Request Restraining OrderCal. Super. - 6th Dist.January 6, 2021Request for Civil HarassmentCH4 00 Restraining Orders Read ('un u Civil Harassment Restraining Order Help Me? (form CH-I 00- INFO) before completing this form. Also fill out Confidential CLETS Information (form CLETS-OOI) with as much information as you know. Person Seeking Protection a. Your FullName: \J Ln ‘4‘ AL“- Age; 3g Your Lawyer ('ifyou have onefor this case) Name: State Bar No.2- Firm Name:Wanted b. Your Address (Ifyou have a lawyer, give your lawyer 's information. Ifyou do not have a lawyer and wan! to keep your home address private, you may give a different mailing address instead. You do not have to give telephone, fax, or e-mail.) '4qu (Pu \ avg DrAddress: City: Such Naz- Statezd Zip: “5" B Telephone: Fax: E-Mail Address: Q) Person From Whom Protection Is Sought Clerk stamps date hem when form is filed. F JAN - 6 2021 e Cou RS noCrl “QuntyouoI Santa Clara 15ups DEPU Uy Fill in coun name and street address: Superior Court of California, County of Santa Clara 191 N. First Street 191 N. First Street San Jose, CA 95113 Civil Courthouse- DTS Court fills in case number when form is filed. Case Number' zicaoo9800 Full Name: g’rcSL‘“ V4 H s Age: 2f? Address (ifknown): Lluo-q ©U\Qvfl Q F Cit)“ ‘2 “A 3 ‘5 Q’ State: QLZip:3513b ® Additional Protected Persons a. Are you asking for protection for any other family or household members? DYesm Ifyes, list them: Full Name fl Age Lives with you? D Yes D N0 D Yes D No D Yes D No D Yes D No How are they related to you? a Check here ifthere 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 Ifthere is not enough spaceforyour answer. Put your complete answer on the attached sheet of paper orform MC-025 and write “Allachment 3b-Why Others Need Protection "for a title. This is not a Court Order. Request for Civil Harassment Restraining Orders (Civil Harassment Prevention) audlual Counol 01 California www courts ca gov vnsed anuary1 2018 Manda Code ov ml Proce‘dura ‘55 527 6 anuF527 9 CH4 00’ Page 1 0f 6 ROHCI [1 PVERN9 Egflmam! Case Number: ® Relationship of Parties How do you know the person in®? (Explain below): D Check here ifthere is n0! enough spacefor your answer. Put your complete answer 0n the attached sheet 0f paper orform MC-025 and write “Attachment 4-Relationship ofParties ”for a title. ® T(nw-k \Qymmkk. Venue Whyou filing in this county? (Check all that apply): a. MJ‘JIe person in ® lives in this county. Ib. was harassed by the person in® in this county. c. D Other (specify): ® Other Court Cases a. Have you or any the persons named in® been involved in another court case with the person in®? D Yes o ([fyes, check each kind ofcase and indicate where and when each wasfiled.) Kind of Case Filed in {County/Stare) Year Filed Case Number (ifknown) (l) D Civil Harassment (2) D Domestic Violence (3) D Divorce, Nullity, Legal Separation (4) D Paternity, Parentage, Child Custody (5) D Elder or Dependent Adult Abuse (6) D Eviction (7) D Guardianship (8) D Workplace Violence (9) D Small Claims (10D Criminal (l 1D Other (specifiys l..- b. Are there now any tective or restraining orders in effect relating to you or any of the persons in @and the person in®? No DYes (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. n (1) When did it happen? (provide date or estimated date): ‘Q [ 2/7 I 20 4’0 2 Wh l h ?( ) 0 e se waSt ere [See attached declaration for a Description of Harrassment] This is not a Court Order. Request for Civil Harassment Restraining Orders CH-1oo, Page 2 ate (IB /Em (CIVII Harassment Prevention) 9 Revised January 1. 2018 Case Numabelrzc H 00 98 00 ® a. (3) How did the person in® harass you? (Explain below):D Check here ifthere is not enough spacefor your answer. Pu! vour complete answer on the attached sheet ofpaper orform MC-025 and M rire ‘Anachmem 7a/3)-Describe Harassment for a title. [4 c $\IMANJ M ”th‘ Cnl Sfirfl 11min ML 4L1- zLC“ “- ‘AL S‘hél‘ 41A ‘4: Hr“. mime); fig ' 4+ 5L“)- " ‘AJ ’ro «Fucv, 5MW Tint k ?advn wm+ B‘c K 4M bu.- {b kxm U‘ + 13‘1““ 0A\I’LU'W‘ W'Ifk WAQ‘ r ~ 4.x i «mas \olq WM (Amy ‘4 no}- bum CMWMK 1K \Aq QLnRC 7C4 WC]kauv. (I‘m MeMLSdPS I‘lld‘ 7L4 (‘nO\ d C- Mcdc- Q eMW 2194+- «C-or mu flzukJC (4) Did the perso n® use or threaten to use a gun or any other weapon? 0‘ v d Cw c h’ 70‘362M D Yes NO (IfyeS, explain below). D Check here ifthere is not enough spacefor your answer. Put your complete answer 0n the attached sheet ofpaper orform MC-025 and write “Altachmenl 7a(4)-Use of Weapons "for a title. (5) Were you ha led or injured because of the harassment? CI Yes m); D Check here iflhere is not enough spacefor your answer. Put your complete answer 0n the attached o (Iers, explain below): sheet ofpaper orform MC-025 and write "Atlachmenl 7a(5)-Harm or Injury "for a title. (6) Did the police come? {Yes D No If yes, did they give you or the person in ®an Emergency Protective Order?D Yesm If yes, the order protects (check all that apply): D Me D The person in ® D The persons in @. (Attach a copy OfIhe order ifyou have one. ) b. Has Lhe person in ® harassed you at other times? Yes D No (Ifyes. describe prior incidents andprovide dates ofharassment below): D Check here iflhere is n0! enough spacefor your answer. Put vour complete answer 0n the attached sheer of paper orform MC-025 and write “Alluchmen 7b-Prcvi0us Harassment ’for III] {\F\ LLy-x\ I/‘o Th0? CI" L mu flw/yx rank Paw 5A gunk 05' Zola - 13‘th RCJ’NLK d +vlc9 \am" kc. cmr Ad, $2. manna" TDW‘de $omn~JALJM ?blvlum 4 Straws +0 Lo‘L Comm -k¢/ 6F ULSJ/m'Yk m 0M4 cMaA’k This is not a Court Order. 64 ) &oc;\l.\« fld’aoi'm "““d’”"'""°'° Request for Civil Harassment Restraining Orders CH-1oo, Page 3 ots (H3 m'“ Civil Harassment Pre ention \m...IBM ( v ) hoax 0F nu L lad? L odo‘ 0941A RM! Laud music”, Case Number: Check the orders you want. E m Personal Conduct Orders l ask the court to order the person in ®not to do any of the following things to me or to any person to be protected listed in @1 a. a Harass, intimidate, molest, attack, strike, stalk, threaten, assault (sexually or otherwise), hit, abuse, destroy personal propefly of, or disturb the peace of the person. b. Contact the person, either directly or indirectly, in any way, including, but not limited to, in person, by elephone, 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 {fthere is not enough spacefor your answer. Put your complete answer 0n the attached sheet ofpaper orform MC-025 and write ”Attachment 8c-01her Personal Conduct Orders, "for a title. The person in ®will be ordered not to take any action Io get the addresses or locations ofanyprorectedperson unless the courtfinds good cause n0! to make the order. ® DStay-Away Orders A a. I ask the court to order the person in ® to stay at leasti yards away from (check all that apply): (”X Me. (8) a My vehicle. (2) D The other persons listed in@. (9)m Other (specify): (3)g My home. axcemm: 10-96»?quww Mutt (fig My job 0r workplace. W (5) D My school. (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 away from all the places listed above, will he or she still be able to get to his or her home, school, or job? D Yes DNO (Ifno, explain below): D Check here ifthere is not enough spacefor your answer. Put your complete answer on 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? DYes DNO DI don’t know lfthejudge grams a protective order, the person in ® will be prohibitedfrom owning, possessing, purchasing, receiving, 0r attempting to purchase 0r receive a gun. otherfirearm, and ammunition while the protective order is in effect. The person in ®wi/I also be ordered r0 turn in to law enforcement, or sell to or store with a licensed gun dealer, any guns orfirearms within his or licr immcdic‘lte possession 0r control. This is not a Court Order. Revised January 1. 2018 Request for Civil Harassment Restraining Orders CH-1oo page 4 ofe l Emnfld . . _ .013' ‘Em (CIVII Harassment Prevention) 9 Case Number: ® E Temporary Restraining Order I request that a Temporary Restraining Order (TRO) be issued against the person in ® to last until t_he hearing. I am presenting form CH-l 10, Temporary Resrraining Order. for the court's signature together with thls Request. Has the person in ® been told that you were going to go to court to seek a TRO against him/her? DYes No (Ifyou answered no, explain why below): D Check here ifthere is not enough spacefor your answer. I’m your complete answer on the attached sheer of paper orform MC-025 and write “Arlachment 11*Temporary Restraining Order "for a title. 1 ”J‘rzul kmx V‘c/L-UM ¢S(w¢ fhflr-Ls Q W500- bo» as;w mud “Lccr {Mm h; Lnnfld tug ,an QANXcA/ £ rhumrfi Ac do 'yd- Md Aol- u’rn l'hm r0 ® \AI- VJOM’ (9..) CAN L‘fidD Request to Give Less Than Five Days' 0%:ch of Hearing You must have your papers personally served 0n the person in® al Ieaslfive days before the hearing, unless the cour! orders a shorter timefor service. (Form CH-200-INFO explains What Is “Proof of Personal Service”? Form CH-200, Proof of Personal Service, may be used Io show (he 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. Put your complete answer on the attached sheer of paper orform MC-025 and write “Attachment 12-Requesl Io Give Less Than Five Days’ Notice "for a title. ® D No Fee for Filing or Service a. a/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. mhe sheriff or marshal should serve (notify) the person in ®about the orders for free because my request or orders is based on unlawful violence, a credible threat ofviolence, or stalking. c. ‘fiffhere 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 mus! complete andfileform FW-OOI, Application for Waiver of Court Fees and Costs.) E Lawyer's Fees and Costs l ask the court to order payment of my D lawyer's fees E Court costs. The amounts requested are:m Amount ltfl Amount Eifingfiee s 435 s $ $ $ $ ktD Check here ifthere are more items. I’m the items and ummmls on the attached sheet ofpaper orform MC-025 and write ”Attachment 14 Lawyer 's Foes and ( 'osls”f0r a title. This is not a Court Order. “mmmm‘” Request for Civil Harassment Restraining Orders CH-1oo, Page 5 ors(mim (Civil Harassment Prevention) 9 Case Number: @ D Possession and Protection of Animals l ask the court to order the following: a. D That l be given the sole possession, care. and control of the animals listed below, which l own, possess, lease, keep, or hold, or which reside in my household. (Identifiz animals by, e.g., type, breed. name, color, sex.) I request sole possession of the animals because (specifi/ good causefor granting order): D Check here ifthere is not enough spacefor your answer. Put your complete answer 0n the attached shee! ofpaper orform MC-025 and write “Aflachmen! l5a-Possession ofAm'mals "for a title. b. D That the person in® must stay at least conceal, molest, attack, strike, threaten. harm, or otherwise dispose of, the animals listed above. yards away from, and not take, sell, transfer, encumber, DAdditional Orders Requested I ask the court to make the following additional orders (specifi): D Check here ifrhere is not enough spacefor your answer. Pu! your complete answer 0n the attached sheer of paper orform MC-025 and write “Attachment 16-Addilional Orders Requested. "for a title. ® Number of pages attached to this form, if any: Date: SemRepLesannL __Sfilf:Repmsgnted } s -Lawyer 's name (ifany) Lawyer ’s signature I declare under penalty of perjury under the laws of the State of California that the information above and on all attachments is true and correct. DME ’3)» Ix x(‘wz ’ 9A a 6‘» Type or print your name Signyanme This is not a Court Order. “"‘mfaw’ ‘- 2°“ Request for Civil Harassment Restraining Orders cmoo, Page s ofe (H3 1 DE'MW'“ (Civil Harassment Prevention) 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 CASE NAME(M’L and Va ks CASH; ZICHUO 93 00 Last Name Last Name CH-1 00, Item 7a(3) - DESCRIBE HARASSMENT: a) How do you know the person you want to restrain? 12 uovvxm‘K I((A‘H b) Are you living with the person? ”ES D NO c) Has the person D physically abuse you, D physically or verbally threatened you and/or flarassed you many times? (Please check all that apply.) d) In the past three months, what did the person do or say that made you afraid (please start with the most recent event and explain exactly what happened in detail, include dates and times): skkfim V‘ks \M$ cum Came kcc 4-0 X7“: ha w mefl t Jnsresyece-g m g MWWN KWr - “c. G&J‘U‘ PMOKKQ Wu. 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