Request Restraining OrderCal. Super. - 6th Dist.February 9, 2021CmSS'YEQOCXT Request for Civil Harassment , CH4 00 Restraining Orders Read ('un a ('ivi/ llurusus'rnen! Restraining Order Help Me? (/brm CH-IOO‘ INFO) before completing this form, Also fill out Confidential CLETS Information (form CLETS-OUI) with as much information as you know. Person Seeking Protection a. Your iull Name: \M mm Pmma 0mm Age; 33x Your Lawyer (Ifyou have onefor this case) Name: SelERepmSfinIed- State Bar No.2_- Firm Name: jelfflepmsflnled b. Your Address ((fyou have a lawyer, give your lawyer 's information. [fyou d0 not have a lawyer and want (0 keep your home address private, you may give a diflerent mailing address instead. You d0 n0! have Io give telephone, fax. 0r e-mail.) Address: QDIZ CVAV’IS Ln fl '3 City: State:CA Zip:fl§LL Telephone. £9) g 30 4'“ L8 Fax: E-Mail Address: ® Person From Whom Protection ls Sought FullName: JOSPIHM “Rag“ Silva Address (ifknown): 3080 DAV! 01 AVfl A'Ip+# I I City: San :FOSC, State: O ‘4 ® Additional Protected Persons Clerk stamps date here when form is filed. FILE FEB 2 5 2021 CI k tthe Court K NGUI Superior Co A C nty ol Santa Clara BY DEPUTY Fill in court name and street address: ’EN Superior Court of California, County of Santa Clara 191 N. Fgrst Street 191 N. Flrst Street S_ar3 Jose, CA 95113 CIVII Courthouse - DTS Coun fills in case number when form is filed. Case Number: ?\CH MWfiBS Age: 2'_l Zipzm a. Are you asking for protection for any other family or household members? DYes aNo Ifyes. list them: Full Name _Se_x Ag; Lives with you? How are they related to you? D Yes D No a Yes D No D Yes D No D Yes D No D Check here ifthere are more persons. Anach a sheet ofpaper and wriIe "Attachment 3a-Additional Protected Persons "for a title. You may useform MC-025. Attachment. b. Why do these people need protection? (Explain below): D Check here ifthere is not enough spacefor your answer. Put your complete answer on the attached sheet 0f paper orform MC-025 and write “Altachmen! 3b-Why Others Need Protection ”for a title. This is not a Court Order. fififiaémfl9§1¥wamm°°¥$mmm Request for Civil Harassment Restraining Orders CH-1oo, Page 1 ore °°°°°' '“'P'°°°°“'°‘§§5276“5279 (Civil Harassment Prevention) ROHC, [l pVERNe gm... jam Case Number: G) ® Relationship of Parties How do you know the person in ®? (Explain below): D Check here xfrhere is not enough space for your answer. Put your complete answer 0n the attached sheet of paper orform MC-025 and write “Attachment 4-Relationship ofParn'es "for a title. HYYM/Y {Tim M Venue Why ar you filing in this county? (Check all that apply): a. JThe person in ® lives in this county. b. El was harassed by the person in® in this county. c. mOther (specify): EMU“? Mn A 0‘55“ V l+ . Other Court Cases a. Have you or any of the persons named in® been involved in another court case with the person in Q)? D Yes a No ([fyes, check each kind ofcase and indicate where and when each wasfiled.) Kind of Case Filed in (Countv/Srate) Year Filed Case Number (ifknown) (l) D Civil Harassment (2) D Domestic Violence (3) D Divorce, Nullity, Legal Separation (4) D Paternity, Parentage, Child Custody (5) D Elder or DependentAdult Abuse (6) D Eviction (7) D Guardianship (8) D Workplace Violence (9) D Small Claims (10D Criminal (l ID Other (specifi): b. Are there now any protective or restraining orders in effect relating to you or any ofthe persons in ®and the person in®? No DYes (Ifyes, aflach a copy ifyou have one.) Description of Harassment Harassment means violence or threats of violence against you, or a course of conduct that seriously alamed. 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. (1) When did it happen? (provide date or estimated date): N 0V0? '‘W 1 ,1 lbw Wh l h ?(2) o e SC waSt ere [See attached declaration for a Description of Harrassment] This is not a Court Order. “WWW" ‘- 2"” Request for Civil Harassment Restraining Orders CH-1oo, Page 2 ore (IB‘ ohm EJM“ (Civil Harassment Prevention) 9 Case Number: SUCH GM 0055 ® a. (3) How did the person in® harass you? (Explain below):D Check here ifthere is n0! enough spaceforyour answer. Putyour complete answer on the attached sheet ofpaper orform MC-025 and write "Attachment 7a(3)-Describe Harassment "for a title. (4) Did the pers n in® use or threaten to use a gun or any other weapon?D Yes No (lfyes, explain below): D Check here ifthere is no! enough spaceforyour answer. Putyour complete answer on the attached sheer ofpaper orform MC-025 and write “Attachment 7a(4)-Use 0f Weapons ”for a title. (5) Wer you harmed or inj ured because of the harassment? Yes D No (Ifyes, explain below): a Check here ifthere is not enough spacefor your answer. Put your complete answer 0n the attached sheet quaper orform MC-025 and write “Attachment 7a(5)-Harm 0r Injury "for a title. SMlm mH-mmcml mo wnm. Mfim mm: swM [EH mulled (22$;i [Mlflhr Sb: QLSQ PubChfld m; (l! jflfig . (6) Did the police come? Yes DNO ((MMCS [fyes. did they give you or the person in ®an Emergency Protective Order?D Yes We “111'CW) If yes, the order protects (check all that apply): D Me D The person in ® D The persons in @. (Attach a copy offhe order ifyou have one.) b. Ha the person in ® harassed you at other times? Yes D No (Ifyes. describe prior incidents andprovide dares ofharassment below): D Check here iflhere is not enough spacefor your answer. Put your complete answer on Ihe attached sheet of paper orform MC-025 and write “Allachmem 7b-Previ0us Harassment ”for a title. This is not a Court Order. “°“’°°""‘“‘” ‘- 2°” Request for Civil Harassment Restraining Orders CH-1oo, Page 3 ate(m [w (Civil Harassment Prevention) 9 Case Number: Check the orders you want. E m Personal Conduct Orders I ask the court to order the person in ®not to do any of the following things to me or to any person to be protected listed in @z a. E Harass. intimidate, molest, attack, strike, stalk, threaten, assault (sexually or otherwise), hit, abuse, destroy ersonal 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. D Other (specifl'): D Check here iflhere is not enough spacefor your answer. Pu! your complete answer 0n the attached sheet ofpaper orform MC-025 and wrile "Attachment 8c-01her Personal Conduct Orders, "for a title. The person in ®will be ordered n0! to take any action Io get the addresses 0r locations ofany prorectedperson unless the courlfinds good cause n0! Io make the order. ® DStay-Away Orders a. l ask the ourt to order the person in ® Io stay at leastL yards away from (check all that apply): (l) Me. (8) y vehicle. (2) D The other persons listed in@. (9) Other (specifiy'): (3) M My home. qs ?\qu 81' SM" fl3( I Cfiqsuo (4) dMyjob or workplace. M (5) a/My school. Mu“ requfis‘l‘ . (6) D My children‘s school. (7) D My children's place ofchild care. b. If the coun orders the person in ®to stay aw y from all the places listed above, will he or she still be able to get to his or her home, school, orjob? Yes DNO (lfno, explain below): D Check here ifthere is not enough spacefor your answer. Put your complete answer on (he attached sheer of paper orform MC-025 and write "Atrachmem 9b-SIay-Away Orders. "for a title. Guns or Other Firearms and Ammunition (SN MMVd YWWC 0‘?m W‘f ma“ WMJ d’ Does the person in ®own or possess any guns or other firearms? DYes DNO I don't know "mom" 5L 310(84 lfthejudge grants a protective order. the person in ® will be prohibitedfrom owning, possessing. purchasing. ‘n hwé’fll‘ receiving. or attempting lo purchase or receive a gun. otherfirearm, and ammunition while (he protective order orm 9x is in eflecl. The person in ®will also be ordered I0 turn in m lcm' en/brcemem, or sell to or store with a badhmd/ licensed gun dealer. any guns orfirearms within his or lwr immudiule possession 0r control. ymnv'f This is not a Court Order. car) . R'“”°""“" “ 2°” Request for Civil Harassment Restraining Orders CH-1oo, Page4 ore (I3Em (CIVII Harassment Prevention) 9 Case Number: mCHUMwSB ® a 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 ENC (Ifyou answered no, explain why below): D Check here ifrhere is not enough spacefor your answer, Put your complete answer 0n the attached sheet of paper orforr MC;025 and write "Attachment I I-Temporary Restraining Order "for a title. I- ocMm WIsh +0 gnmlc 1-0 or 3a hm’ A‘f Ml. g dgrq fig; safe a'roon'd hex. ® D Request to Give Less Than Five Days' Notice of Hearing You must have your papers personally served on the person in® at leastfive days before the hearing, unless the court orders a shorter timefor service. (Form CH-200-1NFO explains What Is “Proof of Personal Service”? Form CH-200, Proof of Personal Service, may be used to show the court (ha! the papers have been served.) If you want there to be fewer than five days between service and the hearing. explain why below: a Check here ifthere is not enough spacefor your answer. Put your complete answer on the attached sheet 0f paper orform MC-025 and write “Attachment 12-Reques! to Give Less Than Five Days’ Notice "for a title. ® figFee for Filing or Service 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. a. b. dThe sheriff or marshal should serve (notify) the person in ®about the orders for free because my request for orders is based on unlawful violence, a credible threat of violence, or stalking. c. a There should be no filing fee and the sheriff or marshal should serve the person in ®for free because l am entitled to a fee waiver. (You must complete andfileform FW-001, Application for Waiver of Court Fees and Costs.) E Lawyer's Fees and Costs D lawyer's fees a Court costs.l ask the court to order payment 0f my The amounts requested are: Itfl Amount 1Le__ Amount EiungEee s 4.35 s S $ $$ D Check here ifthere are more items. Put the irems and amounts 0n the artached sheer ofpaper orform MC-025 and write “Attachment 14-Lcm'yer 's Fees and C0s!s”for a title. This is not a Court Order. CH-1 00, Page 5 of6 R°“’°“J‘"“""-2°” Request for Civil Harassment Restraining Orders(m Elm“ (Civil Harassment Prevention) 9 Case Number: D Possession and Protection of Animals I ask the court to order the following: a. D That l 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. (Idemifi' animals by, e.g., 072e, breed, name, color, sex.) l request sole possession of the animals because (specifv good causefor granting order): D Check here Ifthere is not enough spaceforyour answer. Put your complete answer on the attached sheet ofpaper orform MC-025 and write "Attachment 15a-Possession ofAm'ma/s "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. D Additional Orders Requested I ask the court to make the following additional orders (speczfv): D Check here ifthere is not enough spaceforyour answer. Put your complete answer on (he attached sheet of paper orform MC-025 and write “Arlachmenr l6-Addirional Orders Requested, ”for a title. @ Number of pages attached to this form, if any: Date: SelszepLesenteL - d ’ self-Bepmsented- Lawyer 's name (ifany) Lawyer 's signature l declare under penalty of perjury under the laws of the State of California that the information above and on all attachments is true and correct. Date:MM \lmm'm Ochom , T)pe or print your name Sign yo r name This is not a Court Order. Request for Civil Harassment Restraining Orders CH-1oo, Pagesms (H3m (Civil Harassment Prevention)Revused January 1, 2018 1O 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 CASE NAME: MM“ 3"" mam” CASE #: ZICHM 4555 Last Name Last Name CH-1 00, Item 7a(3) - DESCRIBE HARASSMENT: a) How do you know the person you want to restrain? $6W ( I .I find b) Are you living with the person? D YES 1N0 c) Has the person hysically abuse you, Aysically or verbally threatened you and/or Jharassed 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): Februam b um bc’rmm I'me ou-mdt rvw WW 15+ ww Whom! Maw flfldl NM MT W WWImem/H' whm anrw ncclth m pyumc cm: Mm n1! covsm ‘iowmv icvmny had cum anm ha m coma come WW fl drimt lemma b4 was alwm- amA WNHM fl Mm! W’r th Mmmy firm covyu 0+ mmuicr. \lovam mmvw mm A rovpu m,m rmmc of Jamar mm! mummy (Mmf 4nd; meT Once £06va Fob b flwbvqm Wmm beMM{ WV Magmmd m? mWI/u fnm/S Hm /S how Iam/T andI becamc qqmmim). rm 5 of us wcrr amide wmw all 7w guys wore mum; about random wimp. m- om point m+ was CH-1 00, Item 7a(3) - DESCRIBE HARASSMENT Page_ MC-020 SHORT TITLE: CASE NumaER bcmasggm and Wmm 2'\C H0 (mfps 1 ”mm erm Inmd mndm +0 2 mu ms mnrn’ma Tam +0 om am mmln mg 3 amfimgm gmmw kqd mgmm and ewmvnlly 4 made hor ban 44am mu mm! 10cm Annwm 5 6|“!ZIW¥ [MIA ,SflLdl l' 5m flfi§ in MK ibfli baa K55 s +7) Art‘mé Sb 2N, mama h solwr mo”. MINT 01ml}; 7 _pnwedm Tb Walk h) mu apW+ am! Sm a mMmmM mm/mI/hS h Me hon! UMdmc Cowfi’mn-Hv g mow w) oma 0W Issves wt Mm had m W 1o 4m” SW AIM) menflms h) W Irwvy She stupem 11 lmmrw “med messaging anmmmd and Hlflma 12 1mm mm beam Tostlmc and J’mwf mp! .1 was 13 mg Iomef wmq 7mm and 1m! Mr “ Wm; 1: 14 hfflkz SSfflfllflgmlL’lq flhflzz tbflj ‘bl/Vi EH/Sf bf/‘arefl/ 1s 1mm m nmors bmww cnmefima pwpca Ma +0 1e smw} drama fir no reason” and m2 mm, ” Wah, n mmfi True 1mm you firm adwa Law I/m mm 1e amna 11) be FMWM MHz; Tomltm ho ” AfiwWq 19 ml 19H I Spoke coma my bmfiwmd ma 1m! him 20 how Mwef md W Mums fim‘ 303mm Md Joan 21 WW. l was Sthsrd CQMLdvnnmJW 22 maf-Hnb mm hmfl l sawW was Nwmmww. 23 losflumfi ‘3 cmmmw gpmgm mm mom me m 24 omor . m f 25 mm fine momth’r r smegma mnqm n m on mg; own 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 CRC 2°" 5‘" Judaal Council otCaliofomia M0020 Neuwoggn Fog: 19871 Attach to Judicial Council Form or Other Court Paper M run man ssE senh'aIFormsTM W5, I/w Mam Mm mulfipa pupa +M+SMJ mmhmty Wlm 12mm; mlomf} W 01nd monfimmq flue issues hI/r mwA I ona had I/m no+ sun H mmefinmgu 0mm? mtfh W mmmw bemua J: 1mm mm ?monwl 9&0me from Mme! WWh‘m/m, m W past. Sm MS came n me m confidcna, and mammal haw 5m wavm TD 416+ help 1065mm SM; said, ” I fie! mammal; memo! try m mmnd” mam, 0f m {x-Iooyfriand, YWIMg/l. They bum mnvm vamlby oma phyuialu, glowc eaonW Lmd 100444 chem“! (M mob o'H/u/r mulfipm 11mm. Imelmc ls 5m aqqremve omd problomarm gmnn am!W of hm J: f-cel amwvi m! Hz: 11W. 3mm r Md imamc an SW; cvr/r dad Wm MVK mbums mind speak 57on mf mph. Bffire Josenm. mm! I shyya/ qu, Sm mmilmcd fl W wa 5m hm pmloll/MS Wm M/mrw WM ‘IUWWW'J family members speaFu'cmlLu wwh Yovmmu’s oW/rmm {nm ho sure of her name boa” fl 3mm wfin a O) Mamms oldwbm‘myr anal wN-c (WW1 01ml WHID: 0mg Mona, (Manny mm} \[MVWS CMm). MTOW/ Hfl/Ow \3 Whom I dwdtd I: wm/Hod 1'0 alumna flyfilffimm TOHI’VN/ Cnmfld‘uj. Sm dldI/WL d0 mnvfhzml) 1’0 me; alwm Tm flmc (Wm! m+r/r m NWJMZOIwm Mam). I rm mu 308mm \S m JVthmTM, ma/I'H'ow, (WA manna 9mm ~11) M arumd owl I Mm wmmw amma W mu; Iomqw. I mauqm u was tom +u 54w, mow Mm loaf +or WM, own wot! loavw}. J: bloobuj hm nvmlow Mm my phone omd I pulse blgamj M/r fnm a $001M mmm acmmfi :1: hm Wm, wmm was Twwvr omd SnapQWL-f. 0V1 NDVOmW‘Iflow 1i m seamd and Wont: 11W delm M&Swvlrml m. Mg bwfhmd M(mmy's WIMM; W164 a bIm/IQMM MM \Tmllm shawed UV erh YMMV oma m1 lam) 5M Glow“ 0W IA Whiz; m m comw 01mmm pom; m fine, bmotoymml Icy WWWWU.I m5 01Hm vow]! 0Y1 m oH/mmswU’ m+ m mam MHz, mH'h my bvgfn'md am! hi5 171mb; - Dmnc;W mam, 5w ‘m‘ea r0 appmmob wm mm spam m m ma r \qnom/j W. Mm walks awwg 01nd M?Promd’vfis M71 lmle‘rimdé (‘bUsll/I, NONL- (A ‘F-cw days befom J: blooiad mallm/Wja 12a») ihemols oma I we/m 0qu +o a Mm low lacfm we le{+; JDSrf/hm mcmvvwl W 01nd 81mm smwm Doom 0+ Mom. Ebselme, SM “Dude 1: Wm +5 Ml vm; Swahm mom Mme, sm’s mllm awmvmm I dompevm laww WW sm’s 0mm ’mm/AM \nl/hfm I mVHC W/Y M SM dueSI/H Wm dVWll‘ WW MA' fma 3N wcvamifw kw SM” , M’s 30 chmgp.’ WY]: filo! WW], "L001! Tosflmc 1f um mm (m 135m wuHa MMUL ylm/ Mould smyjm MW mmm m‘ mulling mlaox/Jr Law. Thm’s Dar 01¢. Tm TUHV fl WY baffle wp 40 0qu SQ w ml MM MW a 5,1005! mmi‘r- .31 1+ ,wm’T be WWW. mi \nm/c fim.” 1mm, manna 3mm! “I dovfl xcvww dwelt sine”) ward I/m Lam 4mm, ’rv ms \nw 0133.” Mama mm! I Jefl m cmvmaflm m oxlmxd Wm; fl) me wan 0W mm mm mow er MmW; 0x c400!) flwxe- TN mm cmma, \lovmm picked vy) Monet, Mama ,awd T MW! Iwama was m fine pass.enqwxea+. m 501m ms I om m flu MW, I named mm was M lo+ of mmm, Mfr: 0155mm YWW owzd Iosame, argued mmvsc Tmm’ Mam WM VXUMW do $1) I )qmomd dr. \NQ S’mppga m a 3m +0 gov 0p Same mg]. Low} Mmce, sand SN mam WWH 17mm 04?. I s’mxlzcd mm backsem th low Wm . Yuvmnv mm! Josclw om off- Monce immeatawlq saws h m} “Did vw mafia. Iosellm Mm? 5M hi h mp”. HWW mmc back Mmm 8m, I nomcd Wm mom Tmslon mm car. 1: 4601444 +0 ma Dseltm om (AW hm n’ Elm Wm 0k mam SN. was mm} rude. Rm mpnal wflm “I'm évs’r VHH 4011/29 1’6 TML h MW m all .” 0W wz amvcd MM palm , 105mm appmmms W on +w gm 173 my, "Hm vmlmfifimx MW Wands \{W I was VMJr loam; m 1mm bemvfi (H Mona,” (M01 I sand “I male/mwd , law mm doem’T mmla d 014. \Jou com’f Hey ownm M5 wmy mm! “peak evmmmq 4p ago \gnw Wm! ’.’ TWIN”)? med 1’0 Jusfifij 1am Vembhimg as +0 Mm: she mam) (Dole “Wank \Js WW +hmm/M \X wag nwwdg Mom, fifiwwm, we m1 WNW m’ro fine mm fw ahmm mmv’ccs , 10qu m; Whiwd mm) I Mama, tnm bemuu I didn’f He! rmew anymommmm/rmd Mona. Mam»! mom, mud I oleoWd 1'0 1mm fir WWW 8mm“ 9W. YUWWM mm! Tosatm Shaw“! W2 1’0 W 361M 9mm we, won m am now Wm loselmt Md I diam} spam 1'0 wowW m Whom mower or mavmwwh Ioselmc M mgr smrmq 01+ Mom and I) clump; Mata +0 Nommw mom Imam armada MBWL; [W4 MW m L/vw; Le‘hm, was bpgfi wl+|fl Tommi became gm gong! u} wmmm 11W ow place, +7) apprman 80mm, ‘H/xc waxy Smmdl. (Spcm'mw/ m’r a ”melg pmfl-IIL 1+ was gamma; Wm so I dmdcd m‘ was hme +0 ago - I was excusmq misclfi moi gamma; wt h Mmmfs «whoa. WWW I was wmucmq 0W I smw Mame, mm! vms 01mm} m MW] WagoMWc, buf Joffllm Immedw'amvz cm rm off 0mm 3M3, "n0 pom) you Mal 1v WMWM pun b&rfinqw m WM Mu oma I hm \mrvzof 11) do H4415 She Mm pmdnej w TM 3de M W mac. IRH tWMw‘a/za) mm) ‘scmmdW mq, soer'vlz go t Mam 1: healed 1‘0 olexcand mng omd Ham, I], pUthed hm bmotL hoqu 5W WWW bmalé 06?. I-rflea 1’0 Wm mwmy ,, km Unsallmrqurs mmmm; She pufis m4 \nmr; Sm pmoh€§ me m JrW £10m of-Hrtmic (:6 vvw ma; va SWMCS ma m rm: \owwmm; mad 013W chm mama ( moms mfimed) mad sows ‘vm: m Vw WWW? ’ahd 1mm {m Emhm Hm mmm “Vow um! SM"). Wm, She mum HM 9mm mm vvf wmfid fir how» h come. Tm 9mm (Amwld, we \oofln 0,:qum gmmmh SCWM. Tm omwr mm rm gm waquL 11) ppm charms bemuse shogmml I m Wfim’r Mum wms a He bcmwc W mmuh‘u/ WM +m+. Idzd nof mm nor wad war. me mam ma m gm m5 fine, SW6 AIM”; Wflm’r DY wad Nay mama»! ammvmcc 0f am/ leM lunar ma I. Nowm WW Mammal mm M 0M was evwmmfiw becmvu J: mm told mus was a loam and firm )ssve. 1: \ef 1+ 40 01ml Wfiml/JowW cumplfir/ty omd mvw mw harmony: mfiwfims mm. Sammm mum wmswefim mmAenT mm occvmi bd'mm 108mm MM I WW1 3m fimmsmufiw m. Mamvw (ma I WM m \ms oldw lomm/v Willy’s hem wan VHS wwvj, Meat. TMUIN SWWM up wHa Mar bowfnmol, WWW, (01+Mfiw mmW wm a comm). M mm pow, {MUN mud n 5pm; mm amide (Mum Wm Manrw 01ml \lm/mrw WM WWW n myoloam, becmw Sm s’wrmcd speakma TD anwmd J: 1065mm WWW MAM hw Ibschm Mommy, mm! I mm 11> lot WM mom WWW» b\JT \fovmm’; was ve/vw, 5961110111 m‘ Momm omd 3molm€3 mmmmm I wamcd n 0mm hm awow ,Wr gm W713 mum (Md 5mm f0 W passwe Mamsxv\°,t~;. I mid Mm “LOW Tosflim we should wae HIM mhvfmflmm Wham vou/H’ Wow loecmuyc Th6 wow noun swemzama TU me \3 hm b\L fiwwm’n:mm pemme. 0mm bemm m; IS wnm Imim- Sm vaartd polvmmq hormaa and Middu 1°!qu nth/IM fl mg Wchmd. I mot a cngtg Qt 3mm mov- and Tm MM hm +0 40mm. SN proceeds 1'0 ow clbswh ma and pm boH/v gf WW fimm M my face mam. Them, WMW 4mm a’r Tbsclme/ mad mud], “ W1, WP 'lflmethnd M qmbbw kw ww mm! w mom mrs’rw. My bmgh‘mmd 1 Mammy and I mead“! TD Wm: becaust I dmm’f Ha smft 01+ +WS pow WWW Im(md aggression “WMW‘S W. T‘rwnfibrmi-mm omd fwd 11m, Toselmt CMmeS W Mam WWW hm fimm m rm; face, 01nd pvshes my 1901a 10ch rmwg mm. Im++hmmmcd for m4 3mm so Mam: and W225 pvsh harm'yMm me WM) vwg howl H014; (M. Than, \lovmnxg [Mamas W (AM armies mfimm W firearm aqqnmmly (Ht WNW, m+la m \oYUISC 0n W“; Vim fiYearm mnd a IEHLL Hyman om ml; mm]; wmw 4117161494). I 3mm} angina; and my \oowrvimd,MmmW ?\Jlluj \ll/me Md “HUN WWW; Mm m mad wm (‘qu m becmm I mm pmlstcmux; hmMmm Wemm .Wm Manw am! I leek OHM! I mam 31%me Wm aflwfiwfir. fiJg‘ow \JMUAS \UdI/r, I waved m +063Mm KbSflIm gau‘mafi “ HOV V53 TWAIN I mvfitd ’ro apologize H you gout 1 dovfi Anew vvvww PW] aPoMme +orgou+ I \wr wmflHfi Wu WMLQ bemvxt vow WWW: ammwd and [rm \lovmnvs ammma Lb Jrvwn‘ mmm we W amvm n be mmd mm W’.’ rammed MM hm wmvmvwx 11> mom Exam, mm flood mas 5w TMHr happened [08mm \JS. m I monmmd eMw! Ing m»; ow: wan; ammo! 11> complémutj ms’mmoa rwsel’r Mm \nf/r, lolootccd WV “mm uEf m»! phum 01ml am) Mm 500W mM/L/xl 0n {)m‘vbw 4,71% W loo+lq M M1 ever sec each HWY M swam 1:0 9an 0W mm! N(JmeIoe/y 711%?» Wm 5M assavhw vm Now MNI have FeceU/m lM/V Nflmmma bmw aammfi m Hr mm IaJ W VMII’LL mm I domm’l M156 am Incw on Mon 196(va 0+ her. 1M WWW +0)” mj/ SOhQ/hg OM01 Ifmrwm I/m m hr/V confimm Hmmhfl WM/vJe uym'l MW 3m wafircd Lk monfias n HM Six 1: Sfmmlw Hal sh 10m rm M(Wda Maurm‘ me, whem 5w smd "vas 0) var \mue/m” (memnmq vow mu gee ”Jana \Mhed (NW7 MM) Ms \s Low 3: dmdw) +0 mica mchm 1L0 pmtar mvsalf am! fim a resfmmma me” mefiw. I wam Jusehm h fichr Mom ma and leave me mom firqmd .I‘ 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 CASE NAME: and CASE #z 2 \ ( H0 EWCBS 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 B40 If “YES", describe: f) Were there any injuries during abuse in the past three months? {YES D NO If “YES", describe: SM nghM W m +LL {val pvltul m7 hour, ?mmd m oh H; mu (r? rm!MAM Mt scMm/hes m mi m (,y. 4 oh eM- amen . g) Did the police come to any of these recent events? fiYES D NO h) Did they give you an Emergency Protective Order for abuse in the past three months? D YES ¢NO If “YES", please attach a copy. i) Is the person you want to restrain in jail right now for violence against you? DYES (NO lf“YES",where: j) Has the person you want restrained ever been in jail for violence against you or your children? DYES {NO |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 CASE NAME: 0mm and WWW 01 CASE #: 1\C H \3 0Q‘055 Last Name Last Name' k) Do you have a criminal protective order (restraining order from criminal court)? D YES MO If “YES". please attach a copy. l) Describe the worst abuse and when it happened: fiThe most recent abuse jg the worst abuse OR D The worst abuse was (approximate date) and the person I want a restraining order against (describe what they dad to you): “WM Pmmw rm m m4 Moe“ m puma mMW HM $141 of mg flew- mmmg'd' m brvm. RN, (M80 (w W, sum on rm! head UMM (‘Vlts-r nqwn - 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): WWW“? IBfl/ol’l. {EMIWyL HPf ?omnm MW mam 01nd MIMUfinqe/r qucfl’wfM rm! {mo 3 11mg. TN find hm, 3w 9mm my frat haw rmuy h(AW, Thom, hm boqfvimud m‘ ‘l’u ‘hmfll/mny 9mm M lay my fimam M left me a brwse, and m 5mm” scrum on m Iona; H my hound. CH-100, Item 7a(3) - DESCRIBE HARASSMENT Page_