Request Restraining OrderCal. Super. - 6th Dist.January 11, 2021CH 100 Request for Civil Harassment ' Restraining Orders Read ('u/I u Civil Hurussnwut Restraining Order Help Me? (form CH-100- INFO) before completing this form. Also fill out Confidential CLETS Information (form CLETS-OOI) with as much information as you know. CD Person Seeking Protection a. Your Full Name: WWC/S \A) VejVCm Age: 5a Your Lawyer ([fyou have onéfor this case) Name: State Bar No.2__ Firm Name:Wanted b. Your Address (lfyou have a lawyer, give your lawyer 's information. Ifyou do nor have a lawyer and wan! t0 keepyour home address private. you may give a different mailing address instead You do not have to give telephone. fax, 0r e-mail.) Addressu‘T/O %Dm- gm DQ' jpc’ “4 City:5A’M [OZ Stateza Zip: £5736 Telephone: 465’ 22G '%Q5 Fax: E-MailAddress: KWQ-S'VQJIch (é mm ' COM J® Person From om Protection Is Sought Full Name: MWU (Q (v) Ac H Address (ifknown):5‘0 3AOOLC’ BQG‘K QQQ$OC Ila Clerk stamps date hem when form is filed. ILED JAN 1 1 2021 Clerk of the Coun Superior Coun CA o! Santa Clara N DEPUTY Fill in court name and street address: Superior Court of California, County of Santa Clara 191 N. Fgrst Street 191 N. Flrst Street s_ar) Jose, CA 95113 CIVII Courthouse - DTS Court fills in case number when form is filed. Case NuzTr'c H 00 98 08 Age: -% City: SANon State: Llipzflglé C3D Additional Protected Persons a. Are you asking for protection for any other family or household members?flYes D No Ifyes, list them: Full Name S_ex A e Lives with you? How are they related to you? “LL66“ M« VEIYOQA' F fl wYes DNO W/fe MITU/U C VG {VOM' [7 £0 m Yes D No DA’UQli'rC’JQJ D Yes D No D Yes D No D 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, Attachmem. 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. mfié‘iwafificzacfi‘fgmfimxfigfm“ 9°“ Request for Civil Harassment Restraining Orders CH-1oo, Page 1 ofs Code of Civil Procedure. 527.6 and 527‘9 QUE!” (Civil Harassment Prevention) ROHCI [1 PVERN-) Case Number: ® G) Relationship of Parties How do you know the person in ®? (Explain below): D Check here iflhere is not enough spacefor your answer. Pu! your complete answer on the arrached sheet of paper orform MC-O and write “Attachment -Relationship ofParIies "for a title. Nexv A, Mama Venue Why are you filing in this county? (Check all (ha! apply): a. fl The person in ® lives in this county. b. a l was harassed by the person in® in this county. c. D Other (specifi): Other Court Cases a. Have you or any 0f the persons named in® been involved in another court case with the person in®? D Yes m No (Ifyes. check each kind ofcase and indicate where and when each wasfiled.) Kind of Case Filed in (Counnr/Statq Year Filed Case Number (ifknowm (I) 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 (I1D Other (specify): q b. Are there now any protective or restraining orders in effect relating to you or any of the persons in @and the person in®7 mNo 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. (1) When did it happen? (provide dale 0r estimated date): OA‘ I ' I 12021 2 Wh I z h ?( ) 0 e se M“ ere [See attached declaration for a Description of Harrassment] Mc .- IIHCL 459111me Me ~17“: MaHT fififlc Cmtr {a ML, 0rd mecww/Nq Mr; N'TH VMLCNCC’ (f «1‘33 Z 15 10M H6 5 W Mm/wu‘ max‘rguwmc’ o'o 300m, M(Am Thisis notaCourtOrder. CASI“ 4‘ ’00’ 'Oslb Revusod January 1. 2018 Request for Civil Harassment Restraining Orders CH-1oo, Page 2 ace (E3. gEhm (CIVII Harassment Prevention) 9 Case Nuwlr'c H 00 98 08 ® a. (3) How did the person in® harass you? (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 “Attachment 7a(3)-Describe Harassmem' 'for a title. AT Aflflm ‘lfiéo’ [7M / wfioud [J/h’r Hum 17 ANC/cmeoes wade M I FWD 'Hc Mmc Sevceflc, ammms Mam“ I3 c A-r, lur Mc UP 7&6 Neg prf vBC/Fcflc n6 / LWLKQD WWO 77m 64‘04 Ta Ammo mm cvomq Hmc He “(6206/3 M( jkawc; " ywNM r 1’0 can m3 e,UgymPelee cram" (+5 / dar Hm gl' Wm» m me £4614 Door? «MAS 664.6aC/ZANTLV ?0 0/09 HUG 0D 4W;W Beak ,VC'U. ma {2km M NMVES, Tmfi N8 R(vpcb’co ”u c4664 (9/ ’ o’ed' 5th (4) Did the person in® use or threaten to use a gun or any other weapon?D Yes mo (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 “Attachment 7a(4)-Use of Weapons ”for a title. (5) Were you harmed or injured because of the harassment? D Yesm No (Ifyes, explain below):D Check here [fthere is not enough spacefor your answer. Put your 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? $Yes D No If yes, did they give you or the person in ®an Emergency Protective Order?D Yes No If yes, the order protects (check all that apply): D Me D The person in ® D The persons in ®. (Attach a copy offhe order ifyou have one.) b. Has the person in ® harassed you at other times? Yes D No (Ifyes, describe prior incidents andprovide dates ofharassment below): Check here ifthere is not enough spacefor your answer Put your complete answer on the attached sheer of paper orform MC-025 and write “Allachment 7b-Previ0 Harassment "for a ‘ Itile. U fig évewzmc. or I2 3i '20 20 e //:30m :46 AéfiflooTe/J MC Iiv fire Qméwflcu Amo (2mm mr 'omm AND €77;an CF fir M61611 “ham? ’He szcs MJ’ m’alpaucnémuJ/cy Ac-jl/mww 7’0 7'7“; GAT’Rfiq k This is not a Court Order. R°"”‘“‘"”"’ "2°15 Request for Civil Harassment Restraining Orders CH-1oo, Page 3 ofs(IBEW (Civil Harassment Prevention) 9 Case Number: Check the orders you want. E m Personal Conduct 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 Q): a. E 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. mContact 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. D Other (specifi): D Check here ifthere is not enough spacefor your answer. Put your complete answer on (he attached sheet ofpaper orform MC-025 and wrire ”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 ofcmy protectedperson unless the courtfinds good cause nor to make the order. ® DStay-Away Orders a. I ask the court to order the person in ® to stay at leastl yards away from (check all that apply): (1) w Me. (8) m My vehicle. (2) The other persons listed in@. (9) m Other (Spec'ifW-' (3)aMy home. é [S C ‘1 I C6,? (4) m My job or workplace. ‘ (5) D My school. ‘ v (6) D My children’s school. (7)U 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? m Yes DNO (Ifno, explain below): D Check here ifthere is no! enough spacefor your answer. Put your complete answer on the attached sheet 0f paper orform MC-025 and write “Attachment 9b-Stay-Awagv Orders, "for a title. Guns or Other Firearms and Ammunition Does the person in ®own or possess any guns or other firearms? “Yes DNO DI don’t know IfIhejudge grants a protective order. the person in ® will be prohibitedfrom owning. possessing, purchasing, receiving, 0r attempting Io purchase or receive a gun. otherfirearm, and ammunition while the protective order is in effect. The person in ®will also be ordered Io turn in r0 law enforcement, or sell t0 0r store with a licensed gun dealer, any guns orfirearms within his or lwr immediate possession 0r control. This is not a Court Order. Revised January 1‘ 2018 OB. 1m Request for Civil Harassment Restraining Orders CH-1oo, Page 4 ore ' 3Eh (Civil Harassment Prevention) . 9 Case Number: 216N009808 ® E Temporary Restraining Order l 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 IO. 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? ”Yes a N0 (Ifyou answered no, explain why below): D Check here ifthere is n0! enough spacefor your answer. Pu! your complete answer on the attached sheer of paper orform MC-025 and write “AIIachmen! 1 I-Temporary Restraining Order ”for a title. ® D Request to Give Less Than Five Days' Notice of Hearing You must have your papers personally served 0n the person in ® a! leastfive days before the hearing. unless the court orders a shorter Iimefor service. (Form CH-200-INFO explains What ls “Proof of Personal Service”? Form CH-200. Proof of Personal Service. may be used to show the 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 n0! enough spacefor your answer. Pu! your complete answer 0n the attached sheer of paper orform MC-025 and wrire “Attachment 12-Requesl Io Give Less Than Five Days' Notice "for a title. D No Fee for Filing or Service a. $ 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 0r spoken in some other way that makes me reasonably fear violence. b. m 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. a There should be no filing fee and the sheriff or marshal should serve the person in ®for free because l am entitled to a fee waiver. (You mus! complete andfileform FW-001. Application for Waiver of Court Fees and Costs.) E Lawyer's Fees and Costs I ask the court to order payment ofmy D lawyer's fees m Court costs. The amounts requested are: _I_te_m Amount l_t_§_ Amount Eilingfiea $ 435 $ $ $ $ $ D Check here ifthere are more items. Pu! the ilems and amounts on the attached sheet ofpaper orform MC-025 and write "Attachmem [Jiltlujvl‘ 's Fem uml ( 'osls”f0r a title. This is not a Court Order. Request for Civil Harassment Restraining Orders CH-1oo, Page 5 ate (I3 ‘w (Civil Harassment Prevention)Revused January L 2018 Case Number: @ D Possession and Protection of Animals l ask the court t0 order the following: a. D That l be given the sole possession, care. and control of the animals listed below, which I own, possess, lease, keep, or hold, or which reside in my household. (Idenlifl animals by, e.g., type, breed. name. color, sex.) l request sole possession of the animals because (specifiz good causefor granting order): D Check here Iflhere is not enough spacefor your answer. Put your complete answer on the attached sheet ofpaper orform MC-025 and write “Allachment l5a-Possessi0n 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 (specifl): D Check here ifrhere is not enough spacefor your answer. Put your complete answer 0n the attached sheer of paper orform MC-025 and write "Allachmen! 16-Addilional Orders Requested, "for a title. ® Number of pages attached to this form, ifany: _,_ Date: SelfiRepmsemeL - d ’ seIf-Bepzesented__Lawyer ’s name (ifany) Lawyer 's signature ia that the information above and on allI declare under penalty of perjury under the laws of the State of attachments ls true and correct. Date: {'H I m Wes w.Vow» T_1pe OMiHLvour name Sign your name ‘ ‘ \ This is not a Court Order. Rewsed January 1, 201B _ Request for Civil Harassment Restraining Orders CH-1oo, Page 6 ore (IB 53'3"“ (Civil Harassment Prevention) ‘ 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 8 CASE NAME: VEy/LM and CP u Am CASE #: 21 CHOU 98 0 Last Name Last Name CH-1 00, Item 7a(3) - DESCRIBE HARASSMENT: a) How do you know the person you want to restrain? Hf [S & £6 Am fecm mu Méx T Done A/cqu8c/e b) Are you living Wlth the person? D YES QNO c) Has the person D physically abuse you, D physically or verbally threatened you and/or D harassed 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): [176!ce fl 77f? ?va/TS 0f N(w yaw Allow 26% (bum Ms 6mm! 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