This form is to document that children were not exchanged at the stated time per court order. It can be used for minimal violations of the court order. Do Not Use for Missing Child, Child Abduction, or Restraining Order Violation cases. You MUST live within Irvine city limits or the violation MUST have occurred within the Irvine city limits to file this report. This form is provided to document your statement should you desire to take action. Please provide as much detail of the incident as possible and please list the child(ren) that are involved in the incident.

Please click the button below to go to the form.