Declaration In SupportCal. Super. - 6th Dist.February 4, 2021ATTACHMENT CV-5014 NAME ANDmADDRES; OF PARTg OR ATTORNEY FOR PARTV TELEPHONE NUMBER: FOR COURT USE ONLY ATTORNEYm: SUPERIOR COURT OF CALIFORNIA, COUNTY 0F SANTA CLARA STREET ADDRESS: 191 Nonh First Street. San Jose. CA 95113 MAILING ADDRESS: 191 North First Street CITY AND ZIP CODE: San Jose'. CA 951 13 BRANCH NAME: Downtown Courthouse Person/Entity Seeking Protection:1mm Person From Whom Protection is Sought. SI ‘Se Cr 132g lez s 4! DECLARATION IN SUPPORT 0F EX P‘XTE APPLICATION FOR CASE “UMBER 05"”- CIVIL RESTRAINING ORDERS 2 1 c H 00 98 5 1 l, the undersigned. declare: 1. l am (choose one): D attorney for Person or Entity Seeking Protection seIf-represented Person or Entity Seeking Protection D other (explain): 2. The opposing party is represented by an attorney: D Yesfl‘ (If you checked yes". fill In the attorney s name address and tefl!ep one number. If you checked“no. fill In the other party's 24162 name address. and telephone number. Party/Attorney name: ez’égmmpte .(m cbooe 3. OTHER CASES: Have the parties to this case en involved in litigation with each other In another Civil Family Probate Juvenile. or Criminal Court Case? D Yes gNo If “"yes , case(s) number(s ): 4. NOTICE a. l HAVE given notice to the opposing party and/or their attorney by the following method: D Personal delivery D Overnight Carrier D FirstClass Mail D Other: Date: Time: | have received confirmation that the other party has received my papers as follows: (describe) Address/Telephone number. b. I HAVE NOT given notice of the request for orders because (Check all that apply. You must explain below): m This is an application for Civil Harassment Prevention Act. Elder Abuse. Private Postsecondary School Violence. Transitional Housing Misconduct. or Workplace Violence Act restraining orders and: m 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 | am asking that this motion be heard at the same time. D | am unable to serve the other party in the time required by law. m | fear for my physical safety (and that of others. if applicable), D Other: | declare under penalty of perjury that the forgoing is true and cor \__9__\9021 WMM ‘ . K&L-Date D claran ‘ n ure CV-sw REVOSHBHG DECLARATION IN SUPPORT 0F EX PARTE APP TION 0R” Page 1 0'2 CIVIL RESTRAINING ORDERS
