Request Restraining OrderCal. Super. - 6th Dist.January 4, 2021CH 100 Request for Civil Harassment Clerkstampsdarehere wnenrormis med. - Restraining Orders Read Can a Cn'il Harassmen! Restraining Order Help Me? (form CH-100- INFO) before completing this form. Also fill out Confidential CLETS Information (form CLETS-OOU with as much information as you know. G) Person Seeking Protection a. YourFullN'Wé' @0225 Wfié/I/cé MooWEI/Age: ha Your Lawyer (ifyou have onefor this case) Fill in court name and street address:Name; State Bar No.2 . I - Superior Court of California, County of F N . Vum ame S’fl/v 7/} (W b. Your Address (Ifyou have a lawyer, give your lawyer 's /?I NOR 7/7 F’egr’mié’f information. Ifyou do'Foit’have a lawyer and want lo keep your H fiflfNrUfé 04 ?5743 home address privale, you may give a diflerem mailing address instead. You d0 not have to give telephone, fax, 0r e-mail.) Address; 8 0 S ARaTV&US ClR. Court fills in case number when form is filed. City: F os Tee c. t 73 State: a_4L zip; emf Case Number: Telephone: b -b Fax; _-_-__ 2 1 CH 0 0 9 7 9 5 E-Mail Address: ® Person From Whom Protection ls Sought Full Name: VINCENT EWflKb 020$ Age: fl i Address (ifknownkflzzgaeg \I' M 54 AD/fllq 40H); Hp” 5&1 - I7- 00é City: mogeAA) fl/LL State; C g Zip: Qifiéo Additional Protected Persons a. Are you asking for protection for any other family or household memberS? D Yes D No If)“, 1m (hem; Eullflame 5;; fig livggwjtb mu? Howaggtbev relatgfitg ygg? matamHfiM/V I'waobwoe‘rfi f 95 m/Yes a No cd/FéMaya I&Qot/UN I7? (05 D Yes B/NO NE/G/rBae D Yes D No D Yes D No D Check here tftlzere are more persons. Attach a sheet ofpaper and write “Attachment 3a-Additional Protected Persons "for a title. You may useform MC-025, Attachment. b. Why do these people need protection? (Explain below).- D Check here iftlzere is not enough spaceforyour answer. Putyour complete answer on the attached sheet 0f paper orform MC-025 and write “Attachment 3b-H71y Others Need Protection ”for a title. VERBAL TA/AEAT AME HHRQsSM/zwri This is not a Court Order. WW°W°“”;°Z?;°"ZZTW”:;“‘WV Request for Civil Harassment Restraining Orders CH-100. Page1 of6 eoaolcmpwcoduro.§§5276and5279 (Civil Harassment Prevention) '9 Case Number: Relationship of Parties V How do you know the person in ® ? (Explain below): NE[éKEOR QAMfi CLAM dawfj) D Check herr ftlzere is not enough spaceforyour answer. Putyour complete answer on the attached sheet of paper orform MC-025 and write "Attachment 4-Relationship ofParties "for a title. Venue Why are you filing in this county? (Check all that apply): a. MThe person in® lives in this county. b. MI was harassed by the person in® in this county. c. L, Other (speczfv): Other Court Cases a. Have you or any of the persons named in®been involved in another court case with the person in ®? El Yes D No (Ifyes, check each kind ofcase and indicate where and when each wasfiled.) Kind ofCase Filed in (Countv/5tate2 Year Filed Case flumber (it anwnl (1) M Civil Harassment 5m4 MR4 CA 3020 30 -023 «9/214 . I (2) D Domestic Violence (3) D Divorce, Nullity, Legal Separation (4) D Paternity, Parentage, Child Custody (5) D Elder or Dependent Adult Abuse (6) M Eviction 5mm %3 g, M lflcyssosgz (7) D Guardianship (8) D Workplace Violence (9) D SmallClaims 54/1/14 MM CA /8'&Q 'Og/éé’ (10) MCriminal4 531nm Wa'w 4019 ’9.-aé€-ozoig (11) M Otherapecvfw: Momma: -» 57mm cum 'e44 420/? ADA No, /9-00( ADM: [taxisi bEPury bis mL-r flmeuty r b. Are there now any protective or restraining orders in effect relating to you or any of the persons in© and the person in®? g No D Yes (Ifyes, attach a copy ifyou have one.) Description of Harassment Harassment means violence or threats of violence against you, or a course of conduct that seriously alarmed, annoyed, or harassed you and caused you substantial emotional distress. A course of conduct is more than one act. a. Tell the court about the last time the person in® harassed you. DA7£ 7/Mé (l) When did it happen? (provide date or estimated date): __d$'v 0/ Qogo a /2:57Hk 3 (2) Who else was the_re?’ magk‘ s7W 640w/d.- This is not a Court Order. W’”“‘”"’°“ Request for Civil Harassment Restraining Orders CH-1°°v Page 2 °f5 (Civil Harassment Prevention) -> Case Number: ® a. (3) £2 (5) (6) How did the person in ®harass you? (Explain below): D Check here ift/zere is n0! enough spaceforyour answer. Putyour complete answer on the attached sheet ofpaper orform AlC-O25 and write " 4Itaclzment 7a(3)-De5cribe Harassment' 'for a title. ymgo gag?2p gamma 020‘ HPP/QOHCM 0U l/Iz’ c; c w/f/A WRK ow/d Ava I715 5/214: wflaetzWWWMWMJ/aé) VaRMLUz THRQA Tchb flora 0F {/5 1441/in QLENcth/e H13 F/SE. fir omé 155m] 74x35" A Swims AT IIMRK ékomu ”mg/A/é 79 hum M5 Cm Pflour 00; 0F #15 l/éluas 71/45 a fia flécoaoésMILE- Did the person {n® use 0f threatep to us¢_a gun or any oger weaBon‘? D Yes g No ([fyes, explain below): D Check here ifthere is not enough spacefor your answer. Put your complete answer on the attached sheet ofpaper orform [VIC-OZJ' and write “A ttachment 7a(4)-Use of Weapons "for a title. Were you harmed or injured because of the harassment? M Yes D No (Ifyes, explain below): D Check here [fthere is not enough spaceforyour answer. Putyour complete answer on the attached sheet ofpaper orform AJC-025 and write Attachment 7a(5)--Harm or Injzm 'for a title. TJ/ZS Comsvflwr fi/feassmm'?’ fog Tx/a M52" v_flflgdéf5.2,,“ ?EM WM. M FtelmbsWW; b’zv' SW63: Ecénuz 1/1) 72/6, QuAL/P’ol 9F A/FE.oqmmr afl owe. flngZfl 1. £572&L/5//¢& ml l7a7 Did the police come? MYes D No If yes, did they give you or the person in® an Emergency Protective Order? D Yes MNO If yes. the order protects (check all that apply): D Me D The person in® D The persons in @. (Attach a copy ofthe order ifyou have one.) b. Has the person in® harassed you at other times? M Yes D No (Ifyes, describe prior incidents andprovide dates ofharassment below): D Check here ifthere is not enough spaceforyour answer. Putyour complete answer 0n the attached sheet of paper orform MC-025 and write “Attachment 7b-Prevz'0us Harassment"f0r a title. 430/6 W004i 0&0; flflofimgo m comp. / M4; wackwe, arc m3 fifofimerg Hmelefiggxzb w SIv/w zu. - , m oxen},.,, 5’1 , U ll A‘ : -n This s not a Court rder. opé’a 3’. W“""a”"2°” Request for Civil Harassment Restraining Orders CH-100, Pageaofs (Civil Harassment Prevention) é Case Number: Check the orders you want. o M PersonalConduct Orders Iask the coun to order the person in® not to do any of the following things to me or to any person to be protected listed in©z a. Harass, intimidate, molest, attack, strike, stalk, threaten, assault (sexually or otherwise), hit, abuse, destroy personal property of, or disturb the peace of the person. b, M Contact the person, either directly or indirectly, in any way, including, but not limited to, in person, by telephone, in writing, by public or private mail, by interoffice mail, by e-mail, by text message, by fax, or by other electronic means. C. D Other (specifiz): D Check here ifthere i5 not enough spaceforyour answer. Putyour complete answer on the attached sheet ofpaper orform AIC-025 and write ”Attachment 8c-Other Personal Conduct Orders, "for a title. The person in ® will be ordered not to take any action to get the addresses 0r locations ofany protectedperson unless the courtfinds good cause not to make the order. @ D Stay-Away Orders a. I ask the court to order the person in® to stay at least 5'0 yards away fiom (check all that apply): (1) M Me. (8) M My vehicle. (2) MThe other persons listed in @. (9) g Other (specifvxsrae WESPASS/A’é 0N (3) E My home. 1 30305- m (4) E] Myjob orworkplace. ° 44% 0 (5) D Myschool. 0‘4- 4935; “34 (6) D My children's school. (7) D My children’s place of child care. b. If the court orders the person in ® to stay a» ay from all the places listed above, will he or she still be able to get to his or her home, school, orjob? YCS D N0 (Ifno, explain below): D Check here ifthere is not enough spaceforyour answer. Putyour complete answer 0n the attached sheet of paper orform MC-025 and write “Attachment 9b-Stay-Away Orders, "for a title. Guns or Other Firearms and Ammunition Does the person in® own or possess any guns or other firearms? D Yes D No g1 don't know Iftlzejudge grants a protective order, the person in® will be prohibitedfrom owning, possessing, purchasing, receiving, or attempting t0 purchase 0r receive a gun, otherfirearm, and ammunition while the protective order is in eflect. Theperson in ® will also be ordered t0 turn in t0 law enforcement, 0r sell t0 or store with a licensed gun dealer, any guns orfirearms within his or her immediate possession 0r control. This is not a Court Order. R‘MJ’M” ‘- 2°“ Request for Civil Harassment Restraining Orders CH-100. Page 4 of 6 (Civil Harassment Prevention) '9 cafiTTfi‘Oo 9 79 5 ® M Temporary Restraining Order I request that a Temporary Restraining Order (TRO) be issued against the person in® to last until the hearing. I am presenting form CH-l 10, Temporary Restraining Order, for the court's signature together with this Request. Has the person in® been told that you were going to go to coun to seek a TRO against him’her? Yes D No (Ifyou answered no. explain why below): D Check here ifthere is not enough spaceforyour answer. Put your complete answer 0n the attached sheet 0f paper orfonn MC-025 and write “A ttachment 1 l-Temporary Restraining 0rder"for a title. D RequgstrtroWGivier ngs Thain“ Five Days' Notice of HeaanQ 7 7 7 You must have yourpapers personally sewed 0n the person in® at leastfive days before the hearing, unless the court orders a shorter timefor service. (Form CH-ZOO-INFO explains What Is “Proof of Personal Service"? Form CH-200, Proof of Personal Service, may be used t0 show the court that the papers have been served.) If you want there to be fewer than five days between service and the hearing, explain why below: D Check here ifthere is not enough spacefor your answer. Pu! your complete answer 0n the attached sheet of paper orform MC-025 and write "Attachment 12-Request to Give Less Than Five Days ' Notice "for a title. MNO Fee for Filing or Service a. w There should be no filing fee because the person in ® has used or threatened to use violence against me, has stalked me, or has acted or spoken in some other way that makes me reasonably fear violence. b. M The sheriff or marshal should serve (notify) the person in® about the orders for free because my request for orders is based on unlawful violence, a credible threat of violence, or stalking. c. M There should be no filing fee and the sheriff or marshal should serve the person in ®for free because I am entitled to a fee waiver. (You must complete andfileform FW-OOI. Application for Waiver of Court Fees and Costs .) D Lawyer's Fees and Costs I ask the court to order payment of my D lawyer’s fees E Court costs. ' The amounts requested are: Item Amount Itgm AmQunt $ $ $ S $ $ D Check here ifthere are more items. Put the items and amounts on (he attached sheet ofpaper orform AIC-025 and write "Attachment I4-Lauyer's Fees and Costs "for a title. This is not a Court Order. WJ'"""Y‘-2°‘3 Request for Civil Harassment Restraining Orders CH-100. Page5°f6 (Civil Harassment Prevention) 9 Case Number: ® D Possession and Protection of Animals I ask the court to order the following: a. D That I be given the sole possession, care, and control of the animals listed below, which 1 own, possess, lease, keep, or hold, or which reside in my household. (Identifianimals by, e.g., type, breed, name, color, sex.) I request sole possession of the animals because (specifi' good causefor granting order): D Check here {fthere is not enough spaceforyour answer. Put your complete answer on the attached sheet ofpaper orform MC-025 and write “Attachment I 5a--Possessi0n ofAnimaIs "for a title. b. D That the person in @must stay at least yards away from, and not take, sell, transfer, encumber, conceal, molest, attack, strike, threaten, harm, or otherwise dispose of, the animals listed above. MAdditional Orders Requested I ask the coun to make the following additional orders (specifiz): D Check here ifthere ts not enough spacefor mm ansn er. Putyour complete answer 0n the attached sheet of papal orfonn MC-O25 and “rite “4tlachment l6-4dditional Orders Requested,’ for a title. mug? go; H45 A Aw a; M49 owae C1954 Loom £6szTo H15 Rapfifl/ Au? Is Nor 7o LEAW ms Vifl/cAL 9g mg I @423 (UH/Lf' TAWT/fflodé’afff m5 Pfiommb04/ u® Number of pages attached to this form, if any: £03€472 (2: :53: Date: Lawyer 's name (ifanfl Lawyer 's signature I declare under penalty ofperjury under the laws of the State of California that the information above and on all attachments is true and correct. Dare alér/T/J‘zoaz/m /A- TMooéééaeTfl Type orprlnt VOMI‘ name This is not a Court Order. “m“ m"? 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