Request Restraining OrderCal. Super. - 6th Dist.March 8, 2021Request for CiVil Harassment Clerkstamps dare here when formis filed. CH'100 _ Restraininq Orders Read Can a Civil Harassment Restraining Order Help Me? 0’01‘111 CH-I 00- INFO) before completing this form. Also fill out Confidential CLETS Ilforman'on (form CLETS-OOJ) with as much information as you know. g L £4,121 3® Person Seeking Protection MAR 8 20 “I . a. Your FullName: 9 k 27 @6M‘xmmqj («v+\ €VV€ZZ-- ' Age: 5 c(vsum” COu Of 9 Cm.» I1 Lou” Your Lawyer ({fyou have anefor this case) FIIHn court nam Waddregs. 0’ Sank? Cla,6’90 Name:SfllfiReplflemed- State Bar N0.:__ Superior Court of Califmfifem’ ’ é Firm Name: Self-Refinresented 133%? gig? Street b. Your Address (Kym: have a lmvyer, give your Imvyer's 191 N. First Street . . I d [h I A d H k) ‘ SanJose, CA95113mformauon. fyou 0 no ave a awyer cm wan 0 ecp yam Civil Courthouse_ DTS home address private, you may give a different mailing address instead. You d0 no! have Io give telephone, far, or e-maiU Court fills in case numberwhen form is flied. Address: 980 5 Charlo++€ Dr. g: 133 c u e: n City:EAJO-SthatepfiZipzfl ii "CHO ' g g ’i 7 Telephone: Fax: E-Mail Address: C2) Person From Whom Protection ls Sought FullName: p-Cél er p-O 5'6- Age: 3D Address (ifknown); C3905” CthoHr; Dr. 4* l :25 City: C34!“ JOS’C State?“ Zip: %\1flb G) Additional Protected Persons a. Are you asking for protection for any other family or household members? EYes DNO Eyes, 11‘s! them: F_u11 Name S_ex ' Agg Lives with [011? How are they related t0 you? [Vlioi/xoth-Da-xxel (oghaacz W] [‘1 m Yes D N0 5Q“ \llcxéw (rm +xcrref2. WW \ \ . m Yes D No 3m Joaqvln (fig fi'lfvvéz VY‘ g E Yes D No SQ“ Nlér‘ia lfiééanw F 33$ a Yes ENG Cairl-Fr‘iw D Check here ffIhGre are more persons. A({ach a sheet ofpaper and wrile "Attachment 3a-Additional Protected Persons "for a title. You may useform MC-025, Allachmenr. b. Why d0 these people need protection? (Explain below): fl Check here ifrhere 1‘s n0! enough spacefor your answer. Pm your complete answer 0n the aztachea' sheer 0f paper 0rform MC-O25and write "Attachment 3b-Why Others Need Protection”f0r a (itlc."RV (\o 00‘ Dram???» \Oécaose +Uy ‘3‘W +Rape. ha \r‘w WOW @wfi x ,0wa A:\LV M Momma 6-“: Lane kg Corwn +o ‘EA ADOV‘ aw) Marmsex U 3 - find WV \Ctd 5 5V6 4H \QNQ/Ltw 43%“ flan! rwwl/ Cnir IwcrleC/L Lb Ca icfc‘u'd ~ This is not a Court Order. Judicial Council of1czaliforrhaa. mm. courts ca gov Reuse mm rm Request for Civil Harassment Restraining Orders CH-1oo, Page 1 ofe Code o! Cm!”Procedure, §§ 527 60wand 527 9 Essential (Civil Harassment Prevention) ROHC/ I 1 pVERN.) Case Number: ® Relationship of Parties How d0 you know the person in @? (Explain below): D Check here ffthere 1's nor enough spacefor your answer. Pm your complete answer on (he a(rached sheet 0f paper orform MC-025 and write “Alrachmem 4-Relal1’onship ofPam‘es "for a title. \zx? Ls r‘rx\./ WK 6km- © Venue Why are you filing in this county? (Check all that apply): a. E The person in ® lives in this county. b. D I was harassed by the person in® in this county. c. D Other (specify): © Other Court Cases a. Have you or any ofthe persons named in® been involved in another court case with the person in®? a Yes m No ([fyes, check each kind ofcase and indicate where and when each wasfiled.) Kind ofCase Filed in (Comml/Srale) Year Filed Case Numberfifknown) (1) a Civil Harassment (2) D Domestic Violence (3) D Divorce, Nullity, Legal Separation (4) a 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 (1mm Criminal (IUD Other (specrfl): b. Are there now any protective 0r restraining orders in effect relaiing to you or any 0f the persons in @and the person in®? D No DYes (Ifyes, a(lac/z a copy ifyou have one.) ® Description of Harassment Harassment means violence or threats of violence against you, or a course ofconduct that seriously alarmed, annoyed, 0r 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 date 0r esrimated dale): Marta») C0 I 90a! e 5: ODam (2) Who else was there? _ . . [See attached declaration for a Description of Harrassment] This is not a Court Order. Revised January 1. 201G . "um Request for Civil Harassment Restraining Orders CH-1ou, Page 20:5 grams. (Civil Harassment Prevention) 9ahmm Case Number: ® a. (3) How did the person in® harass you? (Explain below):D Check here ifthere is not enough spacefor your answer: Put your Compiere answer on (he attached sheer ofpaper orform MC-025 and write "Attachment 7a(3)-Describe Harassment”f0r a title. (4) Di the person in® use or threaten to use a gun or any other weapon? gYes D N0 (Ifyes, explain below): a Check here Ifthere is not enough spacefor your answer. Putyour complete answer 0n the attached sheet ofpaper orform AIC-025 and write ”Attachment 7a(4)-Use 0f Weapons "for a title. ’Mx/ +hr€ou+€rx k9 \Li H W and Cm “Wu D-mcj CW w \> \mxdi rw; 40m Sa C + 0% \Am en: Cr \AJKG’WYW ' (5) Were you harmed or injured because 0fthe harassment? D YesQ No (Ifyes, explain below).D Check here ifthere is not enough spaceforyozu answez Put your complete anSWer 0n the attached sheet ofpape: 0r form MC-025 and write “Atrachment 7a(5)-Harm 01 Injwy‘ ‘fo: a title. (6) Did the police come? m Yes DNO Ifyes, did they give you or the person in @an Emergency Protective Order?D Yes‘fl No 1f yes, the order protects (check all that apply): DMe D The person in ® D The persons in @. (Attach a copy offhe order :‘fyou have one.) b. Has the person in ® harassed you at other times?m Yes D N0 (Ifyes describe prior incidents andpiovide dares ofharassmenl below) m Check here ifthere ts nor enough spacefor your answer Put your complete ansu er 0n fire attached sheet 0f paper 0r orm MC-025 and write "Afraclzment 7b-I’revi0us Harassment"f0r a title On 3 9/?» Q?) 53am Ra (owe +0 Hm/ door MMm mv dame“ ”NA é 5-way“ M, \cvlhq oufiiut‘kfl WV ( 00%”.M 6’ l-ILOJJM 0’1 3/2/34 LL fvivd Jto open Jrke Hw‘f pawn w 2 dallolv-fm wé‘re homa- Thi_s_ is not a Court Order. Request for Civil Harassment Restraining Orders CH-1oo, Page a ore' (Civil Harassment Prevention) 9 Revlsed January 1, 2018 ' Essential Case Number: Check the orders you want. M E Personal Conduct Orders I ask the court to order the person in @not to do any ofthe following things to me or to any person t0 be protected listed in @z a. EHarass, intimidate, molest, attack, strike, stalk, threaten, assault (sexually or otherwise), hit, abuse, destroy personal property of, or disturb the peace of the person. b. ' Contaét the person, either directly 0r 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, 0r by other electronic means. c. D Other (specifil): . D Check here ifthere is not enough spaceforyour answer. Put your complete answer 0n the attached shee! ofpaper orform MC-025 and write 'Qétrachmem 80-01her Personal Conduct Orders, "for a title. The person in @will be ordered no! (0 take any action t0 get the addresses 0r locations ofany protectedperson unless the courtfinds good cause n0! (0 make the order. ® wStay-Away Orders a. I ask the court t0 order the person in @ to stay at leastL yards away from (check all that apply): (1) m Me. (8) Q My vehicle. (2) The other persons listed in®. (9) m Other (specifl): ' (3) My home. qu/Hkm ‘. .UMA flaws} «1&1 ‘5 uyvV? . ’4 A/ 'J-x ‘m AF V’flbé ‘5 I\/\ (4) Myjob or workplace. 7% 0L} é)” {MINE {-r a + .S AMQ f (5) a My school. VI Vflp rah»? HI!- (6) E My children’s school. (7) @ My children’s place 0f child care. b. Ifthe court orders the person in @to stay away from all the places listed above, will he 0r she still be able to get to his or her home, school, orjob? fl Yes DNO (Ifno, explain below): D Check here ifthere is not enough spacefor your answer. Pufyour complete answer on the attached sheet 0f paper orform MC-025 and write "Attachment 9b-Sfay-Away Orders, "for a title. Guns or Other Firearms and Ammunition Does the person in @own 0r possess any guns 0r other firearms? DYes DNO wl don’t know [flhejudge grants a protective order, the person in ® will be prohibitedfi‘om 01ming, possessing, purchasing, receiving. or anempring t0 purchase or receive a gun, otherfirearm, and ammunition while the protective order is in effect. The person in ®will also be ordered t0 tum in to law ery’orcement, 0r sell t0 0r store will: a licensedgun dealer, any guns orfirearms within his 0r her immediate possession 0r control. This is nota CourtOr‘de‘r._ Re“°"“;:;;:gf Request for Civil Harassment Restraining Orders CH-1oo, Page4ofe Elam“. (Civil Harassment Prevention) 9mhcom Case Number: ® E Temporary 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- 110, Temporary Restraining Ozde: for the court’ s signature together with this Request. Has the person in ® been told that you were going to go to court t0 seek a TRO against him/her‘? DYes ENG (Ifyou answered n0 explain why below): D Check heze ifthere is not enough spacefor yow answel. Put your complete answel 0n {he attached sheer 0f papal 0rf01 m 1110025 and write “Attachment 1I-Tempormy Restraining 0rder”f0; a title. BfCause kQ ls hO-l Roma wLe/w Po“ c-e +v\’/ \(Vlm fl +0 +G\\¢ {*0 D Request to Give Less Than Five Days' Notice of Hearing ‘ You must have your papers personally served 0n the person in© at leastfive days before the hearing, unless (he court orders a shorter limefor service. (qum CH-ZOO-INFO explains What Is “Proof of Personal Service”? Form CH-ZOO, Proof 0f Personal Service, may be used t0 show the court that the papers have been sewed.) Ifyou want there t0 be fewer than five days between service and the hearing, explain why below: D Check here ifrhere is not enough spacefor your answer. Put your complete answer 0n the atfached sheet 0f paper orform MC-025 and write “Attachment 12~Requesl t0 Give Less Than Five Days'Notice "for a rifle. No Fee for Filing or Service a. “a There should be no filing fee because the person in®has used 0r threatened to use violence against me, has stalked me, 0r has acted 0r spoken in some other way that makes me reasonably fear violence. b. 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. a There should be no filing fee and the sheriff 0r marshal should serve the person in ®for free because I am entitled to a fee waiver. (You mus! complete andfileform FW-OOI, Application for Waiver of Court Fees and Costs.) E Lawyer's Fees and Costs ~ I ask the court to order payment of my a lawyer‘s fees E Court costs. The amounts requested are: Itfl Amount Itfl Amount Filingjee ~ $ 435 $ S; ' $ $ $ D Check here ifthere are more flems. Put the items and amounts 0n the attached sheet ofpaper orform IMC-025 and write "Attachment 14-Lawyer ’s Fees and Costs”for a title. This is not a Court Order. Revi sed January 1. 201 8 ' Essenfla! mhmm (Civil Harassment Prevention) Request for Civil Harassment Restraining Orders CH-1OD, Page 5 offi 9 Case Number: 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 0fthe animals listed below, which I own, possess, lease, keep, or hold, 0r which reside in my household. fldemifii animals by, e‘gfl type, breed, name, color, sex.) I request $916 possession of the animals because (specifi) 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-Possessi0n ofAnimals ”for a title. b. DThat 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. DAdditional Orders Requested I ask the court to make the following additional orders (specx‘fiz): D Check here z'flhere 1's n0! enough space for your answer. Put your complefe answer 0n (he attached sheet 0f paper orform M0025 and write “A(tachmen! 1 6-Addz’11‘0nal Orders Requested, ”fbr a rifle. (1:7) Number 0f pages attached t0 this form, ifany:_- Date: SeJEBepLesgnted- Self-Represented y Self-Bepzesented Lawyer ‘s name (ifany) Lawyer ’s signature I declare under penalty of perjury under the laws 0fthe State of California that the information above and on all attachments is true and correct. Date:Elig- M'IC‘AM,‘ Cou-i'mwe’z ’p /' Type or print your name S‘ign-yfl' name This is not a Court Order. Rem‘sed January 1. 2018 _ Request for Civil Harassment Restraining Orders CH-1oo, Page 5 ofe Egg)“ $332! (Civil Harassment Prevention) 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 CASE NAMEQqaemz and Dow CASE #z Last Name Last Name CH-100, Item 7a(3) - DESCRIBE HARASSMENT: a) How d0 you know the person you want to restrain? Y\6 ‘1 gklamr b) Are you living with the person? D YES fl NO c) Has the person D physically abuse you.E physically or verbally threatened you and/or'Rharassed you many times? (Please check all that apply.) d) [n 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): Q 4: 90 Gm On 3/0/9“ W Kane; +0 W o‘cor ow‘ rang hm/ doc f W6” . 0h ?D/(o /’}} Q Vigc’m N Co,” .Jro my Otoor w‘t-Fk polacx loolgd five a ma; ea m Lo é Rama emf 100w Luce L‘- W‘W‘ jrC 0e} ‘40 lémo exc- ph my dC’O’ - um 5A 3/Q /’1| g “104m an Came 457-:qu “k? WY (200W L/o‘tfix who? [Obkfid lhc-z G1 \Lhiéc Ln k1; kandoflten 5A 5/5/11 51+ [MQPM Lw awammeyl +0 open +u door UDLQA I WGS a4 Wade quad m] gm CaWaf \Als \moera +cll Raf avo/ 63/1 JrQ v mg; Can ~ we saw l-lr (/94: Lx‘awx go L9H), LL-kJr (ADC/‘xé cwd So 09/4 ZL- Ctnd pom 5K9 4'04 wm Lfi W55 W V\r\\I/ LXOQA éflfiik‘fl fiflA kQ ”haveamaf JUQ CH-100, Item 7a(3) - DESCRIBE HARASSMENT Page__ MC-OZO SHORT TITLEt' CASE NUMBER:- and Last Name Last Name 1 ( hH’u-jij-V Q0 9/6., 2 L1“ ko/ a SO DOW ’1 630+ W»? k9. _ 3 (GM ‘4" m *0 A'Wy rmCX Ficgk" M ‘96 (aum I 4 A0109 \n'». m “VD .>'¥6\’/ away Pram W7; p(czc/ . 5 filmrj Area we I03": 304 \n é! 5C0 {66‘ CANJ. 6 \\o V&vx \och, \K’VO MK) “Pwflmva’r and 7 l (41% 5J?D +0 Mcaxce c- wabcr-4 aboa+ a Aw; madman Paw +a M‘s 2:“ amp; 9 6‘ 77"“ ”W8 La “WW NV door ha“ G’fifc‘fmfl 10 and L/QNA j LNG; (£th +0 Wang Lg 11 \AJGS 1NVWI 6m ’JrQ l/wllwca/ MY4 ’EC? mV 12 Aw WcA j @9ch [mm fie Jaw away 13 ‘wa‘c/m R»? door and \NQ J} c7? m0 -}‘ 14 Lew fl “Le 41"“6- M 15 16 Pr‘Hc‘de-\ =g3 érXcfli-Howl \BYOEOM WCCA n Mam \mémAre F ”3): ermmfld 1a 19 He 1k gemcj‘l-xa} evXL-K’ICx \m/ Our [amcfwa/C 20 \Qowwoie Q»! lnX> \UlelaokAc/v- and dcéi‘roj/xna) 21 AM 01“} V4 VM- I 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 FmAppmvedbv @he . ADDITIONAL PAGE CRC 201.501 Jucfiual Councd of Cahmmla MOOZO NewJanuam. 1987] Attach to Judicial Council Form or Other Court Paper plional Form Marfin Dean's Essential Forms TM 10 11 12 13 14 15 16 17 18 ‘19 20 21 22 23 24 25 CASE NAME: \mhenm/and 9&9?- CASE #: 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? WYES El NO If “YES", describe: ’I \fi erb \J‘x dLC) >41) Cow 3-6 ~Q 01 \Lnk 5C * f) Were there any injuries during abuse in the past three months? D YES fl NO If “YES", describe: g) Did the police come to any of these recent events? fiYES 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) Is the person you want to restrain in jail right now for violence against you? D YES fiNO If WES". where: j) Has the person you want restrained ever been in jail for violence against you or your children? EYES wNo If"YES“.when: Describe what the person did to you or your children that caused them to go to jail: CH-1 00, Item 7a(3) - DESCRIBE HARASSMENT Page 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 CASE NAMEzwmm and Dow“ CASE #2 Last Name Last Name k) Do you have a criminal protective order (restraining order from criminal court)? III YES fl NO - If "YES”, please attach a copy. I) Describe the worst abuse and when it happened: D The most recent abuse i; the worst abuse OR EThe worst abuse was (approximate date)3 l9 2'3“ and the person l want a restraining order against (describe whammy didto you): k OLoA Mu / a-Hempwd "(O 61‘)er 4&1 door pom \m7/ CH 4m (Ame: [POW aloh. mm M JVMNO-vafla‘ wk); gid’w‘rmd Xv WK Lew . Gama! L4 +r; ad Jro Eglm w . 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-1 00, Item 73(3) - DESCRIBE HARASSMENT Page-