Response Petition Civil Harassment Workplace ViolenceCal. Super. - 6th Dist.January 7, 2021‘I .. ‘1 CH 120 I Response to Request for Civil Clemsfampsdarfi here When {Ofmfs fired. Harassment Restraining Orders Use this form to respond to the Request (form CH-100) . Read How Can I Respond t0 a Requestfor Civil Harassment Restraining Orders? (form CH-lZO-INFO) t0 protect your rights. ° Fill out this form and take it to the court clerk. . Have someone age 18 or older-not you-serve the person in® or his 0r her lawyer by mail with a copy ofthis form and any attached pages. (Useform CHA250. ProofofService ofResponse by Mail.) Person Seeking Protection M. a EPUTY Full name 0f person seeking protegtion (seeform CH-IOO, irem@): me coununggférgnd syeeraddresy\m 1X Superior Court of California, County of Person From Whom P o 9&ion ls S ught Superior Court a- Y0urName= u U 1N cm: Division Your Lawyer (:fyou have orzefor {111's case) 191 N_ Flrst Si . _ Ngmjc: . . State BarNo.: _. - S&HJOSB, CA .95113 Firm Name: b. Your Address (Ifyou have a lamxfy‘er, give your Iauyer's information. [fyou d0 no! have a lawyer and want to keep your home address case Number: 6private, you may give a dzfierent mailing address instead. You do not F) 4’\ W664 have to give telephone fax, 0r e-mail.2 Address: um Q: 'WW 6 i?Fm Present your respon’se and any opposition at the City: H! . Smtew Zip: 61qu hearing. Write your hearing date, time, and place- from form CH-109 item©herez Hearing .9 Date: 5|?! MA Timez4 (DIM Date Dept; 4' Room: Telephone: ' Fax: E~mai1 Address: ® Q Personal Conduct Orders E/ If you were served with a Temporarya- I agree t0 the orders requeSted' Restraining Order, you must obey it until the b. D I do not agree to the orders requested. hearing. At the hearing, the court may make (Specify why you disagree in item® 0n page 3.) orders against you that last for up to five years. c. D I agreé f0 the following orders (Specifi/ below 0r in irem@ 0n page 3.) ® $ Et/ay-Away Orders a. I agree t0 the orders requested. b. D I d0 not agree to the orders requested. (Specifiz whyyou disagree in item® 0n page 3.) c. D I agree t0 the following orders (specify below 0r in irem® unpage 3): ® $\Additional Protected Persons a. I agree that the persons listed in item©of form CH-lOO may be protected by the order requested. b. D I do not agree that the persons listed in item ©of form CH-IOO may be protected by the order requested. éuefgilafiiflgflFféliménwawaxofffinoff‘gw Response to Request for Civil Harassment CH-120. Page 1 of4 Code ofCivil Procedure. §§ 527.6 and 527.9 Restraining Orders ‘ 9 (Civil Harassment Prevention) rvc/cM/mm [/oLt/gnu n? “AWW ® @SQ ® Guns or Other Firearms and Ammunition If you were served with form CH-llO, TemporaryRestraining Order, you cannot own or possess any guns, other firearms, 0r ammunition. (See item® of form CH-llO.) You must sell t0 0r store with a licensed gun dealer, or turn in to a law enforcement agency, any guns 0r other firearms in your immediate possession or control within 24 hours of being served with form CH-llO. You must file a receipt with the court. You may use form CH-800, ProofofFirearms Turned In, Sold 0r Stored, for the receipt. a. I do not own or control any guns or fireams. b. D I ask for an exemption from the firearms prohibition under Code of Civil Procedure section 527.9(0 because carrying a firearm is a condition ofmy employment, and my employer is unable to reassign me t0 another position where a firearm is unnecessary. (Explain): D Check here {f(lzere is nor enough space belowfor your answer. Putyour complete answer on an artaclzed sheer ofpaper and write ”Affachmenr 6b*-Firearms Surrender Exemption ” as a rifle. You may useform Mam; Attachmemfl ‘ ‘ ‘ ~ ~~ c. D I have fumed in my guns and firearms to the police or sold them to 0r stored them with a licensed gun dealer. A copy 0fthe receipt D is attached. D has already been filed with the court. Possession and Protection of Animals a. I agree to the orders requested. b. D I d0 not agree t0 the orders requested. {Specifir why you disagree in item® onpage 3.) c. D I agree to the following orders (specyfil below 0r in item® 0n page 3): E/Other Orders a. D I agree to the orders requested. b. D I d0 not agree t0 the orders requested. (Speczfix whyyou disagree in item ® 0n page 3.) c. D I agree to the following orders (specify below 0r in item® 0n page 3): fienial Idid not d0 anything described in item® ofform CI-I-IOO. (Skip t0® .) Revisewamam-m‘a Response to Request for Civil Harassment CH-‘IZO. P3992 0M Restraining Orders . 9 (Civil Harassment Prevention) CaseQNumde%€. .®Eflstification or Excuse IfI did some 0r all ofthe things that the person in® has accused me 0f, my actions were justified 0r excused for the following reasons (arplain): D Check he; e tfthe} e 1'5 not enough space belowfor your answer Put your complete answer 0n an attached Sheet ofpaper a: dwrite "Artachme 1t 10-Justi‘10arijn 0r Excuse" as a title. Youadmay usefoImQ/l MC-025 Attachment. ,1,4313 WT u m . Wahmhm wmw MW m4 mmmww wo Mufim‘ 13M Mflwmhm 40% At/NW \naN/Jm JAM- MewsWMWm NMEQmem/WAM \W mar 4w film‘mpm 43M wi WM up age WV; 4m S00 raga) M mum’s “NwiMW'.§$ 4500 M&WPt/{Vowoémrqmw Mdlw I wi WcmlSW MMWQ mam MU geWM/‘Aép mM/sd'mm wait)? Mbwflio adam- l ‘ - 3M0 _ WWA I’M a, “Um Gal d ,V o ‘ b ' m.‘S D Reasons l Do Not Agree to the Orders Requested Explain your answers I0 each order requested thatyou d0 nor agree with. D Check here ifrhere is nor enough Space belowfor your answer. Put your complete answer 0n an attached Sheet ofpaper and wrire "Atlachment 1 I-Reasons I Disagree " as a rifle. You may useform M0025, Attachment. RBV‘SedJamam-m Response to Request for Civil Harassment CH-120. Page 3 0M Restraining Orders '9 (Civil Harassment Prevention) WWW61M B/No e for Filing@ a. BK:quest that I not be required to pay the filing fee because the person in®c1aims in form CH-IOO {Lem ® to be entitled t0 free filing. b. I request that I not be required to pay the filing fee because I am eligible for a fee waiver. (Form FW-OOI, Request to Waive Court Fees, mus! befiled separately.) ® D Lawyer‘s Fees and Costs a, D Iask the court to order payment ofmy D Lawyer’s fees D Coun costs, The amounts requested are: m mount Item Am ount $ $ 3 ' ' " ‘ $ $ $ D Check Izere ifthere are more items. Put the items and amounts 0n the attached sheet ofpaper and write "Armchmenr 13-Lauyer ’s Fees and Costs ”for a title. You may use orfomz MC-025, Attachment. b. D I ask the court to deny the request 0f the person asking for protection that I pay his or her lawyer’s fees and costs. Number ofpages attached to this form, ifany: Date: Lawyer s name (rfany) Lawyer '5 signature I declare under penalty of perjuly under the laws of the State of California that the information above and 0n all attachments is true and correct. Date: a \ | O" I %9/\ la howMT , o QQ/L- Type orpn‘ntyournameU ‘ Signycfizrw RevisedJanuaw-zm Response to Request for Civil Harassment CH-120. Page 4 of4 Restraining Orders (Civil Harassment Prevention)
