Request Restraining OrderCal. Super. - 6th Dist.January 21, 2021CH 100 Request fOl' CIVII Harassment Clerk stamps dare here when formis filed. ' Restraining Orders Read ('un u Civil llur'u.s'.wzent Restraining Order Help Me? (form (V'H-100- F | L EINFO) before completing this form. Also fill out Confidential CLETSInformation (form C'LETS-OOI) with as much information as you know. JAN 2 1 2021 Person Seeking Protection Clerk 0i t mycdostiga own a. Your Full Name: \ ‘ / Suva“ CW" C DEPUTY / \ {x \ngfiimaxnkm m n \ “KLAVQ mm; h; “a \{O‘g Fxca-mooxLQ chfl :‘lx u, \7‘1 (x; OJ myg L mjfipx QC) (\X’h\£ a ({NKIQ ”r“ Q (lmQRmfé [#9 (MR: L ’\\\r\o:1 )nL \flméwk {CRNO ‘ r; mm \.L( Kc» CLQ&> 990‘ L KtcC \ \Whfix K‘MJO C. fl: RFC: QVQVCQ C mAr \VQ Conm (\‘QAO 8mm? c k AQQ Se \mx \jw m2 @WQOQ C&Q CH-100, Item 7a(3) - DESCRIBE HARASSMENT] Page__ MC-020 SHORT TITLE: CASE NUMBER- and Last Name Las‘ Name 1 2’; \\\0~n\m A \LRQ< \OAL \\\ {ASLm; i ‘gcn 3 mm»: o fig x‘c < '{mmvxm {Cmax (A: ‘3 4 x {\nt 13A On; Ru o” \QLXOJ o ka r\p\L\Q 5 (\(van “fig; \\LL\§~\\ Q\;> 193% Q H\ her fur 25 26 (Required for ven’fied pleading) The items on this page stated on infomation and belief are (specify item numbers, not line numbers): 27 This page may be used with any Judicial Council form or any other paper filed with the court. Page Jmmggggm ADDITIONAL PAGE CRczm. 501 ucozo waggrm‘t wan Attach m Judicial Council Form or Other Court Paper an Dean‘s Essential Forms TM 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 CASE NAME: and CASE #: Last Name Last Name e) Were any guns or other weapons used or threatened to be used during any abuse in the past three months? D YES E NO If “YES", describe: f) Were there any injuries during abuse in the past three months?fl YES. D NO lf“YES”, describe: gm; F $0»an gwb 00 Nk<\3\\\gh \U \ktngtho (:09: g) Did the police come to any of these recent events? ‘KYES D NO h) Did they give you an Emergency Protective Order for abuse in the past three months? D YES fi’NO If “YES", please attach a copy. i) ls the person you want to restrain in jail right now for violence against you? Elves Mo If"YES",where: j) Has the person you want restrained ever been in jail for violence against you or your children? DYES KNO lf“YES",when: Describe what the person did to you or your children that caused them to go to jail: CH-100, Item 73(3) - DESCRIBE HARASSMENT Page_ 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 CASE NAME: and CASE #: Last Name Last Name k) Do you have a criminal protective order (restraining order from criminal court)? D YES m0 If “YES", please attach a copy. l) Describe the worst abuse and when it happened: UThe most recent abuse i_s the worst abuse OR D The worst abuse was (approximate date) and the person l want a restraining order against (describe what they ma m you): m) Describe anym previous (past) violence or threats of violence that you haven’t already written about here (include dates or estimates as to when it happened): gkg Lug (0” hm Jo Mg, Wcrgoml PLOW TO J9” WC; ’Hlul- (Uhtn gum! 551 Saw MC glq \ucs Qolnb Jo tick Mg, (~55; 'H uuL-S CLrwaé UommL-er, j wc-s Lying 1Q Auc‘é keg (3n MJJ Nomwdocrl, 6R4 Lac; A101 6Lom‘w _ 40 morL,6M mes M04 Cloriimfi COfrCcJ'; Zrlm‘i gave \Mr a worm)»; meoS-e Jo Owed Mr: SLC Jolé MC “ml 60mg Do, I Lcélo Se CH-100, Item 73(3) - DESCRIBE HARASSMENT ‘V Page_
