Request Restraining OrderCal. Super. - 6th Dist.January 8, 2021CH 100 Request for Civil Harassment C’°’* “8m”mm”“mm" ’3‘“- Restraining Orfiers j Read Can a Civil Harassment Restraining Order Help Me? (form CH-100- INFO) before completing this form. Also fill out Confidential CLETS Information (form CLETS-OOI) with as much infomation as you know. F I L E D® Person Seeking Protection a JAN - 32021 a. Your Full Name: C'e e UEN Thomas R. Callahan A893 58 SupoflormWwCotosggaNGcam . . . BY DEPUTYY La hav th - Nge: wyer (Ifyou e onefor ls case) State Bar No; Fill in mun name 396 sheet\address: F. N _ - Superior Court of California, County of ’l “m ame' . Superior Court of Santa Clara b. Your Address (Ifyou have a lawyer, give your lawyer 's I Q ) North First Street information. Ifyou do not have a lawyer and wan! Io keep your 191 North First Street home address private, you may give a diflerent mailing address San Jose, CA 95113 instead. You d0 not have t0 give telephone, fax, or e-mail.) Address: 1 309 Oakland Rd spc 43 ‘ Court fills in case number when form is med. City: San Jose State: CA Zip: 951 12 ca“ "“mfit- C H 00 98 0- 6 Telephone: 535-507-5713 Fax: E-Mail Addressz ltnmg83@gmail.com ® Person From Whom Protection ls Sought FullName: Brian Winchester Age: i51- Address (ifknown): 1309 Oakland Rd spc 26 City: Sanjose State: CA Zip: 95112 ® Additional Protected Persons a. Are you asking for protection for any other family or household members? D Yes w N0 Ifyes, list them. Hummus S&x Age mmMW D Yes D No D Yes D No D Yes D No D Yes D No D Check here ifthere are mo: 'e 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 spacefor your answer. Put your complete answer on the attached sheet of paper orform MC-025 and write “Attachment 3b-Why Others Need Protection ”for a title. This is not a Court Order. WWWW m'm“"°' Re uest for Civil Harassment Restrainin Orders °““°°- Page 1 “6Wmy 1. 2018.W Form q cod. «cm: procedure. ss 527,6 ma 527 9 (Civil Harassment Prevention) 9 G) G) Case Number: 21CH009806 Relationship of Parties How do yoy know the person in ® ? (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 4-ReIationship ofPartiesl'for a title. Neighbor in Rv Park 7 Venue Why are you filing in this county? (Check all that apply): a. E The person in® lives in this county. -- b. E l was harassed byfthe person in® in this county. c. D Other (specifiz): Other Court Cases a. Have you or any of the persons named in @been involved in another court case with the person in ®‘7 D Yes E No (lfyes, check each kind ofcase and indicate where andwhen each wasfiled.) (1) 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 (10) D Criminal (l 1) D Other (specifil): b. Are there now any protective or restraining orders in efiect relating to you or any of the persons in© and the person in@17 E 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 ofconduct that seriously alarmed, annoyed, or harassed you and caused you substantial emotional distress. A course ofconduct is more than one act. a. Tell the court about the last time the person in® harassed you. (l) When did it happen? (provide date or estimated date): Januam 7, 2021 (2) Who else was there? H.“ I .l. I E .ISI. El” This is not a Court Order. Rmm-ytmw Request for Civil Harassment Restraining Orders °“"°°v Pm 2 °f 6 (Civil Harassment Prevention) '9 Case Number: 210H009806 ® a. I (3) How did the person in ® harass you? (Explain below):D Check here ifthere is not enough spacefor your answer. Put your complete answer 0n the anached - sheet ofpaper orform MC-025 and write ”Attachment 7a(3)-Describe Haras'sment"f0r a title. (4) Did the person ih® use or threaten to use a gun or any other weapon? E Yes D No (Ifyes, explain below): D Check here ifthere is not enough spacefor your answer. Put your complete answer on the attached sheet ofpaper orform MC-025 and write “Atlachment 7a(4)-Use of Weapons ”for a title. H6 WfléfiEA/ED 7v [77%; ME - Awy‘rmé ‘ fr»! vw/IQCE " M aZAo 514/0 ”I u I/l ’ALMWS 36 /L,l/nrcH/A/c. Wu -" These”m m4or“? 69mm“ [8 e4 #1, 7 yam) mzém (uNFfloVo’Keo) MM??? I IA! Afféoxnwvrzy z flu rm , (5) Were you banned or injured because of the harassment? D Yes E N0 (Ifyes, explain below): D Check here ifthere is not enough spacefor your Wei. Putyour complete answer on the attached sheet ofpaper orform MC-025 and write “Attachment 7a(5)-Harm or Injury "for a title. (6) Did the police come? [i] Yes D No Ifyes, did they give you or the person in® an Emergency Protective Order? D Yes mo If yes, the order protects (check all that apply): D Me D The person in® D The persons in ©. (Attach a copy ofthe order {fyou have one.) b. Has the person in® harassed you at other times? B Yes D No (Ifyes, describe prior incidents andprovide dates ofharassment below): D Check here ifthere is not enough spacefor your answer. Put your complete answer on the attached sheet of paper orform -025 and write “Attachment 7%}:wious Harassment ”for a title. VeKBA‘ #AKAA/gugs m1 fim’f’gw 0/475 a RANK], KEApr r domf/ETE/y, #141990me AND A/so I/[JfflDI/vké’D m4! fiFF 7bralc. This is not a Court Order. Wm"2°‘° Request for Civil Harassment Restraining Orders CH-WO. P890 30's (Civil Harassment Prevention) ‘9 Case Number: . Check the orders you want. E PersonalConduct Orders @ I 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@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. 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. p c. D Other (specifiz): D Check here ifthere is not enough spaceforyour answer. Putyour complete answer on the attached sheet ofpaper orform MC-025 and write “Attachment 8c-0ther Personal Conduct Orders, ”for a title. The person in ® will be ordered not to take any action to get the addresses or locations ofanyprotectedperson unless the courtfinds good cause not Io make the order. E Stay-Away Orders a. I ask the court to order the person in® to stay at leastg yards away from (check all that apply): (1) g Me. (8)fl My vehicle. (2) D The other persons listed in® . (9) D Other (specifii): (3) E My home. (4) E My job or workplace. (5) D My school. (6) D My children’s school. (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 or she still be able to get to his or her home, school, or job? X Yes U N0 (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 9Htay-Away Orders, "for a title. Guns or Other Firearms and Ammunition Does the person in® own or possess any guns or other fireanns? D Yes D No E I don’t know Ifthejudge grants a protective order, the person in® will be prohibitedfrqm owning, possessing, purchasing, receiving, or attempting t0 purchase or receive a gun. otherfirearm, and ammunition while the protective order is in mfect. The person in ® will also be ordered to turn in to law enforcement, or sell to or store with a licensedgun dealer, any guns orfirearms within his or her immediate possession or control. This is not a Court Order. WWLM Request for Civil Harassment Restraining Orders CH4”: P8994 0'5 (Civil 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 the hearing. I am presenting form CH- 1 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 court to seek a TRO against him/her? D Yes X No (Ifyou answered n0, explain why 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 “A tachment 11-Temporary Restraining Order’ for a title #63 MK/mmm Aw Hz H /v me xmfl/g P(LusloNAL map 1M m/m4 Ado AM Wg/‘fé '- zvoT To P/éovo/cz H/M Nolé s K6 771 Prgés. @ E Request to Give Less Than Five Days' Notice of Hearing You must have your papers personally served on the person in® at Ieastfive days before the hearing, unless the court 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 t0 show the court that the papers have been served.) Ifyou want there to be fewer than five days between service and the hearing, explain why below: D Check here {fthere is not enough spaceforyour answer. Putyour complete answer on the attached sheet of paper orform MC-025 and write “Attachment 12-Request to GivegLess 171071 Five Days' Not' ” or a title. 566 ca/wwcovfi m /¢7«V'I flBM/E. ® E No Fee for Filing or Service M'I'here 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 m some other way that makes me reasonably fear violence b.fl 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. D There should be no filing fee and the sherifl' or marshal should serve the person in ®for free because! am entitled to a fee waiver. (You must complete andfileform FW-001, Application for Waiver ofCourt Fees and Costs .) .0E Lawyer's Fees and Cosh I ask the court to order payment ofmy D lawyer’s fees N Court costs. The amounts requested are: .. 11cm, mom 112m Amman:SW $ $ $ $ w D Check here {fthere are more items. Put the items and amounts 0n the attached sheet ofpaper orform M0025 and write “Attachment 14-Lawyer ’s Fees and Costs ”for a title. This is not a Court Order. WM "2°“ Request for Civil Harassment Restraining Orders CH4“. P896 5°f6 (Civil Harassment Prevention) ‘9 CasoNumber: 210H0098 06 ® XPossession and Protection of Animals I ask the court to order the following: . a, E That I be given the sole possession, care, and connol ofthe animals listed below, which I own, possess, lease, keeE, or hold, or which reside m my household. (Identif; animals by, e.g. type breed, name color, sex) SMA// 904, r ’Sfmexy“ 774M, 201.3; - f/z SCH/T'fl ’/7. flbDLg l request sole possession of the animals because (specify good causefor granting order): D Check here if(hefe is not enough spacefor your answer. Put your complete answer on the attached sheet ofpaper orform MC-025 and write “Attachment l5a-Possession ofAnimals "for a title. b- E That the person in ®must stay at least 10 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 (specifiz): D Check here ifthere is not enough spacefor your answer. Putyour complete answer on the attached sheet of paper orform MC-025 and write “Attachment I6-Additional Orders Requested, "for a title. ® Number of pages attached to this form, ifany: 0 Date: January 8, 2021 D 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. Date: Jammy s, 2021 ?M?-Thomas R. Callahan ' / ' Type or print your name Sign your name This is not a Court Order. Request for Civil Harassment Restraining Orders CH4”: "9°50” (Civil Harassment Prevention) Wm‘ljme
