DV-165 - Order on Request to Keep Minor's Information Confidential

Summary

Order on Request to Keep Minor's Information Confidential

Text

Form ID: DV-165
Title: Order on Request to Keep Minor's Information Confidential
Effective Date: 2021-01-01
Mandatory Form: yes
Languages: 汉语, 한국어, español, Tiếng Việt
Info Page: https://selfhelp.courts.ca.gov/jcc-form/DV-165
Primary Download URL: https://www.courts.ca.gov/documents/dv165.pdf
Alternate Download URLs: https://www.courts.ca.gov/documents/dv165c.pdf, https://www.courts.ca.gov/documents/dv165k.pdf, https://www.courts.ca.gov/documents/dv165s.pdf, https://www.courts.ca.gov/documents/dv165v.pdf
Form Detail Page:
Order on Request to Keep Minor's Information Confidential
(DV-165)
Tells you whether a judge granted the request to keep information about a child (age 0-18) confidential.
Get form DV-165
汉语
Get form DV-165 in Chinese Simplified
(Chinese Simplified)
한국어
Get form DV-165 in Korean
(Korean)
español
Get form DV-165 in Spanish
(Spanish)
Tiếng Việt
Get form DV-165 in Vietnamese
(Vietnamese)
Effective: January 1, 2021
Go to
How-to instructions for Domestic Violence
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Domestic Violence Form Packets
PDF Text:
This is a Court Order.
Judicial Council of California,   
Rev. January 1, 2021, Mandatory Form 
Family Code, § 6301.5
www.courts.ca.gov
Order on Request to Keep  
Minor's Information Confidential 
(Domestic Violence Prevention)
DV-165 Order on Request to Keep Minor's 
Information Confidential
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California, County of
Court fills in case number when form is filed.
Case Number:
CONFIDENTIAL PUBLIC VERSION (REDACTED)
1 Parties in This Case
a. Person who requested restraining order (form DV-100, item       ):1
Full Name:
b. Person to be restrained (form DV-100, item      ):2
Full Name:
2 Person Making Request for Confidentiality
Full Name:
(Court will complete item       if request is denied or items      –       if request 
is granted or partially granted.)
3 4 13
Instructions to Clerk: If item       is 
checked, file page 1 in a public file and 
discard pages 2–6. 
3
3 Court Denied Request or More Information Needed
a. Denied. The request to keep information of a minor or minors confidential is denied.  
(1) The court will NOT make a decision on the Request for Domestic Violence Restraining Order 
(form DV-100). The request for restraining order and proposed order forms must be returned to the 
requester personally, destroyed, or deleted from electronic files and not filed with the court unless the 
person requesting the restraining order agrees to file them without any changes.
(2)
The court will make a decision on the Request for Domestic Violence Restraining Order (form 
DV-100). The request for restraining order and any accompanying orders will be filed in the public file.  
b.
More information is needed for court decision. You must go to court on the date and time below. At the 
court date, you must give more information on why you need the court to make information confidential.
Hearing 
Date
Date: Time:
Dept.: Room:
Name and address of court if different from above:
c. If         is checked, only this page of this order form will be issued. All other pages may be discarded.3
Date:
Judge (or Judicial Officer)
DV-165 Page 1 of 6

This is a Court Order.
Rev. January 1, 2021 Order on Request to Keep  
Minor's Information Confidential 
(Domestic Violence Prevention)
Case Number:
Court will complete the rest of this form if the request is partially or fully granted
4 Court Granted Request
a. Granted in full. The request to keep the information of a minor or minors confidential is granted in full.  
Details of the order are stated below in items      –      .5 12
b. Partially granted. The request to keep the information of a minor or minors confidential is granted only 
in part. Details of the order are stated below in items      –      .5 12
5 Findings
The court finds all of the following (all of these findings are required if granting in full or in part):
a. The right to privacy of the minors listed in item      overcomes the public's right of access to the information;6
b. There is a substantial probability that the interests of the minors listed in item       will be prejudiced if the 
information is not kept confidential; 
6
c. The order is narrowly tailored; and 
d. No less restrictive means exist to protect the privacy of the minors in item      .6
c. Name:
6 Minors Subject to This Order
This order protects the information listed in item       for the following minors:7
a. Name:
b. Name:
d. Name:
Check here if there are additional minors. Attach a sheet of paper and write "Attachment 6—Additional 
Minors" for a title.
References in this order to “the minor” refer to all minors listed here.
7 Information to Be Kept Confidential from the Public
WARNING: Unless authorized by the court or by law, if the information listed below is misused or disclosed to 
anyone other than law enforcement, you may be sanctioned up to $1,000 or face other court penalties. See Family 
Code section 6301.5 for the limited situations in which disclosures can be made without a court order.
The following information must be kept confidential and not viewable by the public. (Check all that apply.)
a.
Name of minor 
True name of minor in item    
(to be kept confidential)
6 Initials viewable by the public  
(to be used in redacted version)
DV-165, Page 2 of 6

This is a Court Order.
Rev. January 1, 2021 Order on Request to Keep  
Minor's Information Confidential 
(Domestic Violence Prevention)
Case Number:
b. Address of minor
The following addresses of the minors listed in item      must be redacted and must not be viewable by the
public:
6
c. Information relating to minor (check one):
(1) The information CIRCLED in the attached copy of form DV-100 or other document or form is 
made confidential by this order.
(2) The information below is made confidential by this order: 
Location of Information  
(for example, form #, page #,  
paragraph #, line #, 
attachment #,  or exhibit #)
Information to Be Redacted  
(not viewable by the public)
(a)
(b)
(c)
(d)
Check here if there is not enough space for your answer. Put your complete answer on an attached 
sheet of paper, and write “Attachment 7c(2)” for a title.
d.
Other:
DV-165, Page 3 of 6

This is a Court Order.
Rev. January 1, 2021 Order on Request to Keep  
Minor's Information Confidential 
(Domestic Violence Prevention)
Case Number:
8 Information to Be Kept Confidential from the Restrained Person
will have access to the 
following information checked in item       to comply with the protective order and prepare a response:7
a. All the information, unredacted.
b. All the information except for the following:
Check here if there is not enough space for your answer. Put your complete answer on an attached sheet of 
paper, and write “Attachment 8b” for a title.
The restrained person (full name)
9 People Who May Have Access to Unredacted Court Documents
a. The minor's (check all that apply):
(1) School and after-school program
(2) Childcare provider
(3) Supervised visitation provider   
(4) Other (name):
b. may be given copies of unredacted documents from this case with the following information 
(check all that apply):
(1) Minor's name
(2) Minor's address
(3) Minor's information listed in item 7c.
c. Law enforcement may have access to any information in this case that is necessary to enforce the restraining 
order.
DV-165, Page 4 of 6

This is a Court Order.
Rev. January 1, 2021 Order on Request to Keep  
Minor's Information Confidential 
(Domestic Violence Prevention)
Case Number:
10 Responsibility for Redacting All Forms and Documents
a. All forms and documents submitted with the request for confidentiality must be redacted and filed with the 
court no later than                                                                                              , by the:(number of court days or date)
(1) Court
(2) Person making the request
(3) Other:
b. The redacted documents must be filed in a public file, and the unredacted documents must be filed in a 
confidential file.
11 Court Records and Hearings
The information listed in item      must NOT be disclosed by the court in any:7
a. Registers of actions, indexes, court calendars, court transcripts, or minute orders in this case, any family law 
case, or any civil case with the same parties, in the State of California.
b. Future court hearings, including any documents introduced during a hearing in this case, any family law case, 
or any civil case with the same parties, in the State of California.
12 To All Parties
a. The information made confidential by this order must NOT be made public in this case, any family law case, 
or or any other civil case with the same parties, in the State of California.
b. If you file a document in this case or any case noted above in 12a that includes information listed in item      , 
you must attach form DV-175, Cover Sheet for Confidential Information, to the front, and include a copy of 
this order if there is not already one in the case.
7
DV-165, Page 5 of 6

This is a Court Order.
Rev. January 1, 2021 Order on Request to Keep  
Minor's Information Confidential 
(Domestic Violence Prevention)
Case Number:
13 To the Person Making the Request for Confidentiality
You must do the following:
a. Have a copy of each form listed in item (c) below personally served on (given to) the restrained person.
(See form DV-200-INFO to find out how to meet this requirement. Personal service is required when the 
protected person is making this request and when forms DV-100, DV-109 and DV-110 have NOT been served 
on the restrained person.)
b. Have a copy of each form listed in item (c) mailed to the:
(1) Restrained person
(2) Protected person
(3) Other:
(See form               to find out how to meet this requirement.)
c. Forms to serve:
(1) Form DV-170, Notice of Order Protecting Information of Minor
(Form DV-170 should be the first page with all other forms stapled behind it.)
(2) Form DV-100, Request for Domestic Violence Restraining Order
(3) Form DV-109, Notice of Court Hearing
(4) Form DV-110, Temporary Restraining Order
(5) Form DV-160, Request to Keep Minor's Information Confidential
Unredacted Redacted (if item 8b on DV-165 is checked)
(6) Form DV-165, Order on Request to Keep Minor's Information Confidential
Unredacted Redacted (if item 8b on DV-165 is checked)
(7) Form DV-175, Cover Sheet for Confidential Information (leave blank)
(8) Other:
Date:
Judge (or Judicial Officer) 
Instructions to Clerk 
 
 1. The originals of all unredacted documents containing the information checked in item       must be kept in a 
confidential file and must NOT appear in any register of action, calendar, index, minute order, or transcript 
in this case, or any civil case with the same parties, in the State of California. 
 2. For any copies provided that include confidential information, use Notice of Order Protecting Information of 
Minor (form CH-170) as a cover sheet for each set of forms.  
 3. Any information listed in item 8b must not be available to the restrained person and must be filed in a 
confidential file.  
7
DV-165, Page 6 of 6

Retrieval chunks

• #1

  Form ID: DV-165 Title: Order on Request to Keep Minor's Information Confidential Effective Date: 2021-01-01 Mandatory Form: yes Languages: 汉语, 한국어, español, Tiếng Việt Info Page: https://selfhelp.courts.ca.gov/jcc-form/DV-165 Primary Download URL: https://www.courts.ca.gov/documents/dv165.pdf Alternate Download…

• #2

  requester personally, destroyed, or deleted from electronic files and not filed with the court unless the person requesting the restraining order agrees to file them without any changes. (2) The court will make a decision on the Request for Domestic Violence Restraining Order (form DV-100). The request for restrai…

• #3

  WARNING: Unless authorized by the court or by law, if the information listed below is misused or disclosed to anyone other than law enforcement, you may be sanctioned up to $1,000 or face other court penalties. See Family Code section 6301.5 for the limited situations in which disclosures can be made without a court…

• #4

  (2) Minor's address (3) Minor's information listed in item 7c. c. Law enforcement may have access to any information in this case that is necessary to enforce the restraining order. DV-165, Page 4 of 6 This is a Court Order. Rev. January 1, 2021 Order on Request to Keep Minor's Information Confidential (Domest…

• #5

  b. Have a copy of each form listed in item (c) mailed to the: (1) Restrained person (2) Protected person (3) Other: (See form to find out how to meet this requirement.) c. Forms to serve: (1) Form DV-170, Notice of Order Protecting Information of Minor (Form DV-170 should be the first page with al…