Request Restraining OrderCal. Super. - 6th Dist.February 4, 2021C Request for Civil Harassment cm stamps dare hm when mm. is med. H'1 00 Restraining Orders Read ('un a ('I'vil Harassment Restraining Order Help Me? (form ('H-IUU- IINFO) before completing this form. Also fill out Confidential CLETS F L E DInformation (form CLETS ()0!) wnth as much Information as you know. FEB _ 4 202' ® Person Seeking Protection .Clerq of the Court K NGUYEN a. Your Full Name: 35mm" 0°” °“"'V °‘ Same CW8MM_- Age:§- DEPUTY Your Lawyer (Ifyou have one for this case) Fill in coun name and street address: Name: SelEBepLesented- State Bar No.2 _____ Superior Court of California, County of Firm Name:Wd ?g?t§%|i?;? Street b. Your Address (Iflmu have a lawyer, giveyour lawyer’s 191 N. First Street information. lfyou d0 not have a lawyer and wan! Io keepyour giavqlJcoos‘fihfiéusssg 3 301-8 home address private, you may give a diflerent mailing address instead. You do no! have to give telephone, fat, 0r e-mail.) Court fills in case number when form is filed. Address: \SS (l) fike/SYQ N05; Case Numerl c H 00 9 8 ll 7 City:WML- StatezmZimm- Telephone: f Fax: "_’h E-Mail Address: ® Person From Whom Protection Is Sought Full Name: :gbm'im Mxmc/L- Age:flJO‘S Address (ifknmm): fi\bo 1 “>?de \Ddb (JVCityw State: (A Zip: E§fi_°\ G) Additional Protected Persons a. Are you asking for protection for any other family or household members? ?Yes D No lfyes, list them: Full Name fl Ag; Lives with you? ow are they related to you?LA- Yes DNO mmm« D Yes D No Q D Yes D No D Yes D No D Check here ifthere are more persons. Attach a sheet ofpaper and write “Allachment 3a-Addilional Protected Persons "for a title. You may useform MC-025. Anachmem. b. Why do these people need protection? (Explain below): D Check here ifrhere is not enough space for your answer. Pu! your complete answer 0n (he attached sheet of paper orform MC-025 and write “Arlachmen! 3b-Why Others Need Protection "for a title. This is not a Court Order. fiacfiagrszfiiWfiofig’gjwv Request for Civil Harassment Restraining Orders CH-1oo, Page 1 ova °' ""' ““”'” ' 2 (Civil Harassment Prevention) ROHC, [l PVERN9£173” Case Number: GD GD Relationship of Parties How do you know the person in®7 (Explain below): D Check here ifthere is nor enough spacefor your answer. Pu! your complete answer on the attached sheet of paper orform MC-025 and write “Alrach em 4-Relationship ofParties ”for a title.Mums M p om mm 05m + M as w Lu Venue Why are you filing in this county? (Check all that apply): a. D The person in® lives in this county. b. BI was harassed by the person in® in this county. c. D Other (spec'ifi'): Other Court Cases a. Have you or any of the persons named in© been involved in another coun case with the person in®? D Yes a No (Ifyes, check each kind ofcase and indicate where and when each wasfiled.) Kind of Case Filed in (Counrv/State) Year Filed Case Number (ifknown) (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) a Workplace Violence (9) D Small Claims (10D Criminal (lID Other (specifii): b. Are there now any protective or restraining orders in effect relating to you or any of the persons in @and the person in®? E No DYes ([fyes, 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. (l) When did it happen? (provide date or einmated date): (2) Who else was there? [See attached declaration for a Description of Harrassment] This is not a Court Order. “?“WJ'M’” 2°” Request for Civil Harassment Restraining Orders CH-1oo, Pagez om(m 3"“ (Civil Harassment Prevention) 9 Case Number- 210H009847 ® a. (3) How did the person in® harass you? (Explain below): 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 Harassment ”for a title. (4) Did the person in® use or threaten to use a gun or any other weapon?D Yes ENC (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 "Attachment 7a(4)-Use of Weapons "for a title. (5) Were you harmed or inj ured because of the harassment? D Yes ENC (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(5)-Harm or Injury "for a title. (6) Did the police come? D Yes a No lf yes, did they give you or the person in ®an Emergency Protective Order?D Yes R No If yes, the order protects (check all that apply): DMe D The person in ® D The persons in @. (Attach a copy 0fthe order ifyou have one.) b. Has the person in ® harassed you at other times?D Yes w 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 MC-025 and write “Attachment 7b-Previous Harassment "for a title. This is not a Court Order. Request for Civil Harassment Restraining Orders CH-1oo, Page sofa (I3m (Civil Harassment Prevention) at.- X‘jE!!!‘ 9 Revised January 1. 2018 Case Number: Check the orders you want. E E Personal Conduct Orders l ask the court t0 order the person in @not to d0 any of the following things to me or to any person to be protected listed in® : a. 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. c. DOther (specifir): D Check here ifthere is not enough spacefor your answer. Put your complete answer on the attached sheet ofpaper orform MC-025 and wrile ”Anachment 8c-01her Personal Conduct Orders. "for a title. The person in ® will be ordered n0! Io take any action to get the addresses or locations ofany protectedperson unless the courtfinds good cause not to make the order. ® mStay-Away Orders a. I ask the court to order the person in C2) to stay at leastm yards away from (check all Ihat apply: (l) m Me. (8) m My vehicle. (2) a The other persons listed in®. (9) D Other (specifiz): (3) m My home. (4)w My job or workplace. (S) D My school. (6)B My children’s school. (7) E My children‘s place of child care. b. lf 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, orjob? mYes DNO (Ifno, explain below): D Check here ifthere is not enough spacefor your answer. Put your complete answer on the aflached sheet of paper orform MC-025 and write "Attachment 9b-Sray-Away Orders. ”for a title. Guns or Other Firearms and Ammunition Does the person in ®own or possess any guns or other firearms? DYes ENG DI don't know [flhejudge grants a protective order, the person in ® will be prohibitedfrom owning, possessing, purchasing, receiving, or attempring Io purchase 0r receive a gun, otherfirearm, and ammunition while the protective order is in eflect. The person in ®will also be ordered Io turn in to law enforcement, 0r sell Io 0r srore with a licensed gun dealer. any guns orfirearms within his ur her imnwdiurc possession or control. This is not a Court Order. ““MJ‘W" "2°” Request for Civil Harassment Restraining Orders CH-1oo, Page4ote(m.m (Civil Harassment Prevention)a... Em! 9 Case Nu?TcH00 98 a 7 ® m Temporary Restraining Order l request that a Temporary Restraining Order (TRO) be issued against the person in ® to last until the hearing. I am presenting form CH-l 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? DYes m No (lfyou answered no. explain why below):D Check here (fthere is no! enough spacefor your answer. Pu! your complere answer 0n the attached sheet of gaper orfon‘n MC-025 and write "Anachmem II-Temporwjv Resrraining Order "for a title. _ L A33. 9“ 3235 &¢ Q2 EDS} hfim j: hen) gags g ‘xfi n khg\hs K ‘ {J&> . - - DCA‘r ® 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 u shorter (imefor service (Form CH-ZOU-INFO explains What ls “Proof of Personal Service"? Form CH-200. Proof of Personal Service, may be used Io show the court tha! the papers have been served.) lf you want there to be fewer than five days between service and the hearing. explain why below: D Check here iflhere is n0! enough spacefor your answer. Put your complele answer on the attached sheet of paper orform MC-025 and write “Altachmem IZ-Reques! Io Give Less Than Five Days' Notice "for a title. ® a No Fee for Filing or Service a. m There 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 in some other way that makes me reasonably fear violence. b. a The sheriff or marshal should serve (notify) the person in ®ab0ut the orders for free because my request for orders is based on unlawful violence. a credible threat ofviolence. or stalking. c. m There should be no filing fee and the sheriff or marshal should serve the person in ®for free because I am entitled to a fee waiver. (You must complete andfileform FW-001. Application for Waiver of Court Fees and Costs.) m Lawyer's Fees and Costs l ask the court to order payment of my D lawyer's fees a Court costs. The amounts requested are: Lem Amount ltL Amount Eilingfiee s A35 S $ $ $ $ D Check here iflhere are more ilems. Pur Ilw ircmx um! amounts 0n the attached sheet ofpaper orform MC-025 and write “Attachmem 147Luu1wr 's Fwy um! ( '0srs"fbr a title. This is not a Court Order. "““J'm ‘- 2°“ Request for Civil Harassment Restraining Orders CH-1oo, Page s ote(m (Civil Harassment Prevention) .5... EM 9 Case Number: D Possession and Protection of Animals I ask the coun to order the following: a. DThat I 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. (Idennfl animals by, e.g., type, breed, name, color, sex.) l request sole possession of the animals because (specifv good causefor granting order): D Check here ifthere is n0! enough spacefor your answer. Put your complele answer 0n the attached sheet ofpaper orform MC-025 and write "Attachment 15a-Possessi0n ofAm'mals "for a title. b. D That the person in ® must stay at least yards away from, and not take. sell. transfer. encumber, conceal. molest. attack, strike. threaten. harm, or otherwise dispose of. the animals listed above. a Additional Orders Requested l ask the coun to make the following additional orders (specifi’): D Check here ifrhere is not enough spacefor your answer. Put your complete answer 0n the attached sheet of paper orform MC-025 and write ”Altachment 16-Additional Orders Requested, ”for a rille. @ Number of pages attached to this form, if any: Date: . d } selt-Bepmsenb Lawyer 's name (ifany) Lawyer 's signature l declare under penalty of perj ury under the laws ofthe State of California that the information above and on all attachments is true and correct. Date; C. a 9 - p CWQ‘J, Type or print your name SiMur na)ne This is not a Court Order. “"“J‘m‘ 2°” Request for Civil Harassment Restraining Orders CH-1oo, Page s ots (IE fern“ (Civil Harassment Prevention) 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 CASE NAMERoggficmeg 3““ 'aswame 1&1 CASE #: j 1 C H 00 98 4 7 CH-1 00, Item 73(3) - DESCRIBE HARASSMENT: a) How do you know the person you want to restrain? ‘ ) " \ <\ 2mg ; :r “A. b) Are you living with the person? D YES MO c) Has the person D physically abuse you, U physically or verbally threatened you and/or Narassed 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): 31L WW CH-100, Item 73(3) - DESCRIBE HARASSMENT Page_ D (m ' hmchmem "I (H5)- Degmbe cH0098 \ MOMCM $90va 13+ 10v m‘HatgfimYeéficfip/VM SCYQQhS‘m’fS of Whofi \{Q/ggnm mmfmm hod WSW 0h W msmqmm She Qos‘ved o WW?» 0‘ me 0nd mode o\\eopx\0h§ Sow'mq WW \ grabbed hex bow fiimds davqhmv. 5mg said 0m ’me 905* “ Rmone mm mom ’mw Wm ”r9“ WV. ‘0 mew u?" She mso mm“ x) wowmo #006“ MWO‘!‘ W9“ mm W“ She mgo ma m “ CM? UV \Ow“0“‘-” ‘ “‘9“ ?‘Oweded ’m odomms me, {WWW W Sgfidihq WM a 9M Swyfinq Who \WQS Oh0\ MN“ \ch rm men MMM MY wow \evm mom mm mewm; and Thou \E 6m WM conwmed V‘Q 66m 03m H 69mm m mm. 3m mm mum and gm mm mm ms O Mg of MW” 80>th " She, . "- HI“ She mgo wad . " \1 Wanna ‘09 W’m CX mom mow \nas a mm "men fiovl ’(F m vs and we dom d0 W \J av)“ ur' mace cu; u aom Wow hm cop mm om hem \ow m2 «n \ono \ ’er MY mm \ am o mormr am SQ \wow 5 ‘ - ‘ _ , 21cH009847 WAS comermm omW m WWW MVWV‘I \th mm mmmmmm qo 1n Qoxece. I 0‘60 said H 6m womd +0 “W up and MK we com Semq fl 0W wufi' Sm WOWM mgw'mj w mo \out Wm mama xo goof m1 \(pmowa ahdl ' 6mm Mm WW MC-OZO _S”°R‘;‘“TS‘ and M ‘ “S“Wcuoo 98 A7Woo we" Wren, Last Name Last Name 3 Mb 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 (Required for verified pleading) The items on this page stated on information 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 Form Approved by me ADDITIONAL PAGE CR0 201. 501 Judas] Council of California M0020 Noggnggrrymt 19871 Attach to Judicial Council Form or Other Court Paper Martin Dean's Essential Forms TM Metro by T-Mobile ’9‘ 8:22 PM ® 32%Q' < a salviqueen408_ G) View Profile Hey it's checos girlfriend, l have never hit 'ofltéuched Aaflyah AT: alone ever alone, _ touched your baby please - hesitate to take this t0 the * , are; 8mm youandyouras i ; ’ j:- be:posingmewlm out Il‘iner . aboutme FALSEAC; j-‘i ,, 4 ofvusmacmm ,, fig, ma imut on a GROWN LEVEL. Lol girl court do what u gotta do we gotta the video of Aaliyah saying it so again ? What and 2 dumb ass do I look like her mother naw that’s my god daughter but like I said why would a 4 yr old come home say that to her mother but GROWN NOW THAT I AM SO SHE DID TRY TO ASK U AND U AND SERGIO PLAYED GAMES LIKE LIL ACQ VlnC l I \AIAMKIA DC \AIITLI A RAAM a Message... g Q . Metro by T-Mobile 2? 8:22 PM ® 32%(__J' < 3 salviqueen408_ ® Lol girl court do what u gotta do we gotta the video of Aaliyah saying it so again ? What and 2 dumb ass do | look like her mother naw that’s my god daughter but like I said why would a 4 yr old come home say that to her mother but GROWN NOW THAT l AM SO SHE DID TRY TO ASK U AND U AND SERGIO PLAYED GAMES LIKE LIL ASS KIDS U WANNA BE WITH A MAN THAT HAS A KID THEN STAY TF IN UR PLACE CUZ U DONT KNOW US AND WE DONT DO THAT COP SHIT OVER HERE BUT NICE TO KNOW U DO SO WHAT WERE U SAYING FUCK THIS INTERNET SHIT SINCE U GROWN RIGHT ? Let’s meet up and TALK LIKE GROWN a WOMAN G Message... Q Q . Metro by T-Mobile ’5? 8:22 PM Ci} 32%D' < w salviqueen408_ ® IIKB llel lllUlllBl IIdW llldt 5 llly QUU daughter but like I said why would a 4 yr old come home say that to her mother but GROWN NOW THAT l AM SO SHE DID TRY TO ASK U AND U AND SERGIO PLAYED GAMES LIKE LIL ASS KIDS U WANNA BE WITH A MAN THAT HAS A KID THEN STAY TF IN UR PLACE CUZ U DONT KNOW US AND WE DONT DO THAT COP SHIT OVER HERE BUT NICE TO KNOW U DO SO WHAT WERE U SAYING FUCK THIS INTERNET SHIT SINCE U GROWN RIGHT Let’s meet up and TALK LIKE GROWN w WOMAN 1O 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 210H009847 CASE NAME: E&m and w‘xmn CASE #z 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? U YES BNO If “YES". describe: f) Were there any injuries during abuse in the past three months? D YES E NO If “YES”. describe: g) Did the police come to any of these recent events? D YES ENC h) Did they give you an Emergency Protective Order for abuse in the past three months? D YES E NO If “YES", please attach a copy. i) ls the person you want to restrain in jail right now for violence against you? UYES flNO If“YES".where: j) Has the person you want restrained ever been in jail for violence against you or your children? DYES m0 |f“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 210H0098‘l7 andCASE NAME: CASE #z Last Name Last Name k) Do you have a criminal protective order (restraining order from criminal court)? D YES B NO If “YES", please attach a copy. l) Describe the worst abuse and when it happened: mThe most recent abuse jg the worst abuse 0R U The worst abuse was (approximate date) and the person | want a restraining order against (describe what mey and to you): m) Describe any other previous (past) violence or threats of violence that you haven't already written about here (include dates or estimates as to when it happened): CH-100. Item 73(3) - DESCRIBE HARASSMENT Page_
