Ca_Law

court_form | California

EA-300 - Request for Elder or Dependent Adult Restraining Order Allowing Contact

  • UIDca_court_forms:ea-300
  • CitationEA-300
  • Court / bodyJudicial Branch of California
  • Decision dateN/A
  • CollectionCA_COURT_FORMS
  • SourceOriginal

Summary

Request for Elder or Dependent Adult Restraining Order Allowing Contact

Text

Form ID: EA-300
Title: Request for Elder or Dependent Adult Restraining Order Allowing Contact
Effective Date: 2023-01-01
Mandatory Form: no
Languages: 汉语, 한국어, español, Tiếng Việt
Info Page: https://selfhelp.courts.ca.gov/jcc-form/EA-300
Primary Download URL: https://www.courts.ca.gov/documents/ea300.pdf
Alternate Download URLs: https://www.courts.ca.gov/documents/ea300c.pdf, https://www.courts.ca.gov/documents/ea300k.pdf, https://www.courts.ca.gov/documents/ea300s.pdf, https://www.courts.ca.gov/documents/ea300v.pdf
Form Detail Page:
Request for Elder or Dependent Adult Restraining Order Allowing Contact
(EA-300)
Ask the judicial officer for a restraining order to allow contact and tell the judge why you need one.
Get form EA-300
汉语
Get form EA-300 in Chinese Simplified
(Chinese Simplified)
한국어
Get form EA-300 in Korean
(Korean)
español
Get form EA-300 in Spanish
(Spanish)
Tiếng Việt
Get form EA-300 in Vietnamese
(Vietnamese)
Effective: January 1, 2023
Go to
How-to instructions for Elder Abuse
Go to
Elder Abuse Form Packets
PDF Text:
Judicial Council of California,                          Ne  
New January 1, 2023, Mandatory Form 
Welfare and Institutions Code, § 15657.03 
www.courts.ca.gov
Request for Elder or Dependent Adult 
Restraining Order Allowing Contact
EA-300, Page 1 of 5
EA-300 Request for Elder or Dependent Adult 
Restraining Order Allowing Contact
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:
Use this form to obtain an order allowing contact between an elder or 
dependent adult and another person.
•
Read Can an Elder or Dependent Adult Restraining Order Allowing 
Contact Help Me? (form EA-300-INFO) before completing this form.
• Note: This order cannot be issued if the elder or dependent adult lives in a 
long-term care or residential facility or is a patient at a hospital. 
• If you want a restraining order for other abuse, such as physical or financial 
abuse, use Request for Elder or Dependent Adult Abuse Restraining Orders 
(form EA-100). Read Can a Restraining Order to Prevent Elder or 
Dependent Adult Abuse Help Me? (form EA-100-INFO) for more 
information.
1 Elders or Dependent Adults 
3
(List each elder or dependent adult in the same household who wants 
to have contact with the person named in       and their age below.)
3
Full Name Age
Check here if there are more elders or dependent adults in the same household who also want to have 
contact with the person named in      . List those persons and their ages on an attached sheet of paper and 
write “Attachment 1—Additional Elders or Dependent Adults” for a title.  You may use form MC-025, 
Attachment.  
2 Person Alleged to Be Preventing Contact
Full Name:
Address (if known):
City: State: Zip:
3 Person Who Wants Contact With the Elders or Dependent Adults
Full Name:a.
b. Describe this person’s preexisting relationship to the elders or dependent adults named in      :
Check here if there is not enough space for your answer. Put your complete answer on the attached sheet 
of paper or form MC-025 and write “Attachment 3    Preexisting Relationship” for a title.—
1
This is not a Court Order.

New January 1, 2023
 Request for Elder or Dependent Adult 
Restraining Order Allowing Contact
Case Number:
4 Person Requesting Order
Who is asking the court for an order? (Check a, b, c, or d):
a. The elders or dependent adults named in      .
The person named in       who wants contact with the elders or dependent adults.
Other person legally authorized to make this request (name):
1
b. 3
c. Name:
conservator of the person estate person and estate
Case No.:
named in      , appointed by (name of court):1
,
d.
(Show this person’s legal authority to make this request on an attached sheet of paper. Write “Attachment 
4d—Information About Person Requesting Order” for a title. You may use form MC-025,  Attachment.)
5 Contact Information
Contact information for the person asking the court for an order
a. Your Lawyer (if you have one for this case)
Name:   State Bar No.:
Firm Name:
b. Your Address (If you have a lawyer, give your lawyer’s information. If you do not have a lawyer and want to 
keep your home address private, you may give a different mailing address instead.)
Address:
City: State: Zip:
Telephone: Fax:
Email Address:
6 Description of Elders or Dependent Adults
The person or persons named in       are residents of California and (check a, b, or c):1
a. Are all age 65 or older.
Are all under age 65 and have physical or mental limitations that restrict their ability to carry out normal 
activities or to protect their rights. (Briefly describe limitations on the attached sheet of paper or form 
MC-025. Write “Attachment 6b—Description of  Elders or Dependent Adults” for a title.)
Include some adults age 65 or older and some are adults under age 65. The adults under age 65 have 
physical or mental limitations that restrict their ability to carry out normal activities or to protect their rights. 
(Identify which persons are 65 or older and identify and briefly describe the limitations of those under age 
65 on the attached sheet of paper or form MC-025. Write “Attachment 6c—Description of  Elders or 
Dependent Adults” for a title.)
b.
c.
This is not a Court Order.
EA-300, Page 2 of 5

EA-300, Page 3 of 5 New January 1, 2023 Request for Elder or Dependent Adult 
Restraining Order Allowing Contact
Case Number:
7 Relationship to Person Alleged to be Preventing Contact
How do the elders or dependent adults know the person in      ? (Explain below): 2
Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of 
paper or form MC-025 and write “Attachment 7—Relationship to Respondent” for a title.
8 Facts Supporting Order Allowing Contact
The person requesting the order must show that:
•
•
The elders or dependent adults expressly desire contact with the person named in      ; 
The person in       has repeatedly prevented that contact;  
The prevention of contact was not in response to an actual or threatened abuse of the elders or dependent adults 
by the person named in      ; and  
The prevention of contact was not in response to the desire of the elders or dependent adults to not have contact 
with the person named in      .
•
•
3
2
3
3
a. Describe the desire of the elders or dependent adults to have contact with the person named in (3) and attach 
any documentation demonstrating such desire:
3
Check here if documentation is attached or if there is not enough space for your answer. Put your complete 
answer on the attached sheet of paper or form MC-025 and write "Attachment 8a—Describe Desire to 
Contact” for a title.
b. (1) When has the person in (2) prevented the person named in (3) from seeing the elders or dependent adults? 
(Provide dates or estimated dates):
2 3
(2) Describe how the person in (2) has prevented the person named in (3) from seeing the elders or dependent 
adults.
2 3
Check here if there is not enough space for your answer. Put your complete answer on the attached 
sheet of paper or form MC-025 and write “Attachment 8b—Describe Prevention” for a title.
This is not a Court Order.

EA-300, Page 4 of 5 New January 1, 2023 Request for Elder or Dependent Adult 
Restraining Order Allowing Contact
Case Number:
9 Venue
Why are you filing in this county? (Check all that apply):
a. The person in       lives in this county.2
b. The person in       prevented the person in        from seeing the elders or dependent adults in this county.2 3
c. Other (specify):
10 Other Court Cases
a. Has the person in       or the person in      been involved in another court case with the elders or dependent2 3
adults? No Yes (If yes, specify the kind of each case and indicate where and when each was filed):
Kind of Case Filed in (County/State) Year Filed Case Number (if known)
(1) Elder or Dependent Adult Abuse
(2) Civil Harassment
(3) Domestic Violence
(4) Divorce, Nullity, Legal Separation
(5) Paternity, Parentage, Child Custody
(6) Eviction
(7) Guardianship
(8) Workplace Violence
(9) Small Claims
(10) Criminal
(11) Other (specify):
b. Are there any protective or restraining orders now in effect relating to the elders or dependent adults and the 
person in       or the person in      ?2 3 No Yes (If yes, attach a copy if you have one.)
11
I ask the court to order the person in       to allow the person in       to contact the elders or dependent adults, with 
the following terms:
2
a. The person in (2) may not prevent the person named in (3) from in-person or remote online or telephonic  
visits with the elders or dependent adults named in (1) .
2 3
1
b.
Check here if there is not enough space for your answer. Put your complete answer on the attached  
sheet of paper or form MC-025 and write “Attachment 11b—Other Order Terms” for a title.
Other terms requested for the order allowing contact (specify):
Order Allowing Contact
3
This is not a Court Order.

EA-300, Page 5 of 5 New January 1, 2023 Request for Elder or Dependent Adult 
Restraining Order Allowing Contact
Case Number:
12 Request to Give Less Than Five Days' Notice of Hearing
You must have your papers personally served on the person in        at least five days before the hearing, unless the  
court orders a shorter time for service. (Read form EA-200-INFO, What Is “Proof of Personal Service”?, to learn 
about serving legal papers. Form  EA-200, Proof of Personal Service, may be used to show the court that the 
papers have been served.)
2
If you want there to be less than five days between service and the hearing, explain why:
Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of  
paper or form MC-025 and write “Attachment 12—Request to Give Less Than Five Days’ Notice” for a title.
13 Lawyer's Fees and Costs
I ask the court to order payment of my lawyer’s fees court costs.
The amounts requested are:
Item Amount Item Amount
$ $
$ $
$ $
Check here if there are more items. Put the items and amounts on the attached sheet of paper or form 
MC-025 and write “Attachment 13—Lawyer’s Fees and Costs” for a title.
14 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.
Date:
Type or print your name
 Signature of person making this request
Date:
Type or print your name
 Signature of person making this request
This is not a Court Order.

Retrieval chunks

  • #1

    Form ID: EA-300 Title: Request for Elder or Dependent Adult Restraining Order Allowing Contact Effective Date: 2023-01-01 Mandatory Form: no Languages: 汉语, 한국어, español, Tiếng Việt Info Page: https://selfhelp.courts.ca.gov/jcc-form/EA-300 Primary Download URL: https://www.courts.ca.gov/documents/ea300.pdf Alter…

  • #2

    Check here if there are more elders or dependent adults in the same household who also want to have contact with the person named in . List those persons and their ages on an attached sheet of paper and write “Attachment 1—Additional Elders or Dependent Adults” for a title. You may use form MC-025, Attachment…

  • #3

    Include some adults age 65 or older and some are adults under age 65. The adults under age 65 have physical or mental limitations that restrict their ability to carry out normal activities or to protect their rights. (Identify which persons are 65 or older and identify and briefly describe the limitations of those u…

  • #4

    EA-300, Page 4 of 5 New January 1, 2023 Request for Elder or Dependent Adult Restraining Order Allowing Contact Case Number: 9 Venue Why are you filing in this county? (Check all that apply): a. The person in lives in this county.2 b. The person in prevented the person in from seeing the elder…

  • #5

    Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write “Attachment 12—Request to Give Less Than Five Days’ Notice” for a title. 13 Lawyer's Fees and Costs I ask the court to order payment of my lawyer’s fees court costs. The amounts…