Request Restraining OrderCal. Super. - 6th Dist.January 6, 2021Clerk stamps date here when form is filed. ‘ Request for Civil HarassmentCH4 00 Restraining Orders Read Can u Civil Hum.\'.s'mwz! Reslraining Order Help Me? (form CH-100- INFO) before completing this form. Also fill out Confidential CLETS I L E Information (form CLETS-OOI) with as much information as you know. JAN - 6 2021 Person Seeking Protection K‘ NGUwg® Y rF l ' Cle kolocnglgnyCotosggta Clara N a' °u “Willa MMWL Age; 4H B?MQ' 5 05pm Your Lawyer (Ifyou have onefor {Ins case) Fill in court name and street address:Name: State Bar No.2 . ‘ Firm Name: Superior Court of California. County of Santa Clara b. Your Address (Ifyou have a Iauycr, giveyour lauyer 's Civil Division information. Ifyou d0 not have a lawyer and want t0 keep your 191 North First Street home address private, you may give a different mailing address San JOSC, CA 951 13 instead. You do nor have to gixe telephone, flu or e- mail.) Addres: aq 6166 gig“ Y I I9g m W f L1 SHO Cgun fill; in cabse number when form is filed. City m State: Zip. é!“ ase ”m e“ Teleph\one.4 g EgfloaWOFaK' LA 210H00980‘1 E-MauAddress WWW? {Cf u (r) kmlnou. 00M ® Person Fro Whom Protection Is Sought Full Name: ' fl WW‘fé Age:fl Address (ifknown):m Y“ 9'9 five + 1 fi City: 3a V] JD Y, Case Number: ZicHQQQBQI Relationship of Parties How do you know thc person in ® ? (Explain below): D Check lure ifllure is no! enough spacc lbr vow ansnc.) Put your complete answer 0n the attached sheet of paper m form MC-025 and write “'Atluchmen! 4--Relanonship ome‘ties ”for a title. 5m 15 mu mmhwom Venue Why are you filing in this county? (Check all Ilzar apply): The person in® lives in this county. b. fl I was harassed by the person in® in this county. c. D Other (specsz: Other Court Cases a. Have you or any 0f the persons named in® been involved in another coun casc with the person in ®? D Yes E N0 (Ifyes, check each kind ofcase and indicate where and when each wasfiled.) Kind ofCase Filed in (Counn'/Sfate) Year Filed Case Number (if/mown) (1) D Civil Harassment (2) D Domestic Violence (3) D Divorce, Nullity, Legal Separation (4) D Patemity, Parentage, Child Custody (5) D Elder or Dependent Adult Abuse (6) D Eviction (7) D Guardianship (8) D Workplace Violence (9) D SmallClaims (10) D Criminal (ll) D Other (specifi'): b. Are there now protectiVe or restraining orders 1n effect relating t0 you or any of the persons in© and the person in®7 gNo D Yes (Ifyes attach a cop) Ifyou have one.) Description of Harassment Harassment means violence 0r threats 0f violence against you, or a course of conduct that seriously alarmed, annoyed, or harassed you and caused you substantial emotional distress. A course 0f conduct is more than one act. a. Tell the court about the last time the person in® harassed you. (1) When did it happen? (provide date 0r estimated (lute): C / /09/11 (2) Who else \V as there” 90m mad mu 010.619 WW Sow wemflnM 11L des”lama 9mM 1mm. (M awo flame: mwn m mm b I m ‘ mommy} mow 1} 9w; QmVQI/M, LU) gum (4h) lowmg 04. This is not a Court Order. Rmmmw " 2°” Request for Civil Harassment Restraining Orders CH-100, Page 2 0f 6 (Civil Harassment Prevention) '9 Case Number: 210H009801 ® a. (3) (4) (5) (6) How did the person in® harass you? (Explain below): D Check hue ifthere is‘ not enouolz spaccfor mm (msucL Pu! 10m complete answer 0n the attached sheet ofpaper 0rfoun MC-025 and mm “xlrrmzclmzenrW'fil/fl-Describc Harassment f0) a title. gig: gym women MM w w ODMMw u m 1v {US$64 57ml offal fvul Mn unfit; mdeflh'xu om Mmmn/ r 1m s/maz‘mn me hm WP ems mms QM mum's In“ {ma mm! H115 rm [MMI/Dmmanm'T’QA m“ WM dnd mo! d wmm/vfr ’ Dllh‘f 1/10“.“ 00mmf ‘0“ 90 MY I vm 93ml 16 WW mwm‘mwa} - rfiflm Did the person in® use or threaten to use a gun or any other weapon? D Yes E No (Ifyes. explain below): D Check here iftlzere 1's no! enough spaceforyour answer. Putyour complete answer 0n the attached sheet ofpaper orform MC-025 and write “Almclzmem 7a(4)-Use 0f Weapons "for a title. V‘s E S u5~ (m 8E§ E< Were you harmed or injured because of the harassment? m Yes D N0 (Ifyes, explain below): D Check here [filtere is not enough spaccfm mm (Insuu Pu! vour complete ans‘wer 0n the attached sheet ofpapcr ()rfOIm MC-025 um! “Win 4Imd1mcnt 70(5) g'n‘m 0r Injun' 'for a title rm V2 am mu mm wm mm 01mm m vmm/J mf‘ r1 W! WM' fv‘ M mu WDdWLS [141117014 mad E?m[Z/m h? fl/m n’fil mm}! n’m’ mm ’Mf In m) hh’a'mbmfl 'Tmrf W MW mm meflu’mbolméiags Did the police come. D Ycs a No If yes, did they give you or the person in® an Emergency Protective Order? D Yes D No If yes, the order protects (check all that apply): D Me D The person in® D The persons in ©. (Attach a copy 0ftlze order ifyou have one.) \ b. Has the person 'm® harassed you at other times? E Yes D N0 (Ifyes, describe prior incidents and provide dates ofharassment below): D Check here ifrhere is not enough spaccforyour answer. Putyour complete answer 0n the attached sheet 0f paper orfonn MC-025 and u'rite‘ Atluc lnncm 71% Punious‘ Halussment' lbr a title. 3m qM/MCS W mH hma WW ma mmcd ”m. 8m ?Dm' I’M m2 Md mu fZU/mJ/u fbhfiMI/l I 5m . . ,- WV A14 M W 4/ f/szr [Mg I1 r This is not a Court Order. Re“‘°°J‘““"Y"2°‘3 Request for Civil Harassment Restraining Orders CH-100- Page30f6 (Civil Harassment Prevention) 9 Case Number: 21Cfl009801 Check the orders you want. E D Personal Conduct Orders I ask the court t0 order the person in ® not to do any 0f the following things to me 0r t0 any person to be protected listed in©1 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, 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. g Other (specify): D Check here Ifrhere is not enough .spaceforyour answer. Putyour complete answer 0n the attached sheet ofpupcr orform MC-025 am! write “Allaclzmen! 8c-01her Personal Conduct Orders, "for a title.1mm Mm my b {ms TD CW me m. ,m mu «mm mm mr, Jm mm mu L him! 3m W’ Hm , MM mn/LWM ~ The person in ® mll be Oldered n0! (0 [aka an} action to get IIIL addresses 0r locatzons ofanv protectedperson unless the COurtfimls good cause n0! t0 make the Older @ D Stay-Away Orders a. I ask the court t0 order the person in® to stay at least 19a yards away from (check all that apply): (1) W Me. (8) M My vehicle. (2) R The other personslisted in @. (9) m Other(. wcifi (3) M Myhome. mu Chm(énrfihf vem M3 Md (4) m Myjob or workplace. m” W10 dOMS \ (5) D Myschool. (6) E My children's school. “‘0' 0+)“ - “Mm ' (7) D My children’s place ofchild care. b. Ifthe court orders the person in® to stay away from all the places listed above, will he 0r she still be able to get to his or her home, school orjob? D Yes E NO (If n0 explain bclou) D Check heie iflhcre is not enough 5pm c fbr 10m ansm Pm mm complete ansuer 0n the attached sheet 0f paper 0r arm MC-O25 and write ”Atrachan-At m OnlersfWfia titleMM u A m W LW/nL/w M00 Guns or Other Firearms and Ammunition Does the person in® own or possess any guns or other firearms? D Yes D No 8’ I don’t know [fillejudge grants a protective order, Ilzc person in® will hc prohibitedfrom owning, possessing, purchasing, receiving, 0r altempting t0 purchase 0r receive a gun, otlzerfirearm, am] ammunition while (he protective order is in eflect. The person in ® will also bc ()rdcrczl m turn in Io law enforcement, 0r sell to 0r srore with a licensed gun dealer. any guns orfircarmx wir/u'u lu'x 0r lm- I'mnmliulc possession 0r control. This is not a Court Order. “W‘mamam-m‘” Request for Civil Harassment Restraining Orders CH-100. Pa9e4 of6 (Civil Harassment Prevention) '9 Case Number: 21CH009801 ® D 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 g0 to court to seek a TRO against him’her? D Yes m No (Ifyou answered n0, explain why below): U Check here ift/zere is no! enough spaceforyour answer. Pulyour complete answer 0n the attached sheet of paper orform MC-025 and write “Artachmem 1 I-Tcmpomrj' Restraining Order "for a title. ® D Request to Give Less Than Five Days' Notice of Hearing You must have your papers personally served on the person in® at leastfire days before the hearing, unless the court orders a shorter timefbr service. (Farm CH-200-INFO explains What ls “Proof of Personal Service”? Form CH-200, Proof of Personal Service, may be used t0 show the court that 1/10 papers have been served.) If you want there to be fewer than five days between service and thc hearing, explain why below: D Check here iftllei'e is n0! enough spaceforyour answer. Putyour complete answer 0n the anached sheet 0f paper orfonn MC-025 and u'rirc “Attachment 12-Requesl (0 Give Less Than Five Days ' Notice "for a title. ® D No Fee for Filing or Service a. D There should be no filing fee because the person in ® has used or threatened to use violence against me, has stalked me, 0r has acted or spoken in some other way that makes me reasonably fear violence. b. K 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 ofviolence, or stalking. c. D 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 coun to order payment 0fmy D lawyer’s fees D Court costs. The amounts requested are: Mm Amount k. Amman $ S $ S $ S D Check here ifthere are more ircms. Put the items and amounts on the attached sheet ofpaper orform MC-025 and write “Attachment l4iluu‘ycr Xv Few um! ('m'rx "for a title. This is not a Court Order. “mmmm- 2°“ Request for Civil Harassment Restraining Orders CH-100. Page 5 of6 (Civil Harassment Prevention) '9 Case NuszeézH 00 98 0 1 ® D Possession and Protection of Animals I ask the coun t0 order the following: a. D That I be given the sole possession, care, and control of the animals listed below, which I own, possess, lease, keep, 0r hold, or which reside in my household. (Idenrifl' animals by, e.g., type, breed, name, color, sex.) I request sole possession of the animals because (spccé/fi' good causefor granting order): D Check here {fthere is n0! enough spaceforyour answer. Putyour complete answer 0n the attached sheet ofpaper orform MC-025 and write "Attachment 1 5(1-Possessi0n ofAnimals "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. D Additional Orders Requested I ask the coun to make the following additional orders (specifi'): D Check here ift/zere is not enough spuceforyour answer. Putyour complete answer 0n the attached sheet 0f paper orfbrm MC-025 and u'riIc “Alrachmenr l6~AddiIi0nal Orders Requested, "for a title. ® Number ofpages attached to this form, ifany: Date: } Lawyer 's name (ifcmy) Lauyer ’s signature [declare under penalty ofperjury under the laws ofthe State ofCalifomia that the information above and on all attachments is true and correct. Date: 0//0@/2'/ 58mm flfl/fl/‘rga r QM Type 0r prim your name Sign your nanief This is not a Court Order. R°“S°°“"“'Y‘-2°‘8 Request for Civil Harassment Restraining Orders CH-100, Page 60f6 (Civil Harassment Prevention) (0 m N O) (ll A (Al N -‘ .4 _.x .4 N -l O 0) 15 16 17 18 19 20 21 22 23 25 210H009801 CASE NAME: m CASE #: Last Nate Lasi {Nate CH-100, Item 7a(3) - DESCRIBE HARASSMENT: a) How do you know the person you want to restrain?9m i6 m g WA, (9h 1&0 V. b) Are you living with the persoh? D YES M NO c) Has the person D physically abuse yamflphysically or verbally threatened you and/orxharassed you many times? (P/ease 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 datesandtimes): mow! m 4 50W Mu mm wok mw (AME (m TW WY Wm 0W1 5m mvvxemum WWMH1mHHWMwWA\hzwmwdrmm+Whmd wmrmmum 31mm 30mm mom owflmllu Mm ’m WWI mm Wu mm (Mu 0mm Remains rm Myer»: 41mm;ML wyLm w mm n WMMQVM Mom 20 {2M Wm 1mm mu WWWmm Tm (WMWM 0M Mmmfim sow MM! AM J 40(ch mmWWW A WW mm 9m mus TM {m m MAWw WM Sm jcxm‘cwmat lommww’m Wm WM £1 5K WI m nu 4M Mmmflmmmhm Wm! mu 3w aw) MMb CH-100. Item 7a(3) - DESCRIBE HARASSMENT . ’- SHORT TITLE: and I CA5: Mwasa' MC-OZO 216H009801r 1 2 3 4 5 6 7 8 9 O 11 12 13 14 15 1e 17 18‘ ‘19 20 21 22 23 24 25 25 27 Mama 0mm mu mm 4M \OH WMSm 50W ng/ WOMMM ”WW flWWW RMWM W WW fl \T’M VA m [ML 0H WP} v1 YMMV Wwwd 0m dma am ho+ H 0| WW mvmc mflmwmmms \MW WOW) o Noam mfimk mmmmflsWWW) WM owl m w WW Mu glow! WW mow mxmvs3mm MWW Mu 210013 01M 80M dnmé 11M @mm DIM mec 0f NVM/IW 111mm[m m i 720 VIM Mm mu mm, W mv [216M gouk/m m WM WNW N mmm m Aomm‘wm W «M mm Wt(AW WW (AHMW/ Wm 50h Mm WW) MxINMWW DID 'MWHW I‘m MM f0 Wm ' 19 Wm v56 mm Me mt (mm zamunnmmmWM NV m 0/14 Wok m WW“ (11/ UUWM mMMM MM EDI VW' mow: ( 17mg MWWM ( M} Mu MMWY [fl Amumm ’IWAMM HCWJM WNHA S M SUM Wow W Mm Tn '{7- WmMK WI MN Wr [4M "WNW Jr W! S mu’ 090/05 am Mm(A’Um m mv AuszS 9W m UWUVDWM’WW ‘ mi “-r. ,=ticn and befiefar-s specif ifs nu b As no .n= ‘ SSQ’M‘I Attach to Judicia! Counc ADDITIONAL PAGE il F0 rm or Other Cou rt Paper 16 17 18 19 20 21 22 23 24 CASE NAME: and CASE #; ZICHUO 98 0 Last Name Last Name e) Were any guns or otherweapons used or threatened to be used during any abuse in the past three months? D YES fiNO If ”YES", describe: f) Were there any injuries during abuse In the past three months? MES D NO lf 'YES", describe. ml) dams WQW pmuj} {MHU ml [Zita mu gem mm Wm MMmm) ’mMI[m g) Did the police come to any of these recent events? D YES WNO h) Did they give you an Emergency Protective Order for abuse in the pastthree months? D YES D NO If "YES", please attach a copy. i) ls the person you want to restrain in jail right now for violence against you? DYES MNO If“YES".where: j) Has the person you want restrained ever been in jail for violence against you or your children? DYES fiNo If“YES".when: Describe what the person did to you or your children that caused them to go to jail: CH-‘IOO, Item 7a(3) - DESCRIBE HARASSMENT Para 20 21 22 23 25 210H00980 CASE NAME: and CASE #2 k) Do you have a criminal protective order (restraining order from criminal com)? a YES R/No If "YES". please attach a copy. 1) Describe the worst abuse and when it happened: D The most recent abuse i_s the worst abuse 0R we ow/zo restraining orderegainstr us = =?ny 3y; WWWW cum MIA hm 5 ms armed m4 501/1 MM! Mom www Sm WAWM SN m; m WDWMTD mmuu mm J w ama I'flwmh m vc m) Describe any other previous (past) violence 0r threats of violence that you haven? already written about here (include dates or estimates as to when it happened): CH-100. Item 73(3) - DESCRIBE HARASSMENT Page FELD SERVICES DIVISION Activity Information Card A20-078944- l STRAY/AGGRS l 3 DOG-l Activity Address: Licauc/Prion: OLD PRIORS/EX LICS 994 HARLISS AVE #1 c I ?_SAN JOSE CA 95110 Ow 8.: WILLOW ST ' N0 Activity Details: DOG GOT OUT AND ATTAC