Request Restraining OrderCal. Super. - 6th Dist.February 17, 2021CH 100 Request fOI' CiVII Harassment Clerk stamps date here when form is filed. ' i Restraining Orders Read ("an u ('iw'l Ilurummcnl Restraining Order Help Me? (fbrm ('H-IUU- INFO) before completing this form. Also fill out ('onfidemial CLETS I L E D FEB l 7 2021 Information (form ('LETS-OUI) with as much information as you know. Person Seeking Protection a. Your Full Name: Your Lawyer ([fyou have onefor this case) Fill in court name and street address.- Name: .SelhRepLesented- State Bar No.:- gupegiorcclourt of California, County of ~ . _ an a _a raFlrm Name.WEI 191 N_ first Street b. Your Address ([fyuu have a lawyer, giveyour lmvyer's 191 N. FIfSt Street information. [fyuu d0 not have a lawyer and wan! 10 keepyour giavql‘lcoosghfigusssg 3 301-8 home address private. you may give a different mailing address instead. You do n0! have to give telephone, far. 0r e-mail.) Court fills in case number when form is filed. Address- HZ Mum’tm n 9vm \A R S Di . Cm Numb? CityzéLW-XLJQ-State: Zip: qs' fit” ICHOO 9866 Telephone: Fax: E-Mail Address: Person From Whom Protection ls Sought FuIIName; 39556 \\€v n (mdfl Age: 2% Address (ifknown): \/\ 1 NOV Y\ \vu Y\ S ?n HRS m - City: S q“ 3C Se Statezifl Zip: q 9'77 k ® Additional Protected Persons a. Are you asking for protection for any other family or household members? DYes mo (fives, list them: Full Name _S_§_.x_ Ag; Lives with you? How are they related to vou? D Yes D No D Yes D No D Yes D No D Yes D No a Check here iflhere are more persons. Attach a sheet ofpuper and write “Attachment 3a-Additional Protected Persons ”fbr a title. You may useform 1110025. Attachment. b. Why do these people need protection? (Explain below): D Check here iflhere is not enough spacefor your answer. Pu! your complete answer 0n the attached sheet of paper orform AIC-025 and write "Arrachmenl 3b-Why Others Need Protection "for a lille. This is not a Court Order. nous Comcal MCdrfom-n.m ca my - - . . afiéwwzggwéfigg Request for (Celia: :aarggssrigsgfieeeefiitggwmg Orders CH-1oo, page 1 ore ROHCI [1 PVERN-)mGB E, Case Number: (D C5) Relationship of Parties How do you know the person in ®? (Explain below): D Check here iflhere is nor enough spacefor your answer. Put your complete answer 0n the attached sheet 0f paper orform MC-025 and write “Arlachmenl 4-Relarionship ofParries "for a title. Ne (‘2 heN Venue Why are you filing in this county? (Check all that apply): a. d lhe person in ® lives in this county. lb. was harassed by the person in® in this county. c. D Other (specifi): Other Court Cases a. Have you or a y of the persons named in® been involved in another coun case with the person in®? D Yes No ([fyes. check each kind ofcase and indicate where and when each wasfiled.) Kind of Case Filed in (Countl/State) 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 Dependent Adult Abuse (6) D Eviction (7) D Guardianship (8) D Workplace Violence (9) D Small Claims (10D Criminal (I lD 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®? D No dYes (Ifyes. 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. (1) When did it happen? (provide date or eslimulcd date): (2) Who else was there? [See attached declaration for a Description of Harrassment] This is not a Court Order. R'"’°°”"°"‘ 2°“ Request for Civil Harassment Restraining Orders CH-1oo, Page 2 oreEmmi(IE 1.; (CIVII Harassment Prevention) 9 casemed c H uu 98 6 6 ® a. (3) How did the person in® harass you? (Explain below):D Check here ifthere is not enough spacefor vour ans.wer Pu! your complete answer 0n the attached séeelwofpapr orform MC-025 and write “Attachmen! 7a(3)-Describe Harassment' ’for a title. (4) Did e person in® use or threaten to use a gun or any other weapon? es D No (Ifyes. explain below): D Check here ifthere is not enough space for your uns.wer Pu! vour complete answer on the attached sheet ofpaper orformAIC-025 and write “Attachzent 7a(4)-Use 0f Weapons”for a title. K fl 5656 came m WM x com ox yxxcjwr w \Lx‘dx m OE” WW VQAvocsm Aocv ewxd \mmm me m A‘At’ M60:23 vwv'm A Vx 06 mxA $EMW: A (’ Wm m MAP vavlad/I \MHA WW Vx V? (5) Were you harmed or injured because of the harassment? mes D No (Ifyes, explain below): D Check here ifthere is n0! enough spacefbr vour answer Put vour complete answer on the atlached sheet ofpaper 0 form MC-025 and write “Attach en! 7a(5)-Harm or Injury' 'for a title. ~ \0§€€é\fl ( (\A NANA €644 C4Y\C\ WU! Shmad" \ xWWW 156a. ) (6) Did the police come? Q46 D No Ifyes did they give you or the person in ®an Emergency Protective Order?D Yes B/No If yes, the order protects (check all that apply). DMe D The person in ® D The persons in ® (Attach a copy ofthe order ifyou have one.) b. Has he person in ® harassed you at other times? Yes D No (Ifyes, describe prior incidents and provide dales ofharassmen! below): D Check here ifthere is nor enough spacefbr vour answer. Put your complete answer 0n the attached sheet 0f apcr orform MC-02 and ile “hAlla men! 7b~Previ0usHarassmem'foratitle. T e \méyx QM We Mme) mii- ww wom 4w} oxccvsza me {I \mwm \ms («Jan/wm‘d m mu room. 9A6 \s 77C 4m»; jWQZ/V c0 XWA vwdd fi0+ mime net? This is not a Court Order. mmmm‘ 2°” Request for Civil Harassment Restraining Orders CH-1oo, Page sofaW, (Civil Harassment Prevention)M )lm 9 Case Number: Check the orders you want. E Personal Conduct Orders l ask the court Io order the person in ®not to do any ofthe following things to me or t0 any person to be protected listed in @z 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. QContact 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 (specifi’): D Check here ifthere is not enough spacefor your answer. Pu! your complete answer on (he anached sheer ofpaper orform MC-025 and write ”Attachment 8c-01her Personal Conduct Orders. "for a title. The person in ®will be ordered not Io lake any action (0 get Ihe addresses 0r locations ofany protectedperson unless the courlfinds good cause no! Io make the order. ® DStay-Away Orders a. l ask the court to order the erson in to stay at least ibo- yards away from (check all that appb):P (1) m Me. (8) a My vehicle. (2) a The other persons listed in@. (9) m Other (specqfi'): excee(3) m My home. m. YY- lg'FeflT SW MGMm. (4) D Myjob or workplace. v (5) D My school. (6) D My children's school. (7) D My children’s place of child care. b. If 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? a Yes DNO (lfno, explain below): D Check here iflhere is not enough spacefor your answer. Put your complete answer on the artached sheer of paper orform MC-025 and write “Atlachmenl 9b-Sray-Away Orders, "for a title. Guns or Other Firearms and Ammunition Does the person in ®own 0r possess any guns or other firearms? DYes mNo D1 don‘t know Ifrhejudge grants a proleclive order, the person in ® will be prohibitedfrom owning, possessing. purchasing, receiving. 0r attempting r0 purchase or receive a gun. otherfirearm. and ammunition while (he protective order is in effect. The person in ®will also be ordered In mm in m law m/brcemenl. 0r sell to or store with a licensed gun dealer, any guns orfirearms within lu'x ur lm- izmncdiulv possession or control. This is not a Court Order. R‘“’°°""“"‘ 2°” Request for Civil Harassment Restraining Orders CH-1oo, page 4 ore(m my-am'“ (Civil Harassment Prevention)M )'J__. 9 Case N éT‘d‘Hoo 9e 6 6 @ E Temporary Restraining Order l request that a Temporary Restraining Order (TRO) be issued against the person in ® to last until the hearing. l 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? aYes D No (lfyou answered no, explain why below): D Check here iflhere is not enough spacefor your answer. Pu! your complete answer 0n the attached sheet 0f paper orform MC-025 and write “Attachment II-Temporary Restraining Order "for a title. ® D Request to Give Less Than Five Days' Notice of Hearing You mus! have your papers personally served 0n the person in® at leastfive days before the hearing, unless the court orders u shorter (imefor service. (Form CH-ZOO-INFO explains What ls "Proof of Personal Service"? Form CH-ZOO. Proof of Personal Service, may be used to show the court that the papers have been served.) If you want there to be fewer than five days between service and the hearing. explain why below: D Check here [fthere is not enough spacefor your answer. Put your complete answer on Ihe attached sheet of paper orform MC-025 and write “Attachment 12-Requesl Io Give Less Than Five Days' Notice "for a title. D No Fee for Filing or Service a. D 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. D The 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 ofviolence, or stalking. c. D 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 complere andfileform FW-001. Application for Waiver of Court Fees and Costs.) E Lawyer's Fees and Costs l ask the court to order payment of my D lawyer's fees E Coun costs. The amounts requested are:m Amount lt_e__ Amount Eumgjee s 435 s $ $ $ $ D Check here iflhere are more items. Pm the items am] amounts on the attached sheet ofpaper orform MC-025 and write “Attachmem Hilluniwr 's Fwy um! ('()s!s"for a title. This is not a Court Order. mmmmm‘” Request for Civil Harassment Restraining Orders CH-1oo. Page 5 ore (IB' Mr"u (Civil Harassment Prevention) u... mm -) Case Number: D Possession and Protection of Animals l ask the court to order the following: a. DThat l be given the sole possession, care. and control 0f the animals listed below, which I own, possess, lease, keep, or hold, or which reside in my household. (Identifi’ animals by, e.g., ape, 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. Pu! your complete answer on the attached sheet ofpaper orform MC-025 and write “Attachment 15a-P0ssession ofAnimals "for a tille. 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. DAdditional Orders Requested I ask the court to make the following additional orders (specifi): D Check here (fthere is nol enough spaceforyour answer. Pu! your complete answer 0n the attached sheet 0f paper orform MC-025 and write ”Attachment 16-Addiri0nal Orders Requested, "for a tille. @ Number of pages attached to this form, if any: Date: SeJLRepLesameL - d } self-Bepnesented _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: 7 Cvowhkmoc MmAUM ’ MSign your name /Type 0r prim your name This is not a Court Order. Revusod January 1. 201B , Request for Civil Harassment Restraining Orders CH-1oo, page e ore (IBm (Civil Harassment Prevention) 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 2 1 C H 0 8 CASE NAME: MNAOM 3"“ WVMNWZ CASE #z 0 9 Was! Name Last Name CH-1 00, Item 7a(3) - DESCRIBE HARASSMENT: a) How do you know the person you want to restrain? NQVhQW b) Are you living with the person? dYES D NO c) Has the person m/physically abuse you. N/physically or verbally threatened you and/or D/harassed 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): 0W ’L\NM kesge \QdZeA mg \oedvoom AW WM m Nam 0M A Mr WW m MW head (MA 9Wb€d WW \n «WW 25v YW d: \M\\/\ m ’P\ D6 MM head \Mts \Okth/M ama \ \Acwe \mm éma (m WM 9h mack \ W4 Ski’sgmg \zm 6AA \ne (mVMG M NH room “m6 m‘xm \thw W numb me h? haw \\\L [\MMEM mm WN Vbum 9/19 \S ?)L \mms qmmw WNW WW 5D 4W9 \A/NéivM W MW \ WNQ vst 0Q WM m \ww qu We Mm Meé £9 mvvxe va\ M9 \nvfl CH-1 00, Item 7a(3) - DESCRIBE HARASSMENT Page_ 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 CASE NAMEMDM and WYmndfl CASE #z 2 1 c H 00 93 645 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? dYES D NO If “YES", describe: ,A Y -\ ‘Ve MS V 98d ‘\0 \m-t we ‘1 n Hf hen c\ CWA 99x5 WW m W9 9% YV‘ “Ch f) Were there any injuries during abuse in the past three months? M/YES U NO If“YES", describe: M4 “fad W a S \Ok6dlwg 51 Nd W0! 9hmam M5 \om W g) Did the police come to any of these recent events? G/YES D NO h) Did they give you an Emergency Protective Order for abuse in the past three months? D YES fl/NO If "YES", please attach a copy. i) Is the person you want to restrain in jail right now for violence against you? E/YES DNO If“YES",where: j) Has the person you want restrained ever been in jail for violence against you or your children? DYES Emo If“YES",when: Describe what the person did to you or your children that caused them to go to jail: CH-1 00, Item 73(3) - DESCRIBE HARASSMENT Page_ 10 11 12 13 M 15 16 17 18 19 20 21 22 23 24 25 - 2 1 C H 00 98 6 6 CASE NAME: Mmdm and “a 0614f”; CASE #: Last Name Last Name k) Do you have a criminal protective order (restraining order from criminal court)? E] YES dNO If “YES", please attach a copy. l) Describe the worst abuse and when it happened: {The most recent abuse i3 the worst abuse OR D The worst abuse was (approximate date) and the person I want a restraining order against (describe what they aid to you): 8M amokvmm4/ 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-1 00, Item 73(3) - DESCRIBE HARASSMENT Page