Request Restraining OrderCal. Super. - 6th Dist.February 18, 2021C/DSJ’mm QH- Request for Civil Harassment Restraining Orders Read ( 'un a ('ix'i/ lluruxsnmu Restraining Order Help Me? (form (‘H-l()()- INFO) before completing this form. Also fill out Confidential CLETS Information (form (‘LETS-UOI) with a much information as you know. Person Seeking Protection a. Your Full Name: Hagyam mm m [’1ercS Your Lawyer (ijyou have onefor this case) Name:Wanted- State Bar No.:___ Firm Name:Wd b. Your Address ([fynu have a lawyer, give your lawyer 's ge:_ugil information. Ifyou d0 not have a lawyer and wan! to keepyour home addres's' private. vou mav give a different mailing address instead You do no! have to giwéfgzhone,Hfav 0r e- mail ) Address: MN PH“ fip‘ a l3‘o ’ City:L“O..S__6- State:QB Zip:M Telephone: Fax: E-Mail Address: ® Person From Whom Protection ls Sought FuuName x _ Hommez. umehm Address (ifknoun) MCI N ?\m [dl «Pf mo] City:\SQH JOOC State. CH G) Additional Protected Persons Clerk stamps date here when form is filed. FILED FEB 2 2 2021K CI the CourtNG Superior C ty 0d Santa Clara BY DEPUTY Fill in court name and street eddies: Superior Court of California County of Santa Clara 191 N. First Street 191 N. First Street San Jose, CA 95113 Civil Courthouse- DTS Court fills in case number when form is filed Case Number: ZICH 00497] Age: j.g- Zip: EEIE) a. Are you asking for protection for any other family or household members? mYes D No If yes list them. i Full Name Sex Lives with you? How are they related to you? gmmmvT-am no mew ? ‘é m Yes a No dawmer n76“ 60mm) HWHQ F \3 m Yes a No V Adan50mm mevm m l\ m Yes a No 5n {mom JOWHO Lemm m m Yes a Nom_-D Check here iflhere are more persons. Attach a sheel ofpaper and write "Attachment 3a-Additional Protected Persons " fur u title. You may useform MC-025. Attachment. b. Why do these people need protection? (Explain below): D Check here ifthere is‘ no! enough space for your answer. Pu! your complete answer on the attached sheet 0f paper 0r form MC 025 and write “Altachmen! 3b- Wh) Others Need Protection''for a rifle. Then (MSG need ?(Ckcchon bccaxbc WMHdS CW6 écdnzd o6 bemg Qmohd thm This is not a Court Order. udvau Councnl of Czaélformuamwad onuay 1 vnl Proooduro§§ 5267 (IB‘M nu- 371M “tawgg 9°” Request for Civil Harassment Restraining Orders (Civil Harassment Prevention) CH-100, Page 1 of6 ROHCI [] PVERN9 Case Number: G) C5) Relationship of Parties How do you know the person in Q)? (Explain below): D Check here iflhere is nor enough spacefor your answer. Pu! your complete answer on lhe attached sheet of paper org rm MC-025 and write “Attachment 4-Relalionship ofParties "for a title. (‘0‘hb0 rv Venue Why are you filing in this county? (Check all that apply): a. m The person in ® lives in this county. b. m l was harassed by the person in® in this county. c. D Other (specify): Other Court Cases a. Have you or any of the persons named in® been involved in another court case with the person in®? D Yes m No (Ifyes. check each kind ofcase and indicate where and when each was filed.) Kind of Case Filed in (Coungy/Stalez Year Filed Case Number {ifknowm (l) D Civil Harassment (2) D Domestic Violence (3) D Divorce. Nullity, Legal Separation (4) D Patemity, Parentage, Child Custody (5) a Elder or Dependent Adult Abuse (6) D Eviction (7) D Guardianship (8) D Workplace Violence (9) D Small Claims (10D Criminal (l 1D Other (specifi'): b. Are there now any protective or restraining orders in effect relating to you or any of the persons in @and the person in®? m 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. (l) When did it happen? (provide dale or eslimaled dale): (2) Who else was there? [See attached declaration for a Description of Harrassment] This is not a Court Order. “mm“ ”m“ Request for Civil Harassment Restraining Orders CH-1oo, Pagezots (113' nh- m (Clwl Harassment Prevention) 9 Case Number: Zncmoqm I ® a. (3) How did the person in® harass you? (Explain below).- Q Check here ifthere is n0! enough spaceforyour answer. Pu! your complete answer 0n (he attached sheet ofpaper orform MC-025 and write “Atlachmem 7a(3)--Describe Harassment "for a title. (4) Did the person in® use or threaten to use a gun or any other weapon? D Yes m No ([fyes, explain below): D Check here if(here is n0! enough spacefor your answer. Put your complete answer 0n the attached sheet ofpaper orform MC-025 and write "Attachment 7a(4)-Use of Weapons "for a title. (5) Were you harmed or injured because of the harassment? $ Yes D N0 (Ifyes. explain below):D Check here ifthere is not enough spacefor vour answer. Put vour complete answer on the attached sheet ofpaper orform MC-025 and M rile“ 'Altachment 7a(5)-Harm 0r Injurv 'for a title Im bruised fxom mu take mm scum hes on mu men, mm mopmm mam 'm mt: amerqehm J meansf m Ox sxmnm neqdcmhc (6) Did the police come? m Yes D No lf yes. did they give you or the person in ®an Emergency Protective Order?D Yes m No If yes, the order protects (check all that apply): DMe D The person in ® D The persons in @. (Attach a copy offhe order Ifyou have one.) b. Has the person in ® harassed you at other times? m Yes D N0 (Ifyes, describe prior incidents cmdprovide dates ofharassmem below):D Check here ifrhere is not enough space for vour answer Put your complete answer 0n the attached sheer of paper orform MC-025 and write "Attachment 7b-Preu'0us Harassment for a tirle.@wm ’mc chr Poxw C0mc5 ficross me and msm‘xs mc: COhacmMg- This is not a Court Order. "““mm’y‘ 2°“ Request for Civil Harassment Restraining Orders CH-1oo, Page sore (IE Ff‘mu (Civil Harassment Prevention) 9 Case Number: Check the orders you want. 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 ©: a. E 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. wContacl 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 (specifi'): D Check here ifthere is n0! enough spacefor your answer. Pu! your complete answer 0n the attached sheet ofpaper orform MC-025 and write "Altachment 8c-Other Personal Conduct Orders, "for a title. The person in ®will be ordered n0! 10 take any action Io gel (he addresses 0r locations ofany prorectedperson unless the courlflnds good cause no! t0 make the order. ® mStay-Away Orders a. l ask the court to order the person in ® to stay at least “i. yards away from (check all that apply: (l) $ Me. (8)g My vehicle. (2) The other persons listed in@. (9) m ether (specify): (3) My home. nxcrflvom ‘- W muaf 6M7 (a ww’s . hWLu {mam Aymara“) ’l'A fl) (4) $ MyJoborworkplace. (A rd 1/!) mkdd [A f, l; [J Vcdv (5) D My school. AMMt ~x+ ru infalc r’ (6) m My children's school. (7) m My children's place of child care. b. If the coun 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? E Yes DNO (lfno, explain below): D Check here ifthere is nor enough spacefor your answer. Pu! your complete answer 0n the attached sheer of paper orform MC-025 and write "Arlachmem 9b-SIay-Away Orders. "for a title. Guns or Other Firearms and Ammunition Does the person in ®own or possess any guns or other firearms? mYes DNo DI don't know lflhejudge grants a protective order, the person in ® will be prohibitedfrom owning, possessing, purchasing, receiving. or attempting r0 purchase or receive a gun, wherfirearm. and ammunition while (he protecrive order is in eflecl. The person in ®will also be ordered Io turn in m law enforcement. or sell t0 or store with a licensed gun dealer. any guns orfirearms wiI/n'n 111‘s nr lu'r imrm'diutc possession 0r control. This is not a Court Order. "m”“m’ 2°” Request for Civil Harassment Restraining Orders‘ CH-1oo, Page 4 oreQB (Civil Harassment Prevention) ' ’n... riom -) Case Number: Q7 ® m 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 l0. Temporary Reslraim'ng 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 a No (Ifyou answered n0, explain why below): D Check here Iflhere is not enough spacefor your answer. Put your complete answer 0n the aflached sheel 0f paper orform MC-025 and wrile “Attachment ll-Temporary Restrainin Order "for a title. \dmwx teu *mcm \occaucde \\ com Cause mc to gm hUYt m th Oth QCYSOD ® D Request to Give Less Than Five Days' Notice of Hearing You mus! have your papers personally served on (he person in® at leuslfive days before the hearing, unless the court orders u shorter time for service. (Form ('H-ZOU-INFO explains What ls "Proof 0f Personal Service”? Form CH-200. Proof of Personal Service. may be used (o show the court that the papers have been served.) If you want there t0 be fewer than five days between service and the hearing. explain why below: D Check here [flhere is n0! enough spacefor your answer. Pu! your complere answer 0n the attached sheet of paper orform MC-025 and write “Atlachmem l2-Reques! Io Give Less Than Five Days' Notice "for a title. 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. m 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 ofCourt Fees and Costs.) E Lawyer's Fees and Costs l ask the court to order payment of my D lawyer's fees E Court costs. The amounts requested are: Lem Amount ltL Amount Eiflngfiee s 435 s $ $ S $ D Check here ifthere are more items. Put Ilzc items um] amounts 0n the attached sheet ofpaper orform MC-025 and write “Attachmenl l 4i Luugwr 's Fwy um/ ( 'osrs"fi)r a rifle. This is not a Court Order. mmm" " 2°” Request for Civil Harassment Restraining Orders CH-1oo, page s ore(m (Civil Harassment Prevention) u... Em 9 Case Number: D Possession and Protection of Animals l ask the coun 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. (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 spacefor your answer. Pu! your complete answer on the attached sheet ofpaper orform MC-025 and write "Atluchmem l5a-Possession ofAm'mals ”for a title. b. DThat the person in ® must stay at least conceal. molest. attack. strike. threaten. harm. or otherwise dispose of. the animals listed above. yards away from, and not take. sell. transfer. encumber. DAdditional Orders Requested l ask the court to make the following additional orders (specify: D Check here iflhere is n0! enough spaceforyour answer. Pu! your complete answer on the altached sheet of paper orfbrm MC-025 and write “Attachment l6-Addili0nal Orders Requested. "for a title. ® Number of pages attached to this form, if any: Date: S&lfiBepmsented- - d p selt-Bepmsanted _ Lawyer 's name (ifany) Lawyer 's signature I 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:MA- Mflrlna/ta Hunk; A ’ 7 er Type 3r prim your name Sign your name This is not a Court Order. Request for Civil Harassment Restraining Orders - CH-1oo. Pagesote (IE Er.“ (Civil Harassment Prevention) ' ‘ “ - ‘ Rwud JUIuly 1 201a 1O 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 CASE NAME: mg 13g: 3"“ flmasuaflmefil CASE #: u CHILD Q87! CH-1 00, Item 7a(3) - DESCRIBE HARASSMENT: a) How do you know the person you want to restrain? Sh€ VS m9) qumbov b) Are you living with the person? E1 YES MNO c) Has the person D physically abuse you, Nphysically or verbally threatened you and/or m 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): 1!\1[2\2\w05\mv\nc3t0 mum omen umena mmhneg 'me gmbxem \s nox Mm goo pm mmmu bnch‘mohn Mamnez mas gomg towwm me when m3 msbomdWand 5mm "mm“ xemm“whcnhasa\d mmW hand. menu mummy then gxoqbcd mc b9 me new l.m rm: Woke on We (Owe Gm Vh‘rem (hr om \he (\OOV ' qmmmmvcd to rm me. men dam momma coma m \o gum ms (mm pm \hgngd Hgm mgémmm. m5, Has mmmsd “ms cm howen om cm: ommd of mem- Decembex 2020 z bhc woo ?\cxngJ (com; \QUO muw L cm one nr rm omcr ncxgmoors cancd our manogmen’r gm ant than (nmc’ (ma mm hcr to lower me CH-1 00, Item 7a(3) - DESCRIBE HARASSMENT Page MC-OZO SHORT TITLEz' ' ' CASE NUMBER: mafia and Hmfimez ’UCWOVQS'H 1 Last Name x Last Name 2 ‘ 'x ’r « “ She hob n0 3 Emu I0 come 00f“ (mo “ IwhemeJ om \ Wm mu: gaumhn“ (mo 4 "mew remnem (1mm mmmfi Wm" 5 VHOT “DOW r‘ QGOW ago lUMAS WMFWCQ OUK m UM‘C WM HM t0 e 0\ o d «31 t \ 7 h WU 5 B r s m mime om OY mu howsa To on‘Ot her. 9 (mo, 2. mews omo m Ecbwmm \ wove ov to qe\ rm Ads 1o SQQ§4 £9! S(XWWEAWS-m-Mr 11 and De EEYY'fid SC/ICQYYMQ; IOWY¢ m% ‘anfiC tm§\\flg b\w 12 Gt Khe \ T V Y 13 she: finch (mht dommb’mxvs m *mt: ?oW'qu \O’r OmOx \ See,“ 14 bg[ figxgjm mg (9x g“ On Qng Qfizfi Qflgfijmfl) gngn WK 15 k9 bcfi ggr QhQ mgfl Egg E \‘O mfl]; QDSA Q'CKQ‘H mg) m 1e othcrexdcg "R Geog 609.5 Qfier mxg cm mos gmmn (-vom 17 tho W flax“ 0mm Tm: oohccAé (pert hon 0mm 18 QH’hOUBh \(Mth 5r: \bc\'\C\1C H N06 Yhem- 19 20 21 22 23 24 25 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 201, 501 Judicial Council of California uoozo NewJanuaryt 19871 Attach to Judicial Council Form or Other Court Paper tional Form Marlin Dean's Essential Forms TM “)021\?l202\ ‘ (7.) Mon 50mm Lemusi Momowno fluehm ,‘Jenmtek SMUHO mem memmolence t was wawmgoox 0f mu house when V(Meha Mamncz Cam: L19 to m6 0Y0 610nm \mm‘nng mc Khan vahcd me mom“ e mumcx @hd Whghcd me Mme she men vushed mt? 10 WWW Q‘nd COmeecI V0 hn me am men d(mn Hmnncz Came \ch m: figm mm amazed me. 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 CASE NAME: VN Q(M and MCMWB? CASE #z {ZJ[ng 5 Z! 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? D YES WNO If “YES”. describe: f) Were there any injuries during abuse in the past three months?m YES U NO g) Did the police come to any of these recent events? $YES C] NO h) Did they give you an Emergency Protective Order for abuse in the past three months? DES m NO If "YES". please attach a copy. i) ls 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 ENO lf“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: HUGH“ and HWWWZ CASE #z 1n CH’UO 487' Last Name Last Name k) Do you have a criminal protective order (restraining order from criminal court)? D YES E NO If “YES”, please attach a copy. l) Describe the worst abuse and when it happened: D The most recent abuse i_s_ the worst abuse OR D The worst abuse was (approximate daze) ll \7 ‘ Z\ and the person I want a restraining order against (describe whatmey amoyou): §n£% m‘2kg ”)fi from meng a vawnm vaved me mg Mama: omd Imt me Mme 0n me 60m Wen pushed me to me ?\(sor- Wen mgmsmhd gmwc‘fldmn kcausé he ma) abomk) gel m .(d Mk; “mam Sfiogycd him omUcms mud m5 {mane om 0s ms mmh \1a\ex m mg me on mg fig“ hegfing me anQ mgn 1mmvm 036m m N grow her m1 ended 0? Hon'mcdrx me. 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-100, Item 73(3) - DESCRIBE HARASSMENT Page___