Request Restraining OrderCal. Super. - 6th Dist.February 23, 2021Restraining Orders Read Can u Civil llamxsmcnt Restraining Order Help Me? (form CH-IOO- INFO) before completing this form. Also fill out Confidemial CLETS l L E Information (/brm CLETS-OOI) with as much information as you know. JUN 2 2 202: Q) Person Seeking Protection 'er of m Ke New a. Your ll Name: J ‘ QS’B‘S‘WJQ a CA cmwcogosgnrg am ‘m .nAa L a A‘n‘ g (\a Age' DEPUTY Your La“ yer (1 'w hme onefor IL; ca ' Name State Bar N0; Fill in court name and street address: . . Superior Court of California, County of Flrm Namc' v ' (emg};A£3”. Santa Clara b. Your Address (Ifyou have a Iauyer. givcyour lawyer's Civil Division information. Ifyou d0 not have a Ianycr and want to keep your 191 North First Street home address private, you may give a different mailing address San JOSC. CA 951 13 instead. You d0 not have t0 give ’Iephone, fax, 0r e-mail.) Address: fig, man [I flag #fi Court fills in case number when form is filed. City: $1“ \A\e/ State: c’ a Zip:m case Number:\ ‘Jv \ ‘ v “\\ Telephone: Fax: %K\>\r\ CRRXL E-Mail Address: Person From Whom Protection ls Sought Full Name: LYAVL C&Sklvnyfl Age: gs Addressdijxnown): 4$q Arel/ Dr Cityi \{3‘ keg State: 06 Zip: Zfz; ® Additional Protected Persons a. Are you asking for protection for any other family or household members? D Yes B N0 Ifyes, list them.- EgllName 51x Ag; Live; with mu?WWW Down LAM“ F 1/1 Q Yes D No Monef D Yes D No D Yes B No D Yes D No D Check here [fthere are more persons. Attach a Sheet ofpaper and write “Attachment 3a--Additi0nal Protected Persons "for a title. You may useform MC-025, A(tachment. b. Why do these people need protection? (Explain below):D .Check here ifthere is not enough spaceforyour answer. Put your complete answer 0n the attached sheet 0f paper orfurm MC-025 and write ”Atlachment 3b-Why Others Need Protection "for a title. ?S‘nfio “\Mafia? in er Mb mcwher [{P J This is not a Court Order. fggflfiflfigmnmwfl°mv Request for Civil Harassment Restraining Orders CH-WO. Page 1 0‘6 eoaeotcm'n Procedure. §§ 527 6 and 527,9 (Civil Harassment Prevention) 9 Cas\eCN mbfmfim ® Relationship of Parties How do you know the person in ® ? (Explain below): Ex - 106mw D Check here ifthere is not enough spaceforyour answer. Put your complete answer 0n the attached sheet 0f paper orform MC-025 and write “Attachment 4-Relan'0nship ofParties ”for a title. ® Venue Why are you filing 'm this county? (Check all that apply): a. Z The person in® lives in this county. b. Q Iwas harassed by the person in®in this county. c. D Other (speczfv): "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 (1) (2) (3) (4) (5) (6) (7) (8) DDDDDDDDD g N0 (Ifyes, check each kind ofcase and indicate where and when each wasfiled.) Kind of Case Filed in (Counru/State) Year Filed Case Number (ifknown) Civil Harassment Domestic Violence Divorce, Nullity, Legal Separation Paternity, Parentage, Child Custody Elder or Dependent Adult Abuse Eviction Guardianship Workplace Violence Small Claims Criminal Other (specifiz): b. Are there now any protective or restraining orders in effect relating to you or any of the persons in® and the person in®? Z No D Yes (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 coun about the last time the person in® harassed you (1) When did it happen? (provide date 0r estimated date): @ber \l g &®\ X , fl (2) Who else was there? I £4831 QJ-OS’} 0626 San 50:0, ?D Le.“ 8M1 “x ' $5 This is not a Court Order. Revised January 1. 2018 Request for Civil Harassment Restraining Orders CH-100- Page20f6 (Civil Harassment Prevention) '9 §§"""§E&m%b ® a. (3) How did the person in ® harass you? (Explain below):D Check here iftlzere is no! enough .s'pt‘zccfbr_\v)zn' answer. Putyour complete answer 0n the attached sheet ofpaper orform MC-025 and write “Attachment 7a(3)-Describe Harassment "for a title. “Ema“? \tmeckgmapa) QM armlh. \ (4) Did the person in® use or threaten to use a gun or any other weapon? D Yes E No (lfyes, explain below): D Check here ifthere is not enough spacefor your answer. Putyour 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 0r injured because of the harassment? E Yes D No (Ifyes, explain below): D Check here ifthere is not cnoug/z S‘paccfor vour ans‘ner Put tour complete answer 0n the attached sheet ofpaper orform/MC-025 (1nd urftc ”Artudxmcnt 7a/5)-Harm 0rln urv " ora title. flLll/- mg} Mm; anr/ (bayn] gngpg (6) Did the police come? E Yes D No If yes, did they give you or the person in® an Emergency Protective Order? D Yes E No If yes, thc 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? fl Yes D N0 (Ifyes, describe prior incidents am! provide dates oflxarassment below): D Check here ifrhere is not enough spaccforyour answer. Put your complete answer on the attached sheet 0f paper orfbrm MC-025 and u'rije “Attachment 7b~Prcvious Harassment "for a I'llc. SX\\ Puff \y hmraSQw. aflex fzf [ht]! [err éQl 1 Am" l‘nmfad 1m: ow more J 1 This is not a Court Order. “W‘W‘W‘W‘W‘” Request for Civil Harassment Restraining Orders CH-100. Page 3of6 (Civil Harassment Prevention) 9 “Wfiififlfib R) Check the orders you want. m .fl Personal Conduct Orders @fl 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©2 a. g Harass, intimidate, molest, attack, strike, stalk, threaten, assault (sexually or otherwise), hit, abuse, destroy personal property of, 0r disturb the peace of the person. b, E Contact 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 (specifiz): 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 8c-01her Personal Conduct Orders, "for a title. The person in ® will be ordered not t0 take any action to get the addresses or locations ofany protected person unless the courtfinds good cause not t0 make the order. Stay-Away Orders a. I ask the court t0 order the person in® t0 stay at leastfl yards away from (check all that apply): (l) Q Me. (8) g My vehicle. (2) B The other persons listed in© (9) D Other (specifi’): (3) m My home. (4) a My job or workplace. (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 Sta way from all the places listed above, will he 0r she still be able to get to his 0r her home, school, orjob? fl Yes D N0 (Ifno, explain below): U Check here ifthere is not enough spacejbryour answer. Put your complete answer on the attached sheet of paper orform MC-025 and write "Attachment 9b-Stay-Away Orders, ”for a title. Guns or Other Firearms and Ammunition Does the person in® own or possess any guns or other firearms? D Yes D No W I don‘t know Ifthejudge grants a protective order, the person in® will be prohibitedfrom owning, possessing, purchasing, receiving, 0r attempting t0 purchase 0r receive a gun, ()Iherfirearm, and ammunition while the protective order is in efléct. The person in ® will also be ordered t0 turn in Io law enforcement, 0r sell t0 0r store with a licensed gun dealer, any guns orfireamzs within his ur l’u'r inmmliatc possession 0r control. This is not a Court Order. WWW“ ”m3 Request for Civil Harassment Restraining Orders CH-100. P8994 °f6 (Civil Harassment Prevention) 9 Case Nu ‘Adggmftfib ® flTemporary Restraining Order I request that a Temporary Restraining Order (TRO) be issued against the person in® to last until the hearing. I am presenting form CH-l 10, Temporary Restraining Order, for the coun’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? D Yes D No (Ifyou answered n0, explain why below): U Check here ifthere is not enough spacefor your answer. Put your complete answer on the attached sheet of paper orform MC-025 and write “Attachment II-Temporary Restraining 0rder"for a title. ® D Request to Give Less Than Five Days' Notice of Hearing You must have your papers personally served 0n the person in® at leastflve days before the hearing, unless the court orders a shorter timefor service. (Form CH-200-1NFO explains What Is “Proof of Personal Service”? Form CH-200, Proof of Personal Service, may be used t0 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 i there is not enouc'h s ace 0r vour answer, Put vour com [ere answer 0n the attached sheet 0c P , . P paper orform MC-025 and write “Attachment 12-Request t0 Give Less Than Five Days ' Notice "for a title. ® fl No Fee for Filing or Service a. a There should be no filing fee because the person in ® has used or threatened t0 use violence against me, has stalked me, 0r has acted or spoken in some other way that makes me reasonably fear violence. b. fl The sheriff 0r marshal should serve (notify) the person in® about the orders for free because my request for orders is based 0n unlawful violence, a credible threat of violence, or stalking. c. g There should be n0 filing fee and the sheriff or marshal should serve the person in ®for free because I am entitled to a fee waiver. (You must complete andfileform FW-OOI, Application for Waiver of Court Fees and Costs .) Q Lawyer's Fees and Costs I ask the coun to order payment ofmy D lawyer's fees D Court costs. The amounts requested are: Item Amount 1te_m mm flaw. W4, S 438““ $ A s S $ $ D Check here ifthere are more items. Put the items um! amounts 0n the attached sheet ofpaper orform MC-025 and write “Attachment 147Lum~cr '5 Fem um] Costs "for a title. This is not a Court Order. Re“‘e“J3"°a'Y‘- 2°” Request for Civil Harassment Restraining Orders CH-100. Page 5 of6 (Civil Harassment Prevention) '9 Case Number: 1mWfifibQ ® D Possession and Protection of Animals I ask the court to order the following: a. D That I 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. (Identify? animals by, e.g., type, breed, name, color, sex.) I request sole possession of the animals because (specifi' good causefor granting order): D Check here ift/zere is not enough spaceforyour answer. Putyour complete answer 0n the attached sheet ofpaper orform MC-025 am] write “Attachment 15a-Possession ofAnimals "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 0f, the animals listed above. D Additional Orders Requested I ask the court to make the following additional orders (specifi'): D Check here ifthere is not enough spacefor your answer. Put your complete answer 0n the attached sheet 0f paper orform MC-025 and write "Attachment I 6-Additi0nal Orders Requested, ”for a title. ® Number of pages attached to this form, if any: Date: b Lawyer ’s name (if(my) 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: (W 90: glob /Kiam Mfiflfllné ’ (mm, YM/V 7 vae 0rprintyour name Sigrfyour nam! This is not a Court Order. Request for Civil Harassment Restraining Orders CH-100. Page60f6 (Civil Harassment Prevention) Revised January 1. 2018 10 11 12 13 15 16 17 18 19 20 21 22 23 24 25 CASENAME: mn‘“ 3““ (lo CASE#:9\\Q,\\BO%%Q LES! Nam L (Name CH-100, Item 7a(3) - DESCRIBE HARASSMENT: a) How do you know the person you want to restrain?a ' {Abmnuflflr b) Are you living with the persoh? D YES KNO c) Has the person D physically abuse you, fiphysically or verbally threatened you and/orfl 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 \‘vith the most recent event and explain exactly what happened in detail. include dates and times): Rumba 9‘14'2624 [1mg 311me *0 bar /7,’J [A AM she mmmp 0mm £4532} Lam m1 "HA MW; \M: mug Lug m; cm! /5/ (go/géflg l éé gals ng 5m ' ?ff/of J #15 3% 5a; I M11 An» Q//4/21§94 In mu car / //&// gked LID nn/l/ Jinn In{‘r 0pc 4/ Arr jfi/EIT 7A,! MASH? j/MT 4/45 //7 xn/l fl/r‘ AS 5663/13? I Ms Aclmj hpr lo Mp/Aer 51h k 14/ MEWS 504% CAI‘ JZ’OH/[nafl /0 Aarras/ Mfi £4ch /{x/5 (”51/3 43 Joan 43 T/W/ éwaz J m or 4a LA 34¢ 3.4/14 /// ' (b Ed gym, J 410(k- CH-100, Item 7a(3) - DESCRIBE HARASSMENT Page__ ITLE.SHORT F flflm flag Last Nay \ 3 [>le anrl '\ and (1355 flfl" Lydia? onl/s. La'st NEFné v (‘nnhmvxfg 3&464 8h p l CAs= NUM2=R (MW(mm) l7) ’VM‘RR mA Ev M&Sh £ VD’M. n n 1 \xJ V I 4 aa& 3kg Ag; {Ml‘pfi [A [Dr‘moe’ IL \n (’Akggé. 1O 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 25 (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 Judici: ICcuncil form or :ny Oin-r paper fil:d wth the court Page Form Aapraved Dy me Jukal Council a! Calflsmm MCQO [New January 1‘ 1957] Optional Form _ Martin Dean‘s Essential Forms 'M ADDITIONAL PAGE Attach to Judicial Council Form or Other Court Paper 10 11 12 13 16 17 18 19 20 21 22 23 24 25 CASE NAME: mqucw e) Were any guns or other weapons used or threatened to be used during any abuse Last Name Last Name in the past three months? D YES W0 If “YES”, describe: f) Were there any injuries during abuse in the past three months?flYES D NO If“YES".describez IHQQQA UV emofioga “lg ab‘figfi M111 \n HLQ/ “mg kOCC Arm g) Did the police come to any of these recent events? RYES D NO h) Did they give you an Emergency Protective Order for abuse in the past three months? D YES M NO If “YES", please attach a copy. i) ls the person you want to restrain in jail right now for violence against you? EYES WNO |f“YES",where: j) Has the person you want restrained ever been in jail for violence against you or your children? EYES iNo If“YES“,w'nen: Describe what the person did to you or your Children that caused them to go to jail: CH-100. Item 7a(3) - DESCRIBE HARASSMENT 1O 11 12 2O 21 22 23 24 CASE NAME: Las‘ Name k) Do you have a criminal protective order (restraining order from criminal court)? D YES )Z 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 (apprcma;a ca =) and the person l want a restraining order against (desc. ib- whemeyac m you): ' fipa r £{ MIA m 3m! HZ: \ g) C : XE d Sop L5 Mn”MAE mmerJUu we; nwer‘ kw! Q» gagg/m bQCrme, u Alia I XSQ- her n76 SAC - Inna; “I 1'1 '14 n tat “:14.” 1-. 'All’ ll m) Descrio- any other previous (pest) violence or threats of vio! e that you haven’t already written about here (include dates or estimates as to when it happened): CH-100, Item 7a(3) - DESCRIBE HARASSMENT Page