Response Petition Civil Harassment Workplace ViolenceCal. Super. - 6th Dist.January 7, 2021_ Response to Request for CivilCH4 20 Harassment Restraining Orders Use this form to respond to the Request (form CH-1 00) o Read How Can [Respond t0 a Requestfor Civil Harassment Restraining Orders? (form CH-lZO-INFO) lo protect your rights. o Fill out this form and lake it lo Ihc court clerk. o Have someone age l8 or older-not you-serve the person in ®or his or her lawyer by mail with a copy 0f lhis l'orm and any attached pages. (Useform CH-250, Proof 0f Service 01‘ Response by Mail.) Person Seeking Protection Full name 0f person scckin protection (seeform CH-IOO, item®): bum“ yAN£2- ® Person From Wh m Protection Is Sou ht Clerk stamps date here when fonn is filed. FILED FEB - 5 2021 Fill in court name and street address: a. Your Name: 4‘90“ $+x C 00 V‘ W\ Your Lawyer (ifyou have onefor this case) Name: SfilEBepLESfinled- Slalc Bar No.: Firm Name: Semaapmsented Superior Court of California, County of Santa Cllara 191 N. Fgrst Street 191 N. First Street San Jose, CA 951 1 3 Downtown Courthouse - Civil b. Your Address (lfyou have a lawyer, give your lawyer’s information. Ifyou d0 not have a lawyer and want t0 kee your home address private, you may give a different mailing (u dress instead. You do n0! have to give telephonefax. or e-mail.).' Cour? fills in case number when form is filed. Case Number: 1 lCHOOqSO'Z A A’L’l Du\ Cefi O'KHAddress: Telephone: ‘i ° 5 3 K9 Hap Fax: E-Mail Address: @MPersonal Conduct Orders a. D I agree lo the orders requested. b. D Ido not agree 10 the orders requested. Date: ____- Time: Dept; Room: Present your response and an opposition at the City, gum o «L StateLA- Zip. a 5' 3! I hearing. Write your hcari from form CH-109 item here: Hearing Date If you were served with a Tem orary Restraining Order, you must o y it until the hearing. At the hearing. lhc court may make orders against you that lasl for up t0 five years. ale, lime, and place (Specify why you disagreé in item ® 0n page 3.) c. D I agree l0 the following orders (Specify below or in item® on page 3.) Q) DStay Away Orders a. D I agree lo the orders requested. b. D I do not agree lo the orders requested. (Specify why you disagree in item ® on page 3.) c. D I agree (o the following orders (specify below or in item® 0n page 3): @DAdditional Protected Persons a. D I agree that the persons listed in ilem®of form CH-lOO may be protected by the order requested. b. D I do not agree lhal the persons listed in item® 0f form CH-IOO may be protected by lhe order requested. .JRtAdiglaldCouncil 011 Czaloigoamaémml ‘ootFms‘cagovmsa anu , a o orm Coda ov éwu awrocadura. 55 527.6 9nd 527.9 £§5fim~m§ Restraining Orders (Civil Harassment Prevention) Response to Request for Civil Harassment CH-1 20, Page 1 oi 49 Case Number: ® Guns or Other Firearms and Ammunition If you were served with form CH-110, Tem orary Restraining Order, you cannot own 0r possess any guns, other firearms, 0r ammunition. (See item of form CH-llO.) You must sell to or store with a licensed gun dealer, or turn in to a law enforcement agenc , any uns or other firearms in your immediate possession or control within 24 hours 0f being served with orm C -110. You must file a receipt with the court. You may use form CH-800, Proofof Firearms Turned In, Sold or Stored, for the receipt. 1/5! d0 nol own or control any guns 0r firearms. b. D I ask for an cxcmpgion from Ihc firearms prohibition under Code 0f Civ_il Procedure section 527.9(0 because carrying a firearm ls a condition 0f my emgloymem, and my employer 1s unable lo reassngn me lo another position where a firearm is unnecessary. ( xplain): D Check here ifthere is not enough space belowfor your answer. Put your complete answer on an attached sheet ofpaper and write “Attachment 6b-Fireamts Surrender Exemption " as a title. You may useform MC-025, Attachment. c. D I have turned in my guns and firearms to the police 0r sold them to or stored them with a licensed gun dealer. A copy 0f the receipt D is attached. D has already been filed with the court. ® DPossession and Protection of Animals a. D I agree l0 lhc orders requested. b. DI do n01 agree lo the orders requested. (Speczfy why you disagree in item® 0n page 3. ) c. DI agree lo the following orders (specify below or in item® on page 3.) DOther Orders a. D I agree to the orders requested. b. a1 do not agree lo the orders requested. (Specify why you disagree in item® on page 3.) c. DI agree lo the following orders (specify below or in item ®on page 3.) ®D Denial I did not do anything described in item®0f form CH-lOO. (Skip to® .) "°““°“,J‘”“a"’"2°‘“ Response to Request for Civil Harassment CH-120, Page 2 ot 4 CEB Sea’ggm Restraining Orders 9“W“ -- (Clvll Harassment Preventlon) Case Number: .Ddustification or Excuse If I did some or all 0f the things that [he person in G) has accused me of. my actions were justified or excused for the following reasons (explain): DCheck here i there is not enough flee belowfor your answer. Put your complete answer on an attached sheet ofpaper an write “Attachment 1 Justification 0r Excuse ” as a title. You may useform MC-025,Allachmcnt. ®Dfieasons | Do Not Agree to the Orders Requested Ex 11in your answers r0 each order requested that you do not agree with. Check here 1f there is not enough s ace belowfor your answer. Put your complete answer on an attached sheet ofpaper and write “Attachment I -Reasons I Disagree " as a title. You may useform MC-025, Attachment. ““‘°‘{J‘"“"’"’°‘° Res onse to Re uest for Civil Harassment CH-120.P a t4 CEB 595:3 p Restrqaining Orders age o (Clvll Harassment Prevention) Case Number: ® a No Fee for Filing a. D I request that I not be required l0 pay (he filing fee because the person in ®claims in form CH-lOO item®to be entitled to free filing. b. a I request that I not be required t0 pay the filing fee because I am eligible for a fee waiver. (Form FW-OOI. Request m Waive Court Fees, must befiled separately.) ® D Lawyer's Fees and Costs a. D I ask the court lo order payment of my D Lawyer’s fees D Court costs. The amounts requested are: m Amount m Amount $ S $ $ $ S D Check here 1f there are more items. Put the items and amounts on the attached sheet ofpaper and write “Attachment l3-lawyer’s Fees and Costs"for a title. You may useform MC-025. Attachment. b. D Iask the coun lo deny the request of lhc person asking for protection that I pay his or her lawyer's fees and costs. Number of pages attached to this form, if any: Date: SamBam- - p - Lawyer's name (if any) Lawyer’s signature I declare under penalty of perjury under the laws of the Slate of California that the information above and on all attachments is true and correct. 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