Declaration In Support

Cal. Super. - 6th Dist.February 10, 2021

ATTACHMENT CV-5014 NAME AND ADDRESS 0F PARW 0R ATrORNEY FOR pARTv TELEPHONE NUMBER FOR coum use ONLY Mssmn Awa oxr‘ ighq SiLx/Lr‘ kAan LAM. SM, 305:9 m 4313? ATTORNEY FOR(~ame) Pro SC. SUPERIOR COURT OF CALIFORNIA, COUNTY 0F SANTA CLARA I L ESTREET ADDRESS: 191 North First Street, San Jose. CA 95113 MAILING ADDRESS: 191 North First Street CITY ANDZIP CODE: San José, CA 95113 FEB 1 0 2021 kBRANCH NAME: Downtown Courthouse . Cle of the Court ' Person/Entity Seeking Protection: H 0L S S m“ A b P ' K 0" r' BYSW'W CW“ Ry ofSm ammm DEPUTY Person From Whom Protection is Sought: "TO m o nary. \7“m AnaKm DECLARATION IN SUPPORT 0F ex PARTE APPLICATION FOR CASE ?”fifH 00 9 8 5 9 DEPT” CIVIL RESTRAINING ORDERS l. the undersigned. declare: 1. I am (choose one): D attorney for Person or Entity Seeking Protection fl self-represented Person or Entity Seeking Protection D other (explain): 2. The opposing party is represented by an attorney: D Yes MNO (If you checked “yes", fill in the attorney's name, address. and telephone number. If you checked “no". fill in the other party's name address. and telephone number. Party/Attomey name: Address/Telephone number: 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 fl No 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: U Personal delivery D Overnight Carrier D First Class Mail D Other: Date: Time: l have received confirmation that the other party has received my papers as follows: (describe) 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 l am asking that this motion be heard at the same time. D | am unable to serve the o(her party in the time required by law. I fear for my physical safety (and that of others. if applicable). D Other: I declare under penalty of perjury that the forgoing is true and correct. Fesruwg mom HASsAn Abpnqm ‘ Date ' Print Name Declarant‘s Signature CV-5014 REV 09/13/15 DECLARATION IN SUPPORT OF EX PARTE APPLICATION FOR Page 1 0f2 CIVIL RESTRAINING ORDERS