yes  (Go to      .)11
Yes, but only virtual visits (Go to      .)11
2
11 Do you want visits with the children to be supervised (monitored) by a third party?
(To learn about supervised visitations, go to selfhelp.courts.ca.gov/guide-supervised-visitation.)
Yes (Go to      .)12
No (Go to      .)13
This is not a Court Order.

Rev. January 1, 2026
Request for Child Custody and Visitation Orders 
(Domestic Violence Prevention)
DV-105, Page 5 of 6
Case Number:
12 Details of Supervised (Monitored) Visits
a. Who do you want to supervise the visits? (check one):
Professional (list name, if known):
Professional fees paid by: Me % Person in 2 % Other: %
(1)
Nonprofessional, like a trusted relative or friend(2)
(Name): Check here if the person has agreed to supervise visits.
Other (describe):
b. Location of visits (check one): In person at a safe location Virtual visit (not in person)
Virtual visit 
with  
person in       
How often and how long should the visits be? (check one): 
Once a week, for (number of hours):  
Twice a week, for (number of hours): each visit. 
Other (describe): 
Check here if you want to use the chart listed below for a schedule. 
q
Time
Person to bring children to 
and from visit (or make 
available for virtual visit)
Location of drop-off/pick-up 
Monday Start:
End, if applies:
Tuesday Start:
End, if applies:
Wednesday Start:
End, if applies:
Thursday Start:
End, if applies:
Friday Start:
End, if applies:
Saturday Start:
End, if applies:
Sunday Start:
End, if applies:
Every week Every other week Other
Start date for visits (month, day, year):
2
Plan for Supervised Visits
Follow the plan listed above (check one):
c.
(If you completed      , you are done completing this form. Do not complete      .)12 13
This is not a Court Order.

For your protection and privacy, please press the Clear 
This Form button after you have printed the form.
Rev. January 1, 2026 DV-105, Page 6 of 6Request for Child Custody and Visitation Orders 
(Domestic Violence Prevention)
Case Number:
13 Details of Unsupervised Visits
a. If the judge allows the person in       to have unsupervised visits with your children, you will have to tell the 
judge how you want to handle drop-off and pick-up of the children, also called exchanges. 
Do you want exchanges to be supervised by a third party?
2
No Yes (If yes, do you want a professional or nonprofessional to supervise? Check 1 or 2)
Professional (list name, if known):
Professional fees paid by: Me % Person in 2 % Other: %
(1)
Nonprofessional, like a trusted relative or friend (2)
(Name): Check here if the person has agreed to supervise visits.
b. Parenting time you want the person in       to have with the children.2
Time
Person to bring children to 
and from visit (or make 
available for virtual visit)
Location of drop-off/pick-up 
Monday Start:
End, if applies:
Tuesday Start:
End, if applies:
Wednesday Start:
End, if applies:
Thursday Start:
End, if applies:
Friday Start:
End, if applies:
Saturday Start:
End, if applies:
Sunday Start:
End, if applies:
Follow the schedule listed above (check one):
Every week Every other week Other
Start date for visits (month, day, year):
Other (describe):
(1) Location of visits (check one): In person at a safe location Virtual visit (not in person)
(2) Give details including when visits will happen, how often the visits should be, and who will be responsible 
for transporting the children. (Use the lines or chart below):
Virtual visit 
with  
person in  2
Plan for Unsupervised Visits
This is not a Court Order.

Retrieval chunks

• #1

  Form ID: DV-105 Title: Request for Child Custody and Visitation Orders Effective Date: 2026-01-01 Mandatory Form: yes Languages: 汉语, 한국어, español, Tagalog, Tiếng Việt Info Page: https://selfhelp.courts.ca.gov/jcc-form/DV-105 Primary Download URL: https://www.courts.ca.gov/documents/dv105.pdf Alternate Download …

• #2

  (include tribal land, if applies) Me Person in 2 Other (relationship to child) From: Check here if this address is private (confidential). List the state only. To present From: Until: From: Until: From: Until: From: Until: From: Until: make custody and visitation orders.) This is not a Court Order. Ins…

• #3

  Only the children listed here (names): b. For the following records or information (check all that apply): Medical, dental, and mental health School and daycare Extracurricular activity, including summer camps and sports teams Other (describe): (If the judge makes this order, providers will not be able to releas…

• #4

  10 Do you want the person in to have visits (parenting time) with the children?2 No, I ask the judge to order no visits for the person in (Stop here. You have finished completing this form.)2 Yes (Go to .)11 Yes, but only virtual visits (Go to .)11 2 11 Do you want visits with the children…

• #5

  judge how you want to handle drop-off and pick-up of the children, also called exchanges. Do you want exchanges to be supervised by a third party? 2 No Yes (If yes, do you want a professional or nonprofessional to supervise? Check 1 or 2) Professional (list name, if known): Professional fees paid by: Me % Person …