Declaration In SupportCal. Super. - 6th Dist.February 23, 2021v ATTACHMENT CV-5014 MAKE AND ADDRESS OF PARTY 0R AWORNEY FOR PARTY TELEPHONE NUMBER FOR COURT USE ONLY I '4 . 0M K n‘wwm 1%“) Doom \qo Q, )M. EM T052); w qfi\l% ATTORNEY FOR (Name) SUPERIOR COURT OF CALIFORNIA, COUNTY 0F SANTA CLARA F | L E DSTREET ADDRESS: 191 North First Street. San Jose. CA 95113 FEB 2 3 2021 MAILING ADDRESS: 191 North First Street BRANCH NAME: Downtown Courthouse C'erk t Court ' j 3 n a gt flw ot mt: cumPerson/Entity Seeking Protection: k;W HM n4) mm oou CITY AND ZIP CODE: San José, CA 951 13 Person From Whom Protection is Sought: Ly D] A DECLARATION IN SUPPORT 0F EX PARTE APPLICATION FOR CASE ”W3? 1 c H 00 9 8 fa“: CIVIL RESTRAINING ORDERS l, the undersigned. declare: 1. | am (choose one): D attorney for Person or Entity Seeking Protection m seIf-represented Person or Entity Seeking Protection D other (explain): 2. The opposing party is represented by an attorney: D Yes E No (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 num r. Party/Attomey name:W ‘Mfifim- \VA \5\ C&Q’t‘ ACAO Address/Telephone number: _:_v M\ RW‘ U %¥\gg q913 M tn ‘ 5' 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 WNO |f ”yes". case(s) number(s): 4. NOTICE a. I HAVE given notice to the opposing party and/or their attorney by the following method: D Personal delivery D Overnight Carrier D First Class Mail D Other: Date: Time: | 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): E 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 I am asking that this motion be heard at the same time. D I am unable to serve the other party in the time required by law. | fear for my physical safety (and that of others. if applicable). D Other: | declare under penalty of perjury that the forgoing is true and correct. ~ ”cum MaAwm/a ’ 'nM MM Date nnt Name \j Eefarant‘s §gnafure 4 CV50” REV 09/13/15 DECLARATION IN SUPPORT OF EX PARTE APPLICATION FOR v P396 1 0'2 CIVIL RESTRAINING ORDERS