Request Restraining OrderCal. Super. - 6th Dist.March 5, 2021Request for Civil Harassment Clerk stamps date here when form is filed. Restraining Orders Raw Can a Civil Harm! Haraining Orda Hdp Me? (form CH- 100 I L EINFO) bdoreoomplaing thisform. Also fill out Confidmtial CLEIS lnforn'ation (form CLETSOO1) with a mudw informaion m you know. MAR - 5 2021 Person Seeking Protection é“ a Your Fun Name: ”£3 9'“ athefiosfialggyy Miguel Flores Age: 65 BYSU‘” DEPUTY Your La/vyer (ifyou haveonefor this caw) _ Nane: Nicole Aeschleman Sae Ba No.2 240343 F/ll In court name and street address: firm Nam: Aeschleman Law’ PIC. Ss:nptgrlcolrarcaourt of Calltornla, County of . , 191 N. First Street b. Your Addra (lfyou havea lawya, g/veyour lawya s San Jose, CA 95126 inforrration. Ifyou do not have a Iawye and want tokw your harmaddrw private, you n'ay give a diffamt n'ai/ing addrw inamd. You do not have to give tdmhone fax, or enail.) Addffi 1 550 The Alameda, Suite 308 Cour? fills in case number when Iorm is filed. City; San Jose Sae; CA Zip: 951 26 Case Number: Tdephone: 408.724.8930 Fa: 2 1 C H00 99 1 1 E-Ma'l Addrfii nicole@aeschlemanlaw.com Person From Whom Protection Is Sought Full Nane: Scan Martin Age: 57 BY FAX Addrw (if klvwn): 92 Catalapa Lane City: Campbell aae: CA Zip; 95003 Additional Protected Persons a Are you wang for protedion for my other fanily or household members? D Yes E N0 Ifya Iia than' Eu||_Nm g Age LiV§with mu?MW E] Ya D No D Ya D No [:1 Yes D No D Yes D No D Chaak hae if thee are rmrepawns Attadw am ofpapa and write “Attadmmt 3a-Addtional Protedw Pawns” for a title You rmy aw form MC-025, Afladmmt. b. Why do thwe people need protanion? (Emlain bdow): U Mheeiftheeisnot mough $aoefor your anw. Putyour wrrpldeanm on theattaohwma papa or formM0025 and write “Attadwrrmt 3b-va OthasNew Protaxion” for a title This is not a Court Order. WMIdCdIom-a mmmmgavmme,.m,,'me Request for Civil Harassment Restraining Orders CH'WOv P899 1 0'5 Code o! CM! Prooeoue, §§ 527.6 and 527‘s (Civil Harassment Prevention) Case Number: 216H0099 11 G) G) Relationship of Parties How do you know the person in ® ? (Explain bdow): D Chax haeif thaeis not mough mace for your ansma. Putyour oon'plaeansva on theattadmmea of papa or formM0025 and write "Attao‘vnmt 4-mationd7ip of Partia” for a title Scott Martin is the boyfriend of my estranged wife. Venue Why ae you filing in thisoounty? (Check all that apply): a E Thepersonin®livesinthisoounty. b. E lwahaased bythepasonin®inthisoounty. c. El 0ther(soedfy)r Other Court Cases a. Haveyou or my of thepersonsnaned in©been involved in mother court mewiththeperson in®7 D Yes E No (Ifya Machkindofcawandindicatewhaeandmmmwasfilw.) Ki f FIIQiMQMfi/flgtg) Ya film Q&Nummflflgm) ) D Civil Hamt ) D DomedicViolmoe 3) D Divoroe, Nullity. Legd Sepaaion ) D Paernity,Paent@e, Child Cuaody 5) D ElderorDmendent AdultAbuse ) D Eviction 7) D Guadiawdflp 8) D WorkplaoeViolenoe 9) D SndlCIa'ms 10) D Crimind 11) D Othermoedfy): b. Aretherenow 31y protectiveor rara'ning ordasin dfect rdaing to you or my of the personsin® aid the personin®7 D No D Yes (Hm altachawpyifyouhaveone) Description of Harassment Hament mews violenoeor threas of violenoema'na you, or aoourse of oondud tha serioudy darned, mmyed, orham you md weed you wbamtid emotiond diarea A course of conduct is morethm one mt. a letheoourtwomthelatimethepersonin®hamdyou. (1) Whm did it hwpen? (providedateorflinnthate): 2/10/21 (2) Who dseW$ there? Alma Flores (estranged wife). This is not a Court Order. WWW“ “2°” Request for Civil Harassment Restraining Orders °“'1°°v P89° 2 °' 6 (Civil Harassment Prevention) Case Number: 210H0099 11 ® a(3) (4) (5) How did the permn in® hafi you? (Explain bdow): Cheokhaeif thaeisnot mough $aoe for your answa. Putyour mnpldeansn/a on theattachw gm ofpapa or formM0025 and write "Attadwrrmt 7a(3)-DmibeHarm" for a title Did the person in® useor threaen to useagun or my otherwmn? D Yes E No (Ifyx epiain bdow): U Chxkhaeifthe'eisnot moughmfor your anszva. Puryour wnplaeanswa on theattaohw meet ofpapa or form MC-025 and write “Attadm'mt 7a(4)-Ux ofWm” for a title Were you hamed or inj ured becaJse of thehamt? E Ya D No (Ifyfi Wain bdow): D CMMe/fthaeisnot mough $acefor your anszva. Putyour wnpldeanszva on theattachw died ofpapa or formM0025 and write "Attachnmt 73(5)-Harm or Injury’ for a title No physical injuries but I suffered financial harm and continue to suffer emotional distress. Even though I changed the locks on the home following this incident l am afraid that they can enter my home any time, as they did on February 10 because their entry on February 10 was after I had already changed the locks following Alma's move-out. Didthepolioeoome? D Y$ N0 Ifya didthey giveyouorthepersonin® a1Emergmcy ProtediveOrder? D Yes D No If ya the orda proteds (ohedv all that apply): D Me D Thepersonin® B Thepasonsin@. (Altachaoopyoftheordaifyouhaveone) b. Hatheperson in®ham you a other times? E Yes D No (”ya dmibeprior inddmtsandprovidedataofharmt bdow): E Whaeifthe'eisnolmlghwaoeforyour answe. Putyour wrrplaeanswa on theattadwwmeetof papa or formM0025 and write “ Attachrrmt 7b-PreviousHarmrmt" for a title This is not a Court Order. WM‘WW“ Request for Civil Harassment Restraining Orders CH-100. Pa9e3°16 (Civil Harassment Prevention) Case Number: erflnnon 4.v 71]vvu7 Check the orders you want. M E Personal Conduct Orders ® |$
