Declaration In SupportCal. Super. - 6th Dist.January 4, 2021ATTACHM ENT CV-5014 NAME AND ACCRESS 3F PARTY ca ATTORNEY FCP. PARTY TELEPHONE NLMSER d/A/még W121i 420.?- [floww 9/2 TH 80! Mc- rura 03 avg, Fasrép. Gflj Ml 9%4 A£Q%J%A SUPERIOR COURT 0F CALIFORNIA, COUNTY OF SANTA CLARA STREET ADDRESS: 3999”“ court MAILING ADDRESS: CW" DIVISION CITY AND 2:? CODE; 191 N- Hm s' San Jou. GA 06113 BRANCH NAME: PCP COUPT USE OHLV FILE JAN - 4 2021 er of the Court A County a Santa Gan D Person/Ennty Seeking Protection. U/Aflafi’ Wgéw ,‘Z wwauAfg Person From Whom Protection is Sought: VimaN'T EowflRb 0R0; DECLARATION IN SUPPORT OF EX PARTE APPLICATION FOR CIVIL RESTRAINING ORDERS CASE NUMS ER: 210n009795 DEPT 4‘ I. the undersigned, declare: 1. l am (choose one): D attorney for Person or Entity Seeking Protection B/seIf-represented Person or Entity Seeking Protection D other (explain): 2. The opposing party is represented by an attorney: D Yes Mo If you checked “yes", fill in the attorney's name. address. and te!ephone number. If ou checked “no'. fill in the other ar‘uy P f5 name address, and telephone number. Party/Artcrney name: Addressfl’elephone number: 3. OTHER CASES: Have the parties to this case been involved in litigation with each other in another Civil, Family. Probate Juvenile,orCriminaICourt Case? MYes D No If “yes".case(s)number(s): 4. NOTICE I6 cv 3305's“; a. IHAVE given notice to the opposing party and/or their attorney by the following method: D Personal delivery D Overnight Carrier BFirst Class Mail U Other: Datei Time: AZ 'Ufi' fl,‘ I have received confirmation that the other party has received my papers as follows: (describe) b. ?YE NOT given notice of the request for orders because (Check all that apply. You must explain below): This is an application for Civil Harassment Prevention Act. Elder Abuse. Private Postsecondary School Violence, Transitional Housing Misconduct. or Workplace Violence Act restraining orders and: D Great orirreparable injury will result before the matter can be heard on notice. D It is impossible to give notice. D The other party agrees to the orders requested. D Other: c. Explanation: D A hearing between the parties is already set I am asking that this motion be heard at the same time. D | am unable to serve the other party in the time required by law. I fear for my physical safety (and that of others. if applicable). D Other: l declare under penalty of perjury that the forgoing is true and correct. P4,} ozu \fmmzs LAwgen/VL waoowfi 7L Date Print Name Declarafl s Signature 0M CV50” REV 09"13'15 DECLARATION IN SUPPORT OF EX PARTE APPLICATION FOR CIVII RFSTRAINING ORDFRS Page 1 of 2
