Declaration In SupportCal. Super. - 6th Dist.January 27, 2021ATTACHMENT CV-501 4 NAME AND ADDRESS OF PARTY OR ATFORNEY FOR PARTY: [’wllom ammo Q0 59% El DMM 9 Q5) 2,5 ganJOSC AWORNEY FOR (Name): Self-Reyresented TELEPHONE NUMBER:OVWOL (909155525530 FOR COURT'USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA STREET ADDRESS: 191 North First Street, San Jose, CA 951 13 MAILING ADDRESS: 191 N‘onh First Slreel CITY AND ZIP CODE: San Jose, CA 95113 BRANCH NAME: Downtown Courthouse Person/Entjty Seeking Protection: R U n cumm’ Person From Whom Protection is Sought 1-16rnm D&Z DECLARATION [N SUPPORT OF EX PARTE APPLICATION FOR CIVIL RESTRAINING ORDERS l. the undersigned, declare: fl attorney for Person or Entity Seeking Protection m self-represented Person or Entity Seeking Protection D other (explain): 2. The opposing party is represented by an attorney: U Yes Z No (If you checked “yes", fill in the attorney‘s name, address, and telephone number. 1f you checked “no", fill in the other party's name address, and telephone number. PanyfAttorney name: 50/Y‘Oé Hern0m Dé-Z Addressl'l'elephone number: ZZG’ Blae90M H f" l ad LL] 0g) 70x5"93>7q 3. OTHER CASES: Have the parties to this case been involved in litigation with each other in another Civil, Family, Probate Juvenile. or Criminal Court Case? D Yes E N0 If "yes". case(s) number(s): 4. NOTICE a. l HAVE given notice to the opposing party andlor their attorney by the following method: D Personal delivery D Overnight Carrier D First Ciass Mail D Other: Date: Time: | have received confirmation that the other party has received my papers as follows: (describe) 1. | am (choose one): b. l HAVE NOT given notice of the request for orders because (Check all that apply. You must explain below): E This is an application for Civil Harassment Prevention Act, ElderAbuse. Private Postsecondary School \fiolence, Transitionai Housing Misconduct, or Workplace Violence Act restraining orders and: E Great or irreparable injury will result before the matter can be heard on notice. D It is impossible to give notice. ‘ D The other party agrees to the orders requested. D Other: c. Explanation: D A hearing between the parties is already set l am asking that this motion be heard at the same time. D lam unable t0 serve the other party in the time required by law. m lfear for my physical safety (and that of others, if applicable). D Other: | declare under penalty of peljury that the forgoing is true and correct. o//25/21 Date Print Name Lwtlrjm' 5 defifimflm L/C 3g Declarant‘s Signature CV-5014 REV 09118l16 DECLARATION IN SUPPORT OF EX PARTE APPLICATION FOR CIVIL RESTRAINING ORDERS Page 1 of 2 ATTACHMENT CV-5014 INSTRUCTIONS Please refer to Santa Clara County Local Civil Rules for more information. This form is not for use in restraining order applications filed at Family Court. This form is required in Santa Clara County, if you are asking the Judge t0 make immediate orders without the other party being present for a hearing. These orders are called ex pan‘e orders. This form must be completed in any case where ex parte orders are requested. 1f you have given notice to the other side of your case, you must state the form of notice given. Notice means providing the other side of the case, either the attorney or a self-represented party, with copies of any papers that you want the Judge to review and any orders that you are requesting. 1f you have not given notice, you must explain why you have not given notice. There are some circumstances when notice may be waived, such as cases involving allegations 0f domestic violence where the safety 0f a party or a child might be at risk if notice is given. It is up t0 the Judge in your case to determine whether notice will be required or not. SECTION #1 State whether you are the Petitioner or the Respondent in the case. Once a case is filed, the parties keep the same status in the case. You do not change from the Respondent to the Petitioner by fiIing a new motion in the case. If you do not have an attorney, you are considered seIf-represented. SECTION #2 4 l If the other party is represented by an attorney, you must provide the Court with the attorney’s name and address. 1f the other party is not represented by an attorney, you must provide the Coun with the other party‘s address. SECTION #3 It is very important to list a1] other cases in which you and the other party have been involved with the courts. This would include other Family Law, Probate, Juvenile, Restraining Order, Child Support, Civil, or Criminal matters. lf you do not have the case number, please put unknown and [Ist the county and the year of the filingdf possible. SECTION #4A Unless notice is excused by the Court, you must provide notice of this motion to the other party before you deliver a copy to the Court. When you give such notice, specify how you did it (by courier or personally, for example) and at what time and date. Also, please explain how you know _ that the other side received copies of your papers and what response you were given. SECTION #4B If you did not give notice of this application, explain why in this section. Check as many boxes as ' apply. You may also write out any further explanation of your reasons for not giving notice. After this form is completed, attach it t0 your restraining order application and submit them as follows: o If Civil Harassment, Workplace Violence, Private Postsecondary School Violence, or Transitional Housing Misconduct; to the Civil Division Clerk’s Office at 191 North First Street, San José, CA 951 13 o lf Elder or Dependant Adult Abuse; to the Family Division Clerk's Office at 201 North First Street, San José, CA 95113 CV-5014REVOWI16 DECLARATION IN SUPPORT 0F EX PARTE APPLICATION FOR Pasewz c1v1L RESTRAINING ORDERS