VISITATION /CUSTODY VIOLATION REPORT ?· Visitation /Custody Violation Report Instructions: ... Home…

Download VISITATION /CUSTODY VIOLATION REPORT ?· Visitation /Custody Violation Report Instructions: ... Home…

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<ul><li><p>YOLO COUNTY DISTRICT ATTORNEY CHILD ABDUCTION UNIT </p><p>Yolo County District Attorney Child Abduction Unit Phone: 530 -666-8400 301 Second Street Fax: 530-666-8399 Woodland, CA 95695 </p><p>VISITATION /CUSTODY VIOLATION REPORT FORM </p><p>Visitation /Custody Violation Report Instructions: Use this 4-page form to self-report violation(s) of a Family Court Order related to visitation/custody issues. Please fill in all blanks completely. If a section does not apply, type N/A in the box. If you do not know the answer to a particular question, type UNKNOWN in the box. If you possess a copy of your current court orders please submit those with this completed form. When you are finished, sign and date the form, print it out, retain a copy for yourself and mail (or bring in) to: </p><p>Yolo County District Attorney Child Abduction Unit </p><p>301 Second Street Woodland, CA 95695 </p><p>*IMPORTANT NOTICE* </p><p>Upon acceptance of this report, ACTION MAY BE TAKEN by the Yolo County District Attorneys Office if deemed appropriate. Should you need assistance in pursuing a civil enforcement remedy, contact a private attorney for assistance. The Yolo County District Attorneys Office DOES NOT represent individual parties in a visitation/custody dispute. After you complete this report, it will be kept on file with this office. </p><p>REPORTING PARTY INFORMATION </p><p>First Name Last Name Middle Initial </p><p>Street Address </p><p>City/Province State Zip/Postal Code </p><p>Country Work Phone Cell Phone </p><p>Home Phone E-mail Date of Birth </p><p>Male Female Drivers License Numbe r DL State </p><p>Social Security Number Place of Employment Employment Phone </p><p>Reporting Partys Relationship to Child </p><p>HP_Administrator1</p><p>HP_Administrator1</p></li><li><p>CHILD INFORMATION </p><p>Child 1 Full Name DOB Male Female </p><p>School Address </p><p>Child 2 Full Name DOB Male Female </p><p>School Address </p><p>Child 3 Full Name DOB Male Female </p><p>School Address </p><p>Child 4 Full Name DOB Male Female </p><p>School Address </p><p>Child 5 Full Name DOB Male Female </p><p>School Address </p><p>Child 6 Full Name DOB Male Female </p><p>School Address </p><p>When/Where Did You Last See Children? </p><p>Where Are the Children Now? </p><p>HP_Administrator</p><p>HP_Administrator2</p></li><li><p>VIOLATING PARTY INFORMATION </p><p>First Name Last Name Middle Initial </p><p>Street Address </p><p>City/Province State Zip/Postal Code </p><p>Country Work Phone Cell Phone </p><p>Home Phone E-mail Date of Birth </p><p>Male Female Drivers License Number DL State </p><p>Social Security Number Place of Employment Employment Phone </p><p>Vehicle Make/Model Vehicle Year/Color License Plate </p><p>Pending Criminal Charges? Yes No Location? </p><p>Violators Relationship to Children </p><p>HP_Administrator3</p></li><li><p>CASE HISTORY/OTHER RELEVANT FACTS </p><p>Police Report Yes Agency/Report # No </p><p>Restraining Order Issued Yes Restraining Order # No </p><p>Other Court Order? Yes Court Location/Order # No </p><p>Have You Reported Other Visitation Violations To This DA's Office? </p><p>Yes No </p><p>Case Number Or Date(s) Reported </p><p>Family Court Case Number </p><p>Name Of Court </p><p>Date Of Most Current Visitation Order </p><p>Custody Arrangements You Have: </p><p>Custody Arrangements Other Comments </p><p>What Is The Specific Visitation Arrangement Ordered By The Court? </p><p>Narrative - Explain How The Violation Occurred; Include Date(s), Time(s), And Location(s)? </p><p>Printed Name Signature </p><p>Date Signed/Submitted </p><p>HP_Administrator4</p><p>HP_AdministratorTextBoxNote: If you do not have the full version of Adobe Acrobat (i.e., you only have Adobe Acrobat Reader), you will only be able to fill out the form, print it and send it in to the above address via U.S. mail. Otherwise, you can fill out the form and send it via the email link. </p><p>Text1: Text2: Text3: Text5: Text6: Text7: Text8: Text9: Text10: Text11: Text12: Text13: Text14: CheckBox15: CheckBox16: Text17: Text18: Text19: Text20: Text21: Text22: Text23: Text24: CheckBox25: CheckBox26: Text27: Text28: Text29: Text30: CheckBox31: CheckBox32: Text33: Text34: Text35: Text36: Text37: Text38: CheckBox39: CheckBox40: CheckBox41: CheckBox42: CheckBox43: CheckBox44: CheckBox45: CheckBox46: Text47: Text48: Text49: Text50: Text51: Text52: Text53: Text54: Text55: Text56: Text57: Text58: Text59: Text60: Text61: Text62: Text63: Text64: Text65: Text66: Text67: Text68: Text69: Text70: Text71: Text72: Text73: Text74: Text75: Text76: Text77: Text78: Text79: Text80: Text81: Text82: Text85: Text86: CheckBox87: CheckBox88: CheckBox89: CheckBox90: CheckBox91: CheckBox92: CheckBox93: CheckBox94: CheckBox95: CheckBox96: CheckBox97: CheckBox98: Text99: Text100: Text101: Text102: Text103: Text104: Text105: Text106: Text107: Text108: Text109: Text110: Text111: CLEAR FORM: PRINT: EMAIL: </p></li></ul>

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