Response Petition Civil Harassment Workplace ViolenceCal. Super. - 6th Dist.February 4, 2021a4 Response to Request for Civil 1- ‘é ' Harassment Restraining Orders Use this form to respond to the Request (form CH-100) . Read How Can I Respond r0 a Reguesrfor Ciw'l Harassment Reslmining Orders? (form CH-I20-INFO) t0 protect your rights. Oferk stamps dare here when form is filed. ELE ' Rehsed January 1. 201B, Mandatory Form ~ Fin out this fonn and take it to the court clerk. MAR 2 6 2021 . Have someone age 18 or older-not you-serve the person in® or CI _, ' Of the Court his or her lawyer by mail with a copy 0f this form and any attached me .. anemmy cl fianm 3|: pages. (Useform CH-250, ProofofService 0f Response by Mail.) BY j_ ___ DEF Person Seeking Protection Full name ofperson seeking protection (seeform CH-IOO, irem®): . / ‘ hohufixz fivm+ Person Frorfi Whom Protection Is Soughtm cwK Pr QU‘x \ 0%”a, Your Name: Your Lawyer ({fyou have onefojr this case) Name: 1 Firm Name: State Bar No.2 '- o {a LJW ‘ x r! ~/ , , Fill in court name and street address: (”77 Superior Court of California, County of Sygerior Court Cm! Divlslon 191 N. FlrstSi San Jose, CA 95113 b. Your Address ([fyou have a lawyer, give your lawyer‘s iry‘ormanon. Ifyou d0 not have a lawyer and want t0 keep your home address pi’ivare, you may give a difirerent mailing address instead. You d0 not have r0 give telephone, fax, 0r e-mail.) Address: H75 QM) QC‘ k043i ?%|fo Statechr ZipimCity: Cégm? 'Ia &\ \ Telephone: Lffi qfigflé Fax: E-mail Address: Case Number: 'EUC’HODCIQSQ ® D Personal Conduct Orders n. D I agree to the orders requested. b. . I d0 not agree t0 the orders requested. (SpeczfiI why you disagv'ee in item® 0n page 3.) Present your reSponse and any opposition at thc hearing. Write your hearing date, time, and place from form CH-109 item©here: 2 _ “\ . Hearino .9 Date: ‘ 3 Z gg fll Tlmcfiiliflfl Date Dept.: L_l. Room: l Ifyou were served with a Temporary Restraining Order, you must obey it until the hearing. At the hearing, the court may make orders against you that last for up to five years. c. E] I agree to the following orders (Specify below 0r in item® ozzpage 3.) ® D Stay-Away Orders a. D I agree t0 the orders requested. b. I d0 not agTee to the orders requested. {Speczfi why you disagree in ilem® 0n page 3.) c. D I agree t0 the following orders (specify below 0r in ilem® 0n page 3): ® D Additional Protected Persons a.?gfiae that the persons listed in item©of form CH-IOO may be protected by the order requested. b. I Ido not agree that the persons listed in item®of form CH-IOO may be protected by the order requested. Jud:dalICounciI of Cahfomia. www.courISLaQOV Code ofCiviI Plocedure. §§ 527‘6 and 527.9 Response to Request for Civil Harassment Restraining Orders 9 CH-120, Page1 0M (Civil Harassment Prevention) ' . ’ - NumbeHMg5 K ® Guns or Other Firearms and Ammunition If you \vcre served with form CH-llO, Temporaty Restraining Order, you cannot own 0r possess any guns, other firearms, or ammunition. (See item® 0f form CH-llO.) You must sell to or store with a licensed gun dealer, or turn in t0 a law enforcement agency, any guns 0r other firearms in your immediate possession or control within 24 hours ofbeing served with form CH-110. You must file a receipt with the court. You may use form CH-SOU, ProofofFireamzs Turned In, Sold 0r Stored, for the receipt aw} do not own or control any guns or firearms. b. D I ask for an exemption from the firearms prohibition under Code of Civil Procedure section 527.9(f) because canying a firearm is a condition of my employment, and my employer is unable t0 reassign me to another position where a fireann is unnecessary. (Explain): I: Check here {fthere 1's not enough space belowforyom' answer. Putyour complete answer 0n an atlached sheef ofpaper and write "Attachment 6b-Fz‘rearms Surrender Exemption " as a title. You may useform MC-"025. ‘Attachméht.’ ' ‘ -» ~T . . - c. D I have turned in my guns and firearms t0 the police or sold them t0 or stored them with a licensed gun dealer. A copy of the receipt D is attached. D has already been filed with the court. ® D Possession and Protection of Animals a. D gree to the orders requested. b.‘ I d0 not agree to the orders requested. (Specgfii why you disagree in item® 0n page 3.) c. D I agree t0 the following orders (spectfl below 0r in item® 0n page 3): D Other Orders a. D I agTee to the orders requested. b.‘ I do not agree to the orders requested. (Specifil why you disagree in item® on page 3.) c. D I agree to the following orders (specifil below or in item® 0n page 3): ® QEDenial Idid not do anything described in item® of form CH-lOO. (Skip t0® .) Rev‘smam’am-m‘s ‘ "Response to Request for Civil Harassment ' , CH-120- P6992 of4 Restraining Orders . -> (Civil Harassment Prevention) . ‘ . . Ca§N\umbeHOqu S\ D Justification or Excuse IfI did some 0r all ofthe things that the person in® has accused me of, my actions were justified or excused for the following reasons (explain): D Check here tfthere i5 not enough space belowfor your answer. Pu! your complete mmver 0n (m attached sheer ofpaper and write “Anachment 10-Jusliflcari0n 0r Excuse " as a title. You may useform MC-025, Attachment W; ® fiReasons l Do Not Agree t0 the Orders Requested Explain your answers to each order requested that you d0 not agree with. D Check here [fillere is no! enough space belowfor your anmer. Put your complete answer 0n an attached sheet ofpapez and wnre "Attachment JI-Reasons IDisagiee” a5 a title. You may useform MC-0125, Attachment. Cam; («mu mgr \MQ m +<> mew J’A RN?!Hm HQ; mom; sky éxcmm; {\ndm“ qwfm %\0~_ \‘b \_N\n"\<’_n‘n3 '\-\\\b ‘3‘:Om- gn‘ bum hLRFL :‘rfi Made, m (L&QCAQFMAIOA g.(\ nmoA-lw/f CHAQ (SW4. Mafia dffl «3‘5“? ‘fixfi Munfl4m L‘A- r’}\- ~H/ru GWMq/xa éfiequ-in.\ 1mm m'xh Kan been mp”1;,” rf RevbedJanuaW‘Jm Response to Request for Civil Harassment CH4”, P8993 °f4 Restraining Orders 9 (Civil Harassment Prevention) -. ' mfiumberflmg’a ® D No Fee for Filing a. D [request that I not be required t0 pay the filing fee because the person in®claims 1n form CH- 100 ‘ item ®to be entitled to free filing b. (a I request that I not be required to pay the filing fee because I am eligible for a fee waiver. (Form FW-OOI. Request to Waive Court Fees, must befilea‘ separately.) ® D Lawyer's Fees and Costs a D I 35k the 001m t0 order Payment 0fmy D Lawyer’s fees D Court costs. The amounts requested are: 1te_m Amount Item Amgunt $ ' $ $ ' ' ‘ ‘ $ $ $ D Check here :fthere are more items. Put the items and amounts 0n the atlached sheet ofpaper and write "Arrachment I3-Lmtyer'5 Fees and Costs "for a title. You may me orform M'C-025, Attachment. b:/E/I ask the court t0 deny the request 0f the person asking for protection that I pay his or her lawyer’s fees and costs. - Number ofpages attached t0 this form, ifany: Date: Lawyer's name (if(my) Lawyer's signature I declare under penalty ofperjury under the laws ofthe Slate 0f California that the information above and on all attachments ls true and correct g/amom MMKvlflvauULM-Q )._//// A A , Q“ Type 0r printyour nameJ nKyobfmme U/ ‘ RevisedJanuéM-m Response to Request for Civil Harassment CH-120. Page 4 0f4 Restraining Orders (Civil Harassment Prevention)
