Step 4 of 5 — What happened

This is the most important section. Describe the most recent incident and any history in your own words — the court reads exactly what you write here.

National DV Hotline: 1-800-799-7233 — 24/7, free, confidential

Most recent incident of abuse or harassment (§11)

Describe the most recent incident. Include the date, where you were, exactly what they did or said, any injuries, and who else was present.

Date of most recent incident

Must be today or earlier.

Where it happened

Type of abuse (check all that apply):

Physical

Hit, pushed, grabbed, choked, or physically injured me.

Threats

Threatened to hurt me, my children, or others.

Stalking or following

Followed me, tracked my location, or monitored my devices.

Property damage

Destroyed, took, or damaged my property.

Harassment or emotional

Repeated unwanted contact, intimidation, or isolation.

Weapon involved

Used or displayed a weapon during the incident.

Children were present

Minor children witnessed or were nearby during the incident.

Police were called

Law enforcement responded to this incident.

Police report number (if known) Describe what happened — in your own words (§11)

This goes directly onto the DV-100. Write in your own words — the court will read exactly what you enter here.

Add to your account:

Prior incidents and history of abuse (§12)

If there has been a pattern of abuse, describe it here. Approximate dates are fine. Leave blank if this is the first incident.

There is a history of prior incidents

Check this if this is not the first time — there has been a pattern or prior incidents.

Approximate number of prior incidents (if known) How long has this been happening?

Describe prior incidents (§12)

Include approximate dates, any injuries or police reports, and any pattern of escalation you have noticed.

Prior court orders (§14)

Tell the court if there are any existing court orders involving you and the restrained person.

There is an existing court order involving this person

For example: a prior restraining order, a custody order, or a criminal protective order.

Describe the prior order(s) (if any)

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