Domestic Violence Determination

The following form is available in Microsoft Word, Corel WordPerfect, and Adobe PDF formats. This form is maintained by the Division of State Court Administration. Instructions for completing and filing the form are below.

Form Title MS Word Adobe PDF
Domestic Violence Determination Form Word PDF


Who fills out the form?
The court making the determination of domestic violence will complete the form.

Chronological Case Summary (CCS).
A notation should be made on the Chronological Case Summary that a determination of domestic violence has been made.

Records of Judgments and Orders (RJO).
The original form completed by the court should be placed in the court's Records of Judgments and Orders for the date that the form was completed by the court.

Distribution of copies.
Copies of the finding by the court should be distributed as follows: (1) defendant, (2) prosecuting attorney, and (3) case file.

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