FL-412State (JC)Fillable

Affidavit of Facts Constituting Contempt (Domestic Violence/Custody and Visitation)

Judicial Council of California · Family Law

Verified current as of August 1, 2026

This form is used to document specific violations of a court order related to domestic violence, custody, or visitation in a sworn statement that can be presented as evidence of contempt. A person who believes their ex-partner or family member has violated a custody, visitation, or domestic violence restraining order uses this form to request the court hold that person accountable for breaking the order.

This form has fillable fields — you can complete it directly in the viewer on the right.
Loading…