Request Restraining OrderCal. Super. - 6th Dist.March 12, 2021_ Request for Civil Harassment czerksrampsdaremq whmsnedCH'1 00 Restraining Orders .. 3% L g; ’L 1i Read Can a Civil Harassment Restraining Order Help Me? (form CH-IOO- ' INFO) before completing this form. Also fill out Confidential CLETS Y Information (form CLETS-OOI) with as much information as you know. MAR 12 2021 ourt C‘efk 01A gunlyoot Sama Clam n 0i C BPUTY Person Seeking Protection ‘ _SUF9“°TC°u D I a. Your Full Name: h BY" pvua ra/‘do AfiICaLa Ualjmaha Age.vi? ‘9OA Your Lawyer (zfyou have onefor (his case) I Fill m court name and ywddress Name:Wanted- State Bar No.2 Superior Court of California, County of F' N jelLRepxesanied-__ santa Clara . ”m. ame 191 N. Flrst Street b. Your Address (Ifyou have a lawyer, give your lawyer’s 191 N. First Street ‘ ' t' I d th l ' d 1a tt kee 0r san Jose’ CA95113mfomza Ion. fyou 0 no ave a awye; an n n a py 1r Civil Courthouse_ DTS home address private, you may give a diflerem 4231‘!ng address instead. You d0 not have to give telephone, fax Oge-mail.) Court fills in case numberwhen form is filed, Address: Arl/a CaAfLéa/e; Z Ac CityiMiéflL-Stateéfi Zipm ca’se EnfrEH a g 9 9 2 é ‘ Telephone: Fax: E-Mail Address: Person From Whom Protection ls Sought FulIName: 6.41/05 Wiefvé VQD-QZ. “Mfr,“ Age; 3'3 Address ('fknown) LU”! kmduJA r . City. Saw ESQ. " ‘ ’ State: Cal Zip: ® Additional Protected Persons ' - a. Ar_e you asking for protection for any other family or household members? DYes wNo Eyes 11‘s! them. Full Name ‘ I r fl' Agg _ Lives with v_ou'? How are they related to you? ' ' D Yes D No D Yes D No D Yes a NO D Yes a No D Check here {fthere are more persons Attach a sheet ofpaper and Lwrz're "Attachment 3a-Additi0nal Proiecled Persons'’for a title. You may useform MC-025, Attachment b Why d0 these people need protection? (Explain below). D Check here iflhere is not enough spacefor your answer. Put your compiete answer 0n {he attached sheet 0f ' paper orform MC-025 ana’ write "Attachment 3b-Why Others Need Protection 'for a title. This is not a Court Order: “£133?Cgfifiggfje‘ézflfigisfiagéfiggfi9°” Request for Civil Harassment Restraining Orders CH--1oo, Page 1 ofs _Essenuai , . (Civil Harassment Prevention) ROHC,_ [1 PVERN9 cchmm” Case Number: ® Relationship of Parties HOW d0 you know the person in®? (Explain below): D Check here ifllzere is nor enough spacefor your answer. Put your complele answer 0n the attached sheet 0f _paper orform MC-025 and wrife “Attachment 4-Relan'onship ofParn'es ”for a tirle. 52‘ * bdg/Fflmd 010 m t5 Curjm-F Q ("AI 107241qu - © Venue U ' Why are you filing in this county? (Check all (hat apply): a. w The person in ® lives in this county. b. m I was harassed by the person in® in this county. c. D Other (specifiJ): ® Other Court Cases a. Have you or any ofthe persons named in® been involved in another coun case with the person in @‘P D Yes m No (Ifyes, check each kind ofcase and ina'icqte where and when each wasfiled.) Kind of Case Filed in {ComW/Srare) Year Filed Case Number (iflmown) (1) D Civil Harassment ' (2) D Domestic Violence (3) D Divorce, Nullity, Legal Separation (4) D Paternity, Parentage, Child Custody (5) a Elder or Dependent Adult Abuse (6) D Eviction (7) D Guardianship (8) D Workplace Violence (9) D Small Claims (1ma Criminal (1 DD Other (specz‘fiz): b. Are there now any protective 0r restraining orders in effect relating to you or any ofthe persons in @and the person in®? WNO DYes (Ifyes, attach a copy {fyou have one.) ® Description of Harassment Harassment means violence or threats of violence against you, or a course of conduct 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? @rovide dare 0r estimated date): xg/S/o-Zflcl‘ 2 Who else was there?( ) [See attached declaration for a Description of Harrassment] This is not a Court Order. RevisedJanuary 1. 201B . Request for Civil Harassment Restraining Orders CH-1oo, Page 2 ore Egg $32331. (Civil Harassment Prevention) 9, _ Case Number: ® a. (3) How did the person in® harass you? (Explain below):D Check here ifthere is not enough spacefor yofir answer Put your complete answer 0n rhe attached sheet ofpaper orform MC-025 and wrire ‘Qlttachmem 7a(3)-Describe Harassment "for a title I mar zML/zau 0/ .‘Llupx-omda' 515m [La “5.24 anal Ca/Alas am; 1(o1/morrm m1: Ldbcdlfbbbfii ta mu” dei‘d‘exSic (Alum J: 5115madfilm ookmhflmi haw (matgmpLudLm max) flrmaémixw m. Ale, aamaucphm Carr. and 5%ch Duncmm 1M T Salami quDné W’ELLO anal ?Hd Mm j 75131743 79 rm.movflfl-M read €3an ' 5.2.13 [Mo (4) Did the person in® use or threaten to use a gun 0r any other weapon?_ Yes g N0 (Ifyes, explain below).D Check here ifrhere is nor enough spacefor your answer. Put your complete answer on the attached sheet ofpaper orform MC-025 and write "Attachment 7a(4)~Use ofWeapons”f0r a title. (5) Were you banned or injured because of the harassment? g Yes D N0 (Ifyes, explain below): Check here {fthereiis not enough'spacefor your answer. Put your complere answer on the attached sheet ofpaper orform MC-025 and w: ite “Attachment 7a(5)-Harm 0r Injury"f0r a (I(I. . \De,s Mtg lpflJ/arm Aw: 6min ‘ 71¢. ope (Jae, 11mm [oz omega (6) Did the police come? @Yes D No Ifyes, did they give you'or the person‘ in ®an Emergency Protective Order?D Yes m N0 Ifyes, the order protects (check all that apply): DMe D The person in ® D The persons in ©. (Attach a copy 0fthe order nyou have one.) b. Has the person in ® harassed you at other times? g Yes D N0 (Ifyes, describeprior incidents andprovide dares ofharassmenr below): Check here tfthere is not enough spacefor your ans“ er Put your complete answer on the attached sheer 0f paper orform MC-025 and write “Attachment 7b-Prew'ous Harassment’'for a title. Ever 41m (”Mar sear mp ALJ-ULM Jormm afixgM rb Lo'fl'n‘c Ad; haf/mm c9 awarj’ $5M“. This is not a Court Order. Rme‘tmm‘lfigf Request for Civil Harassment Restraining Orders CH-1oo, Page 3 ore Dessepoms. (Civil Harassment Prevention) 9 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 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 oflhe person. b. Contatt‘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, 11y interofficc mail, by e-mail, by text message, by fax, 0r by other electronic means. c. D Other (speczfl): a Check here ifthere is not enough spaceforyour answer. Pu! your complete answer 0n Ilze attached sheer ofpaper orform 11110025 and write ”Attachment 8c-Other Personal Conduct Orders, "for a title. The person in ®will be ordered not (0 lake any action to get [he addresses 0r locations ofany pl‘oteciedperson unless tire courtfinds good cause no! t0 make (he order. @Stay-Away Orders a. I ask the court t0 order the person in ® to stay at least 3fl_ yards away from (check all that apply): (I) Me. (8) My vehicle. (2) The other persons listed in©. (9) Other (specifii): (3) Q My home. (4) D Myjob or workplace. (5) D My school. (6) D My children’s school. (7) D 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?m Yes DNO {Ifno, explain below).- D Check here ffthere is nor enough spacefor your answer. Put your complete answer 0n [he arlachea' sheet 0f paper orform M’C-025 and write "Attachment 9b-S/ay-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 b1 don’t know Ifthejua'ge grants a protective order, the person in ® will be prohibitedflom owning. possessfng, purchasing, receiving, 0r attempting r0 purchase 0r receive a gun, otherfirearm, and ammunition 11=lzile the protecrive order is in efi'ecr. The person in ®will also be ordered (0 mm in r0 law enforcement, or sell t0 0r store with a licensed gun dealer, any guns orfirearms wirhm his 0r her immediate possession 0r control. This is not a Court Order. Revised January 1, 2018 uhmm Essa Hal Request for Civil Harassment Restraining Orders CH-1oo. Page4 ors rapes“. (Civil Harassment Prevention) 9p .-. Case Number: ® @Temporary Restraining Order Irequest that a Temporary Restraining Order (TRO) be issued against the peyson in ® t0 last Lgntil t_he hearing. I am presenting form CH-l 10, Temporary Restraining Order, for the court’s Slgnature together w1th thls Request. Has the person in ® been told that you were going 10 go to court to seek a TRO against him/her? DYes m No (Kym: answered n0, explain why below): D Check here {fthere is nor enough spacefor your answer. Put your complete answer on the attached sheet of aper orform M0025 and write “Attachment II-Tempormy Restraining Order ”for a title. .Zp 0/1 ’7L Marl ?Lancf (1072-539 a)(?H/L (midi. @ m Request to Give Less Than Five Days' .Notice of Hearing _ You mus: have your papers personally sewed 0n the person in @ a! [eastfive days before the hearing, unless the court orders a shorter timefor service. (Form CH-ZOO-INFO explains What Is “Proof 0f Personal Service”? Form CH-ZOO, Proof of Personal Service, may be med to show the courl that the papers have been sewed.) Ifyou want there to be fewer than five days between service and the hearing, explain why below: D Check here ifthere is nor enough spacefor your answer. Put your complete answer 0n the attached sheet of paper oerrm MC-025 and wrile "Attachment I2-Reques! to Give Less Than Five Days'Non'ce “for a Iille. No Fee for Filing or Service a. There should be no filing fee becausethe person in®has used or threatened to use violence against me, has stalked me, 0r has acted or spoken in some other way that makes me reasonably fear violence. b. D The sheriff or marshal should serye (notify) the person in @about the orders for free because my request for orders is based on unlawful violence, a credible threat ofviolence, 0r stalking. c. D There should be no filing fee and the sheriff or marshal should serve the person in @for free because I am entitled to a fee waiver. (You mus! complete andfileform FW-001, Application for Waiver of Court Fees and Costs) E Lawyer's Fees and Costs I ask the court to order payment of my D lawyer's fees E Court costs. The amounts requested are: -m ' Amount m Amount Filing Fee ' ‘ '$ 435 $ $ $ $ $ D Check here iflhere are more items. Pu! tile items and amounts on (he attached sheet ofpaper orform MC-025 and write “Attachment 14-Lmvyer ‘s Fees and Costs"f0r a title. This is not a Court Order. RWsefiJagm-ifa‘: Request for Civil Harassment Restraining Orders CH-1oo, Pagesore GEE Egg"? (Civil Harassment Prevention) .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 ofthe animals listed below, which I own, possess, lease, keep, or hold, 0r which reside in my household. (Identifiz animals by, e.g., type, breed, name, color, sex.) I request sole possession of the animals because (specifiz good causefor granting order): D Check here ifthere 1's r70! enough spacefor your answer. Put your complete answer 0n the attached sheet ofpaper 0rf0rm 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, 0r otherwise dispose of, the animals listed above. DAdditional Orders Requested , I ask the court to make the following additional orders (specifiz): D Check here ifrhere 1's nor enough spacefor your answer. Put your complete answer 0n rhe atlached sheet 0f paper orform MC-025 and write "Alfachmem 1' 6-Addiri0nal Orders Requested, "for a rifle. @ Number ofpages attached to this form, ifany: Date: SdfiBepmsmted- Lawyer ’s signature Self-Represented )Lawyer ‘3 name (Ifany) Ideclare under penalty of perjury under the laws ofthe State bf Califomia that the information above and 0n all attachments is true and correct. Date: 3/”[231 . ~ Evcmdfi M cu/zf Ktjem {fag } %. . V Type 0rprmt your name Szgn your name This is [iqt a Court Order. Revised January 1. 201B v . Essential Request for Civil Harassment Restraining Orders CH-100. Pagesofe EU?" @th s. (Civil Harassment Prevention)two , ___"" 10 11 12 13 14 15 15 17 18 19 20 2‘1 22 23 24 25 CASE NAMEMOLKQACL q and UafithQS CASE #: Last Name Lastmme CH-100, Item 7a(3) - DESCRIBE HARASSMENT: a) How do you know the person you want to restrain? Ex w loani-a-DQA& 010 MML CM/rimd’j (‘MQu‘w/d b) Are you living with the person? D YES F NO c) Has the person thysically abuse you, Ephysically or verbally threatened you and/or gharassed 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 exactIy what happened in detail, include dates and times): fin 3/5/393i I was dummy lo n/w Q&Iflu'mi‘s subs l/tOr/{S‘t 0Y1 Mmm+ Logan Dfl-L gu’zqrbm. CaAJoS SAM ML and 5AM alumna wackLus/M LLme #44143 ?lb Fun nap 073121 WfowfgmévZO‘fl/‘L/wm m Moan‘f-[vsam 9/20 /aL/d_j 0411/45! AAJ (7M and CW J0 mu (ctr vemm cud Sat/IM hawax 90kt; La ki Lf M éléfié/zfiJ A Dunch me [19(269 ~10 Mack [1M 741M hG‘HC/LS M 05L Mu Ace {é [4-4 ML [@(AAC/Lufl f/z mu A:ALcmfl/L; [?Laé/M, B/f/aogu eL/QLL/yl/nu, AA 32g r m A1 5MB miémé/VL? mwm’lh {1/65 Ca/L-HLL/Jh? 74> muck. xmlo ML 01" er‘Cfi M2- 04¢ flL/oadg 0A 3/5/3694 I Cwlw‘ V’le/Ifiv #29)” CH-100, Item 73(3) - DESCRIBE HARASSMENT Page ‘10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 CASE NAMEz'QJxlmdqand \Jogsmss CASE #: Lafl Name Laflflame e) Were any guns or other weapons used or threatened to be used during any abuse in the past three months? D YES gNo If “YES”, describe: f) Were there any injuries during abuse in the past three months? M YES D NO IWES", describefln B/fzfiha’l’ , ”ado: LQ/Lgdcqac/ AH’ me. M [punchedm v/LLHLKFVLE, m7; 1% mam a g) Did the police come to any 0f these recent events? ?YES El NO h) Did they give you an'Emergency Protective Order for abuse in the past three months? D YES m0 [f “YES”. please attach a copy. i) ls the person you want to restrain in jail right now for violence against you? [WES fiNo |f“YE_S”.where: j) Has the person you want restrained ever been in jail for violence against you or your children? {wYES El NO. |f"YES". when; 3/51/510311 Describe what the person did to you or your children that caused them to go to jail: ICa/QA-Hm. Da/z’ca (m B/Y/Qom u .L gaveflh PQIECL wth Aaflaemufl .1: QQULW 421% paganmlr’am afifi/U CM add [danger [plafi nméém K?Q[olM Dd [/h,%vL (’afllo! Adj .Chqj4d/mszLMf Car 79qu ?Zd HAIL M QMWFOM leaki MM_W-éhaM Pkgxcm/U? A¢#ML cad -/’éL/em%uwl vie) KW” ma CH-100, [tern 73(3) - DESCRIBE HARASSMENT Page- 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 CASE NAME:\2QIgflQeE“d VQSEEQS CASE #z LamName L Name k) Do you have a criminal protective order (restraining order from criminal court)? [II YES WNO If “YES", please attach a copy. I) Describe the worst abuse and when it happened: fiThe most recent abuse i_s the worst abuse OR D The worst abuse was (approximate date) and the person l want a restraining order against (describe what mey did 1o you): m) Describe any other previbus (past) violence or threats of violence that you haven’t already written about here (include dates or estimates as to when it happened): CHJOQHem7afi)-DESCHBEHARASSMENT Page ‘Zpfiéngfi‘efmilhg'; ‘_ L...“ w;