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  • Jennifer Adrian vs Paul Schultz Unlimited Civil - Civil Harassment document preview
  • Jennifer Adrian vs Paul Schultz Unlimited Civil - Civil Harassment document preview
  • Jennifer Adrian vs Paul Schultz Unlimited Civil - Civil Harassment document preview
  • Jennifer Adrian vs Paul Schultz Unlimited Civil - Civil Harassment document preview
  • Jennifer Adrian vs Paul Schultz Unlimited Civil - Civil Harassment document preview
  • Jennifer Adrian vs Paul Schultz Unlimited Civil - Civil Harassment document preview
  • Jennifer Adrian vs Paul Schultz Unlimited Civil - Civil Harassment document preview
  • Jennifer Adrian vs Paul Schultz Unlimited Civil - Civil Harassment document preview
						
                                

Preview

Request for Civil Harassment Glerk stamps date here when form i fled. dae Restraining Orders Read Can a Civil Harassment Restraining Order Help Me? (form CH-100- Filed FEB 10 2021 FEB 1 0 2021 INFO) before completing this form. Also fill out Confidential CLETS Information (form CLETS-001) with as much information as you know. BRANDON,E. isc Gunna, Te ann kK Person Seeking Protection Ter” a, Your Full Name: . an Age: 7 Your Li if you ha thi Name: swer 30 re one for ths case) State Bar No.: Fill in court name and street address: Firm Nae Superior Court of California, County of . San Joaquin b. Your Address (Uf-you have a lawyer, give your lawyer's 180 E. Weber Ave. Ste. 200 information. If you do not havea lawyer and want to keep your Stockton, CA 95202 home address private, you may give a different mailing address instead. You do not have to give telephone, fax, or e-mail.) Address: 10) \N. Blyn. Sk: Court fils in case number when form is filed. City: Low jl State: aA Zip: L/L Case Number: Telephone: L “bp ev-vew201- (280 E-Mail Address: @ Person From Whom Protection Is Sought Full Name: Paul Sdnulrt- Age: 60 Address (if known): _\) $. Crescent G- city: Lodi State: CA, Zip: 9S242 @) Additional Protected Persons a, Are you asking for protection for any other family or houschold members? _[] Yes [] No If yes, list them: Full Name Sex Age Lives with you? How are they related to you? Jennifer Adrian F_ 4h of Yes I No Oj Yes 1] No O Yes (] No OO Yes (] No OO Check here if there are more persons. Attach a sheet of paper and write “Attachment 3a—Additional Protected Persons” for a title. You may use form MC-025, Attachment, b. Why do these people need protection? (Explain below): O Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write “Attachment 3b—Why Others Need Protection” for a title. T lie wth thy mn and caved fir bes Sat dy. SRM eI e- RO Ee Ores (cles Judicial Council of Calfomia, www.courts.ca.gov Reused Jenvary 1, 2018, Mandatory Form Request for Civil Harassment Restraining Orders = CH-100, Page tof 6 Code of Cv Procedure, §§ 827.6 and 527.3 (Civil Harassment Prevention) >Case Number: @) Relationship of Parties How do you know the person in ® ? (Explain below): O Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write “Attachment 4—Relationship of Parties” for a title. My was ex-atrichd. G) Venue . . Why aye you filing in this county? (Check all that apply): a. ( The person in (2) lives in this county. b. [ I was harassed by the person in(@)in this county. c. [] Other (specify): @ Other Court Cases a. Have you or any of the persons named in @been involved in another court case with the person in @ D1 Yes No (Of yes, check each kind of case and indicate where and when each was filed.) Kind of Case Filed in (County/State) ‘Year Filed Case Number (if known) (@) O Civil Harassment (2) 1 Domestic Violence 3) 1 Divorce, Nullity, Legal Separation 4) ( Patemity, Parentage, Child Custody (5) (1 Elder or Dependent Adult Abuse (6) D Eviction (7%) [1 Guardianship (8) [1 Workplace Violence (9) C1 Small Claims (10) (] Criminal (11) 1 Other (specify): b, Are there now any protective or restraining orders in effect relating to you or any of the persons in @) and the person in(@)? Ne OD Yes = (ifyes, attach a copy if you 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 court about the last time the person in ® harassed you. (1) When did it happen? (provide date or estimated date): j ex em bey ob 2029 @) Who else wag there? _ : at ) moose, and Pool . . - a Teo Geketi ace nie Revised January 4.2018 Request for Civil Harassment Restraining Orders CH-100, Page 2 of 6 (Civil Harassment Prevention) >Case Number: a. (3) did the person in (2) harass you? (Explain below): ch eck here if there is not enough space for your answer, Put your complete answer on the attached sheet of paper or form MC-025 and write “Attachment 7a(3)—Describe Harassment” for a title. (4) Did the person in @® use or threaten to use a gun or any other weapon? UO] Yes No Ofyes, explain below): O) Check here if there is not enough space for your answer. Put your complete answer on | the attached sheet of paper or form MC-025 and write “Attachment 7a(4)—Use of Weapons” for a title. (5) Were you harmed or injured because of the harassment? OO Yes LNo (if yes, explain below): OO Check here if there is not enough space for your answer. Put your complete answer on the attached Sheet of paper or form MC-025 and write “Attachment 7a(5)—Harm or Injury” for a title. (6) Did the police come? Yes ONo LpZo- 142 If yes, did they give you or the person in @) an Emergency Protective Order? [] Yes wo If yes, the order protects (check all that apply): Ol Me (CJ Thepersonin@) [1 The persons in @). (Attach a copy of the order if you have one.) b. Has the person in (2) harassed you at other times? O Yes (1 No (ifyes, describe prior incidents and provide dates of harassment below): OO Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write “Attachment 7b—Previous Harassment” for a title. for te las jwo ments Poul git doing +o wee and he nuse leh y Vv This is not a Court Order. Revised January #,2018 Request for Civil Harassment Restraining Orders CH-100, Page 3 of 6 (Civil Harassment Prevention) >Case Number: Check the orders you want. (7 w Personal Conduct Orders Task the court to order the person in @ not to do any of the following things to me or to any person to be protegied listed in@): a. Harass, intimidate, molest, attack, strike, stalk, threaten, assault (sexually or otherwise), hit, abuse, destroy personal property of, or disturb the peace of the person. b. ~ 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. ce. [] Other (specify): 0 Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write “Attachment 80-—Other Personal Conduct Orders,” for a title. The person in (@) will be ordered not to take any action to get the addresses or locations of any protected person upless the court finds good cause not to make the order. Stay-Away Orders a. Lask the court to order the person in (2) to stay at least 00. yards away from (check all that apply): (Q) Me. (8) 1 Myvehicle. (2) x other persons listed in ®. (9) [ Other (specify): 3) wy home. (4) [1 My job or workplace. (5) 1 My school. (6) C0 My children’s school. (7) 0 My children’s place of child care. b. Ifthe court orders the person in ® to stay awgy from all the places listed above, will he or she still be able to get to his or her home, school, or job? Yes [No {ffno, explain below): Oi Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write “Attachment 9b—Stay-Away Orders,” for a title. Guns or Other Firearms and Ammunition Does the person in (2) own or possess any guns or other firearms? [] Yes [] No [] Idon’tknow Af the judge grants a protective order, the person in @ will be prohibited from owning, possessing, purchasing, receiving, or attempting to purchase or receive a gun, other firearm, and ammunition while the protective order is in effect. The person in @ will also be ordered to turn in to law enforcement, or sell to or store with a licensed gun dealer, any guns or firearms within his or her immediate possession or control, This is not.a Court Order. Revised January 1.2016 Request for Civil Harassment Restraining Orders CH-100, Page 4 of 6 (Civil Harassment Prevention) >Case Number: a Temporary Restraining Order 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 Order, for the court’s signature together with this Request. Has the person in(2)been told that you were going to go to court to seek a TRO against him/her? O1 Yes No (ifyou answered no, explain why below): 0 Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write “Attachment 11—Temporary Restraining Order” for a title. TL om Ccoyed 0 fehaliaton @) 0 Request to Give Less Than Five Days’ Notice of Hearing You must have your papers personally served on the person in @ at least five days before the hearing, unless the court orders a shorter time for service. (Form CH-200-INFO explains What Is “Proof of Personal Service”? Form CH-200, Proof of Personal Service, may be used to 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: O Cheek here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write “Attachment 12—Request to Give Less Than Five Days’ Notice” for a title. (3) No Fee for Filing or Service a. LY There should be no filing fee because the person in (2) has used or threatened to use violence against me, has stalked me, or has acted or spoken in some other way that makes me reasonably fear violence. b. C1 The sheriff or marshal should serve (notify) the person in (2) about the orders for free because my request for orders is based on unlawful violence, a credible threat of violence, or stalking. c. 1 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 must complete and file form FW-001, Application for Waiver of Court Fees and Costs .) CO Lawyer's Fees and Costs lask the court to order payment ofmy [] lawyer's fees 1 Court costs. The amounts requested are: Ttem. Amount Item Amount $ $ $ $ $ $ 0 Check here if there are more items, Put the items and amounts on the attached sheet of paper or form MC-025 and write “Attachment 14—Lawyer’s Fees and Costs” for a title. This is not 4-Court Order. Request for Civil Harassment Restraining Orders CH-100, Page 5 of 6 (Civil Harassment Prevention) > Revised January 1, 2018Case Number: DD Possession and Protection of Animals ask the court to order the following: a. (1) That! be given the sole possession, care, and control of 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 (specify good cause for granting order): OO Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write “Attachment 15a—Possession of Animals” for a title. b. (1 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 of, the animals listed above. (0 Additional Orders Requested ask the court to make the following additional orders (specify): 0 Check here if there is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write “Atiachment 16—Additional Orders Requested,” for a title. (i?) Number of pages attached to this form, if any: L Date: Lawyer’s name (if any) 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: oa L308 —ajefsoay Annidke Ad aan p CZ Type or print your name four name This is not a Court Order. Request for Civil Harassment Restraining Orders CH-100, Page 6 of 6 {Civil Harassment Prevention) Revised January 1, 2018onetnanrente Ta ()— Desurlog Havacsrteny” ane wk day oy Tao were Wes getting me recdy Coranber Wi202e) ond I x0\d hor Whek Paal we dowg 3 hed in ber sleet and tid her ps Senwed didnk Wank tele thew Grgenore Monmy/ got gnu waked fo Paul acleany Win why he UsCS cleing in Son ck me. Paul gad her Skurred ages. wa pal wep *Myin} fe yale b me and tid pe nor ¥ \a)\ ayo Ly Yas and phat L cada Sut any ok baat sv Lid paul he Wes Mo 4p hie. 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