Request Restraining OrderCal. Super. - 6th Dist.February 22, 2021Request for Civil Harassment elemsrampsdarenem when romis med. CH'1 00 Restraining Orders Read (‘cm a Civil Harassmen! Restraining Order Help Me? (form CH-IOO- INFO) before completing this form. Also fill out Confidential CLETS l L EInformation (form CLETS-OOI) with as much information as you know. D ® Person Seeking Protection FEB 2 2 2021 K NGUYEN a. Your Full Na e: Clerk Of h 0U“ l M(xuuna \Bmu IX Cmes Age: 37' 33mm" CW" °' C’ ° ‘ Sm C‘m Your Lawyer (ifyou have onefor this case) Fill in court name a u‘gtlrggt ‘ drags: [Y Name:W- State Bar No.:____ Superior Court of Califor\r‘1ia, County of Firm Name:Wanted 189a?tNaCFIi$;? Street b. Your Address (Ifyou have a lawyer, giveyour lmvyer ’s 191 N. First Street information. Ifyou d0 not have a lawyer and want to keepyour giavql‘lcoosgrtfiéussse1_ 1 3DTS home address private, you may give a diflerent mailing address instead. You d0 not have t0 give Ielephone, fax, 0r e-mail.) Court fills in case number when form is filed. Address; C6gq N‘ K\mv '(d HD‘ \3\O Case N|£I18c H City:MLStatezgdZipzm 00 98 7 6 Telephone: H0? $079 '$s “$7, Fax: E-Mail Address:WWW ® Person From Whom Protection ls Sought Fun Name:g (Y ()Ym N\wfinez Age: Q-fis Addres ifknown); ‘60‘0 N \Amg Yd m‘p‘ \3 O q City: '\ QOSa State: C14 Zip:M ® Additional Protected Persons a. Are you asking for protection for any other family or household members? DYes D No lfyes, list them: Full Name m Ag; Lives with you? How are they related to you?4L qé m Yes a No duoghw ’ O E: \a) m Yes D N0 QMHLCY 5*an S mono “mm m U m Yes D No $0n chkm 3b\ono [Amos w 36 m Yes D No \floSbomX D Check here ifthere are more persons. Attach a sheet ofpaper and write “Attachment 3a-Additi0nal Protected Persons "for a title. You may useform MC-025. Attachment. b. Why do these people need protection? (Explain below): D Check here ifrhere is not enough spacefor your answer. Put your complete answer 0n the attached sheet 0f paper orform MC-025 and wrile "Attachment 3b-Why Others Need Protection "for a title. Thug} 05m heed Vm kch rm Mame M3 WA 5 Cm $Lm<>c5 B\ bang cmwnd mmL This is not a Court Order. “dfxiffififl‘ém°2‘6"%m'15n'§":”°°¥:‘7°;9w Request for Civil Harassment Restraining Orders CH-1oo, Page 1 ore °°°°° '“'P'°°°"“'° 55 2 63"“ 2 (Civil Harassment Prevention) ROHCI [l PVERN9Emm Case Number: ® Relationship of Parties How do you know the person in®? (Explain below): D Check here iffhere is not enough spacefor your answer. Put your complete answer on the attached sheet 0f paper orform MC-025 and write “Attachment 4-Relationship ofParn'es ”for a rifle. MQVAJhmf @ Venue Why are you filing in this county? (Check all that apply): a. a The person in ® lives in this county. b. Q I was harassed by the person in® in this county. c. D Other (specify): G) 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 D N0 (Ifyes, check each kind ofcase and indicate where and when each wasfiled.) Kind of Case Filed in (Coumv/State) Year Filed Case Number (ifknown) (1) 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 (10)D Criminal (I1D Other (specijjz): b. Are there now any protective or restraining orders in effect relating to you or any ofthe persons in @and the person in®? BNO 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 dale 0r estimared date): (2) Who else was there? [See attached declaration for a Description of Harrassment] This is not a Court Order. R°“’°‘”“"”°””m Request for Civil Harassment Restraining Orders CH-1oo, page 2 ore (IE E (Civil Harassment Prevention) 9 216H009876 W9, minim-mmmmjm% isohvgg WmfiehmRV Scions “normmmma Marhmzmmmwmm 3mm _Jngnj_GnQJ-_RL¥_H§H also puflimd presslv‘m Qflfiog homing n2 dagm gnd Em); (2 kick xmm \mmgn, mg sbmm- Case Number: 210H009876 <7) a. (3) How did the person in® harass you? (Explain below): D Check here zfthere is no! enough space for your 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 person in® use or threaten to use a gun or any other weapon?D Yes D No (Ifyes, explain below): D Check here ifthere is no! enough spaceforyour answer. Putyour complete answer 0n the attached sheet ofpaper orform MC-025 and write "Atlachmem 7a(4)-Use of Weapons "for a title. (5) Were you harmed or inj ured because of the harassment? m Yes D No (Ifyes, explain below): D Check here ifthere is not enough spacefbryour answer. Put your complete answer 0n the attached sheet ofpaper orform MC-025 and write "Attachment 7a(5)-Harm or Injury ”for a title. s och. (6) Did the police come? m Yes D No If yes, did they give you or the person in ®an Emergency Protective Order?D Yes D No If yes. the order protects (check all that apply): D Me D The person in ® D The persons in ® (Attach a copy 0fthe order ifyou have one.) b. Has the person in ® harassed you at other times? 355% Yes No (Ifyes, describe prior incidents and provide dates ofharassmem below): D Check here ifrhere is n0! enough space for your answer. Put your complete answer 0n the attached sheet 0f paper orform MC-025 and write ”Attachmem 7b-Previous Harassment "for a title. This is not a Court Order. CH-100, Page 3 of 6 R“”°J‘"“”’"2°‘” Request for Civil Harassment Restraining Orders(m PW (Civil Harassment Prevention) 9 Case Number: Check the orders you want. m Personal Conduct Orders l 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. 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. EContact 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. a Other (specifiy): D Check here iflhere is no! enough spacefor your answer. Put your complete answer 0n the attached sheer ofpaper orform MC-025 and write "Attachment 8c-Other Personal Conduc! Orders, ”for a title. The person in ®will be ordered not to rake any action Io get Ihe addresses or Iocarions ofany protectedperson unless the courrfinds good cause no! to make rhe order. mStay-Away Orders a. l ask the court to order the person in ® to stay at least EO- yards away from (check all that apply): (l) Me. (8) E My vehicle. (2) The other persons listed in@. (9) m cher (sp-ecifiz): (3) My home. t7“ “ff: 'OV‘: (Om MM 1 f q fr... é 4 M . b kl mart} 5 Awoq ,fgflym Je .4301, 5< ) Ho 0r wor P ace- gn n7 a v- d 1/?) (MAJ; Q + (5) D My school. slain»: r4 075;)? Ld- Mam 3L Camille)” (6) My children‘s school. (7) My children's place of child care. b. 1f the court orders the person in ®to stay awa): from all the places listed above, will he or she still be able to get Io his or her home, school, orjob? Yes DNO (Ifno, explain below): D Check here ifthere is not enough space for your answer. Put your complete answer on the attached sheet 0f paper orform MC-025 and write “Attachment 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? WYes DNo DI don't know IfIhejudge grants a prorective order. the person in ® will be prohibitedfrom owning. possessing, purchasing, receiving, 0r attempring Io purchase 0r receive a gun. otherfirearm, and ammunition while the protective order is in eflect. The person in ®will also be ordered m turn in I0 law enforcement, or sell to or store with a licensed gun dealer. any guns orfirearms within Iris ur lm- imnmliute possession or control. This is not a Court Order. mm‘m ‘- 2°” Request for Civil Harassment Restraining Orders CH-1oo, page 4 ors (113' utm- E (CIVII Harassment Prevention) 9 Case Nu "é”i'bHoo 98 7 6 ® 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 IO, 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 M No (Ifyou answered n0, explain why 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 wrile “Altachment 11-Temporary Restraining Order "for a title. I a . mwmwrsom ® D Request to Give Less Than Five Days' Notice of Hearing You must have your papers personally served on the person in® a! leastfive days before the hearing, unless the court orders a shorter timefor service. (Form CH-ZOO-INFO explains What ls "Proof of Personal Service"? Form CH-200, Proof 0f Personal Service, may be used t0 show the cour! 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 ifrhere is n0! enough spacefor your answer. Put your complete answer 0n the atlached sheet of paper orform MC-025 and write “Attachment 12-Request Ia 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. m There should be no filing fee and the sheriff 0r marshal should serve the person in ®for free because l am entitled to a fee waiver. (You mus! complete andfilefurm 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 Court costs. The amounts requested are:m Amount [IL Amount Eilingfiee $ 4.35 $ $ $ $ $ D Check here ifrhere are more items. Pu! the items and ammmtx 0n the attached sheet ofpaper orform MC-025 and write “Attachment l 4 Lawyer 's Fees am! ('()sts"/br a title. This is not a Court Order. R'“"'“"“"’"2°‘B Request for Civil Harassment Restraining Orders CH-1oo, Page 5 ofs(m 53m“ (Civil Harassment Prevention) 9 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 of the animals listed below, which I own, possess, lease, keep, or hold, 0r which reside in my household. (Identifiz 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. Put your complete answer 0n the attached sheet ofpaper orform MC-025 and write “Attachment 15a-Possession ofAm'mals ”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 l ask the court to make the following additional orders (specifi): D Check here ifthere is nor enough spaceforyour answer. Pu! your complete answer 0n the attached sheet of paper orform MC-025 and write "Altachmem l6-Additional Orders Requested, "for a title. ® Number of pages attached to this form, if any: Date: mmmmmm- - d } self-Bepcesented _ Lawyer 's name (zfany) 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:WELL- r) oMmmvm‘ \Auwm \k p uononc‘ Hth-c‘ A. Type or print your name Sign your name This is not a Court Order. Request for Civil Harassment Restraining Orders CH-1oo, Page s omGBm (Civil Harassment Prevention)Romeo Januuy 1. 2018 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 CASE NAME: and .2 CAse#: ZICH009876 as ame as ame CH-1 00, Item 7a(3) - DESCRIBE HARASSMENT: a) How do you know the person you want to restrain? “Q \5 mg)h npsgjhmr b) Are you living with the person? D YES D/NO c) Has the person D physically abuse you, m’physically 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): 2A7 lu. I NCLS mmu *0 Q\n\)v(\n \mnmx \Nkno muAmez Omb Gohn Muthm 7 gmomd mo - Wm Wmhm mm. cmmcfi Ema! (\S"WQMH \lmcnq MmMu gm) 5m mmew- Wm am \m Yacom mx Mm mu hmund mm \‘mxx GcmnMWEM‘ mmmmmmg. me: \xmgm MaxxmnMd Omd Mew m 0n Hg HUM \john Mmh’mJ Cgmz m b Smm 30:. my; bmmkad 302 Kilgd m$bmjvm (And I RH \‘orPsgqp 0% him \mkhm m Qggn, Mgé 3m}; mglgbzd g!) o\- mlg bgpmg glm (m (mm o‘c mm CH-100, Item 73(3) - DESCRIBE HARASSMENT Page_ 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 7 6 CASE NAME:\‘\\2Hn and Magma CASE m 21 CHOU 98 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? :1 YES t1 No lf “YES”. describe: f) Were there any injuries during abuse in the past three months? d YES D NO If “YES", describe: Ox) mzmz | fl 6mg Mm I mgz baggy m2W g) Did the police come to any of these recent events? WES 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) ls the person you want to restrain in jail right now for violence against you? EYES dNo If"YES",where: j) Has the person you want restrained ever been in jail for violence against you or your children? DYES MO If“YES",when: Describe what the person did to you or your children that caused them to go to jail: CH-100, Item 7a(3) - DESCRIBE HARASSMENT Page_ 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 CASENAME:MXO\ andeHrvxz CASH; 210H009876 Last Name Last Name k) Do you have a criminal protective order (restraining order from criminal court)? El YES ¢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 U The worst abuse was (approxmate date) Z Z S Zfifls and the person I want a restraining order against (aescnbe vma‘mey ma to you): Him Qn A 1mg g3} k Khwwfie.) gigzggfi km: QM {flf[ 519mm géflgbhgfifm Sgflg‘) pmmd W X0 H19 Moor Oonn \Munkd E C39,} m \ouL Gown Op OMMW Gohn mam *0 gram m b“ ‘no. ended up \ockmsgfm m Pm $\eth (mcs X Xe.“ \Qvesxxhp (A Wm \nddmpd Wu; down. 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___