On October 13, 2017 a
Miscellaneous
was filed
involving a dispute between
Chavez Ii, Carlos Arik,
and
for Petition re Change of Name
in the District Court of San Bernardino County.
Preview
cM o a
ATTORNEY OR PARTY WtTNOUT AT fORNEY fName State Ear numbe and address FOR COURT USE OfltLY
CARLOS ARIK CHAVEZ II
5135 SAGEBRUSH TERRACE
SAN BERNARDINO CA s24o7 F i E D
r EPHONe No g097141043 Ax No SUPERIQR COURT OF CALiFORNIA
AT7oRNEY FOR Name COUNTY OF SF N BFRNARDtNO
SUPERIOR COURT OF CALIFORNIA CQUNTY OF SAN BERNARDINO SAN BERM1iA i INC itVll DIVISION
srREerAooR ss 247 WEST THIRD STREET
r A uN A oR ss 247 West Third Street San Bemardino CA 92415 0210
OCT 1 3 2017
eirvaN z Pcoo SAN BERNARDINO CA 92415 0210
sw r cr NaMr Civil Division of the San Bernardino District
Y es
CASE NAME Petition forChange of Name of
ASHLEY M LCAHY O U7Y
CARLOS ARIK CHAVEZ II
CASE NU iBER
CtVIL CASE COVER SHEET Compiex Case Designation
Unlimited Limited
Gounter Joinder
Amount Amount
U GE
demanded demanded is Filed with first appearance by defendant
exceeds 25 000 525 000 or less Cai Rules of Court rule 3 4Q2 CEP7
tfems 9 6 below must be compieted see insfructions on page 2
1 Check one box below for the case type that best describes this case
Auto Tort Contract Provisianaily Compiex Civil litigation
CaL Rules of Court rules 3 4p0 3 403
Auto 22 Breach of contractlwamanty 06
Uninsured motorist 46 0 Rule 3 740 coilections 09j 0 AntitrusUTrade regulation 03
Other PI PDt4Nd Personal Injury Praperty 0 Ott er collections 09 Construction defect 10
DamagelWrangfui Death Tort Mass tort 40
insurance coverage 18
Asbesios 04 Securities litigation 28
Other contract 37
Product liability 24
Real Pro pe rty EnvironmentallToxic tort 3d
Medical 45j
maipractice
0 Eminent domain inverse
Insurance coverage ciaims arising from the
condemnation 14
Other PIlPD WD 23 above listed provisionaily compiex case
types 41
Non PIlPDIWD Other Tort Wrongful eviction 33
Business tort unfair business practice 07 0 Other real property 26 Enforcement of Judgment
Civii rights 08j Uniawful Detainer Enforcement of judgment 20
Defamation Commerciai 31
13 Miscellaneous Givil Comp aint
Fraud 16 Residentiai 32 RICO 27
intellectual 19 Drugs 38
property Other complaint nafspecified above 42
Professionai negligence 25 Judiciai Review
Misceilaneous CiviE Petition
Other PIlPDM D tort Asset forfeiture 05
non 35y Partnership and corporate governance 21
Ernployment 0 Petitian re arbitration award 11
Other petitian nof specified above 43
Wrongfui termination 36 Writ of mandate 02
Petition far Name Change
Other empioyment 15 Other udicial review 39
X
2 This case is is not complex under rule 3 400 of the California Rules of Court If the case is complex mark the
factors requiring exceptional judicial management
a 0 Large number of separately represented parties d Large number of witnesses
b 0 Extensive motion practice raising difficult or novel e Coordination with related actians pending in one ar more courts
issues that will be time consuming to resolve in other counties states or countries or in a federal court
Substantial amount of f Substantial postjudgment judicial supervision
c documentary evidence
3 Remedies sought check a l thaf apply a monetary b nonmonetary declaratory or injunctive relief c punitive
4 Number of causes of action specify 1
5 This case is is not a class action suit
6 If there are any known related cases file and serve a notice of related case You mayu
Date
CARLOS ARIK CHAVEZ II
TYPE OR PRINT NAAiE tSIGNAT OF PART ATTORNEY F4R PARTY
NOTICE
Plaintiff must file this cover sheet with the irst paper filed in the action or ceeding exc t small claims cas ses filed
under the Probate Code Family Code or Welfare and Institutions Code Cal Rules of Cou Failure to file may result
in sanctions
File this cover sheet in addition to any cover sheet required by local court rule
If this case is complex under rule 3 400 et seq of the California Rules of Court you must serve a copy af this cover sheet on ali
other parties to the action or proceeding
Unless this is a collectians case under rule 3 740 or a complex case this cover sheet will be used for statistical purposes on
a e1of2
Form Adopted for Mandatory Use Cal Ruies of Court rules 2 30 3 220 3 400 3 463 3 740
CIVIL CASE COVER SHEET CaI Standards of Judicial Administration std 3 70
Judicial Council of California
GM 010 Rev July 1 2007J www couNnfo ca gov
CM 010
iNSTRUCTIONS ON HOW TO COMPLETE THE COVER SHEET
To Plaintiffsand Others
Filing First Papers If you are filing a first paper for example a complaint in a civil case you must
complete and file along with your first paper the Civi1 Case Cover Sheef contained on page 1 This information will be used to compile
statistics about the types and numbers of cases filed You must complete items 1 through 6 on the sheet In item 1 you must check
one box for the case type that best describes the case If the case fits both a general and a more specific type of case listed in item 1
check the more speci ic one If the case has multiple causes of action check the box that best indicates the primary cause of action
To assist you in completing the sheet examples of the cases that belong under each case type in item 1 are provided below A cover
sheet must be filed only with your initial paper Failure to file a cover sheet with the first paper filed in a civil case may subject a party
its counsel or both to sanctions under rules 2 30 and 3 220 of the California Rules of Court
To Parties in Ruie 3 740 Collections Cases A collections case under rule 3 740 is defined as an action for recovery of money
owed in a sum stated to be certain that is not more than 25 000 exclusive of interest and attorney s fees arising from a transaction in
which property services or money was acquired on credit A collections case does not include an action seeking the following 1 tort
damages 2 punitive damages 3 recovery of real property 4 recovery of personal property or 5 a prejudgment writ of
attachment The identification of a case as a rule 3 740 collections case on this form means that it will be exempt from the general
time for service requirements and case management rules unless a defendant files a responsive pleading A rule 3 740 collections
case will be subject to the requirements for service and obtaining a judgment in rule 3 740
To Parties in Complex Cases In complex cases only parties must also use the Civi1 Case Cover Sheet to designate whether the
case is complex If a plaintiff believes the case is corriplex under rule 3 400 of the California Rules of Court this must be indicated by
completing the appropriate boxes in items 1 and 2 If a plaintiff designates a case as complex the cover sheet must be served with the
complaint on all parties to the action A defendant may file and serve no later than the time of its first appearance a joinder in the
plaintiffs designation a counter designation that the case is not complex or if the plaintiff has made no designation a designation that
the case is complex
CASE TYPES AND EXAMPLES
Auto Tort Contract Provisionally Complez Civil Litigation Cal
Auto 22 Personal Injury Property Breach Contract d6 Rules Court Rutes 3 400 403
of Warranty of
Damage Wrongful Death Breach of Rental Lease AntitrustiTrade Regulation 03
Contrect not unlawfui detainer Construction Defect 10
Uninsured Motorist 46 if the
invofves insured or wrongful eviction Claims Involving Mass Tort 40
case an w
Contract Warranty Breach Seller Securities Litigation 28j
motorrst claim subject to
Plaintiff not fraud or neglrgerce EnvironmentaVToxic Tort 30
arbitration check this item
instead ofAuto Negligent Breach of ContracU Insurance Coverage Claims
Other PI PDlWD Personal Injury Warranty arising from provrsional y complex
Other Breach of ContractM arranty case type listed above 41
Praperty Damage Wrongful Death
Tort Colleciions e g money owed open Enforcement of Judgment
book accounts 09 Enforcement of Judgment 20
Asbestos 04
Collection Case eller Plaintiff Abstract of Judgment Out of
Asbestos Property Damage
Asbestos Personal Injury Other Promissory NotelCollections County
Case Confession of Judgment non
Wrongful Death
Insurance Coverage not provrsional y domesfic relations
Product Liability not asbestos or
comp ex 18 Sister State Judgment
toxic nvrronmental 24
Auto Subrogation Administrative Agency Award
Medical Malpractice 45
Medical Malpractice Other Coverage not unpaid taxes
Physicians Surgeons Other Contract 37 Petition Certification of Entry of
Contractual Fraud Judgment on Unpaid Taxes
Other Professional Health Care
Other Enforcement of Judgment
Malpractice Other Contract Dispute
Case
Other PI PD WD 23 Real Rroperty
Miscellaneous Civil Complaint
Premises Liability e g slip Eminent Domainllnverse
Condemnation RICO 27
and fall 14
Other Complaint not specified
Intentional Bodily Injury PD WD Wrongful Eviction 33
above 42
e
g assault vandalism Oiher Real title 26
Property e g quiet
Declaratory Relief Only
Intentional Infliction of Writ of Possession of Real Property
Emotional Distress Mortgage Foreclosure
Injunctive Relief Only non
harassment
Negligent Infliction of Quiet Title
Mechanics ien
Emotional Distress Other Real Property not eminent
Other Commercial Complaint
Other PI PD WD domain IandlordRenant or
Case non tort non complex
Non PI PD WD Other Tort foreclosure
Other Civil Complaint
Business TortlUnfair Business Unlawful Detainer
non tort non complex
Practice 07 Commercial 31
Miscellaneous Civil Petition
Civil Rights e g discrimination Residential 32
Partnership and Corporate
false arrest not civil
Drugs 38 if the case involves illegal Governance 21
harassment 08 drugs check this item othenvise Other Petition nof specified
Defamation e g slander libel report as Commercral or Resrdenfral a6ove 43
13 Judicial Review
Civil Harassment
Fraud 16 Asset Forfeiture 05 Workplace Violence
Intellectual Property 19 Petition Re Arbitration Award 11 Elder Dependent Adult
Professional Negligence 25 Writ of Mandate 02 Abuse
Legal Malpractice Writ Administrative Mandamus
Election Contest
Other Professional Malpractice Writ Mandamus on Limited Court
Petition for Name Change
nof inedica or legal Case Matter Petition for Relief From Late
Other Non PIlPD WD Tort 35 Writ Other Limited Court Case Claim
Employment
Review Other Civil Petition
Wrongful Termination 36
Other Judicial Review 39
Other Employment 15 Review of Healih Officer order
Notice of Appeal abor
Commissioner Appeals
CPd 010 Rev July1 Page2of2
2007J
CIVIL CASE COVER SHEET
Document Filed Date
October 13, 2017
Case Filing Date
October 13, 2017
Category
Petition re Change of Name
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Preview
cM o a ATTORNEY OR PARTY WtTNOUT AT fORNEY fName State Ear numbe and address FOR COURT USE OfltLY CARLOS ARIK CHAVEZ II 5135 SAGEBRUSH TERRACE SAN BERNARDINO CA s24o7 F i E D r EPHONe No g097141043 Ax No SUPERIQR COURT OF CALiFORNIA AT7oRNEY FOR Name COUNTY OF SF N BFRNARDtNO SUPERIOR COURT OF CALIFORNIA CQUNTY OF SAN BERNARDINO SAN BERM1iA i INC itVll DIVISION srREerAooR ss 247 WEST THIRD STREET r A uN A oR ss 247 West Third Street San Bemardino CA 92415 0210 OCT 1 3 2017 eirvaN z Pcoo SAN BERNARDINO CA 92415 0210 sw r cr NaMr Civil Division of the San Bernardino District Y es CASE NAME Petition forChange of Name of ASHLEY M LCAHY O U7Y CARLOS ARIK CHAVEZ II CASE NU iBER CtVIL CASE COVER SHEET Compiex Case Designation Unlimited Limited Gounter Joinder Amount Amount U GE demanded demanded is Filed with first appearance by defendant exceeds 25 000 525 000 or less Cai Rules of Court rule 3 4Q2 CEP7 tfems 9 6 below must be compieted see insfructions on page 2 1 Check one box below for the case type that best describes this case Auto Tort Contract Provisianaily Compiex Civil litigation CaL Rules of Court rules 3 4p0 3 403 Auto 22 Breach of contractlwamanty 06 Uninsured motorist 46 0 Rule 3 740 coilections 09j 0 AntitrusUTrade regulation 03 Other PI PDt4Nd Personal Injury Praperty 0 Ott er collections 09 Construction defect 10 DamagelWrangfui Death Tort Mass tort 40 insurance coverage 18 Asbesios 04 Securities litigation 28 Other contract 37 Product liability 24 Real Pro pe rty EnvironmentallToxic tort 3d Medical 45j maipractice 0 Eminent domain inverse Insurance coverage ciaims arising from the condemnation 14 Other PIlPD WD 23 above listed provisionaily compiex case types 41 Non PIlPDIWD Other Tort Wrongful eviction 33 Business tort unfair business practice 07 0 Other real property 26 Enforcement of Judgment Civii rights 08j Uniawful Detainer Enforcement of judgment 20 Defamation Commerciai 31 13 Miscellaneous Givil Comp aint Fraud 16 Residentiai 32 RICO 27 intellectual 19 Drugs 38 property Other complaint nafspecified above 42 Professionai negligence 25 Judiciai Review Misceilaneous CiviE Petition Other PIlPDM D tort Asset forfeiture 05 non 35y Partnership and corporate governance 21 Ernployment 0 Petitian re arbitration award 11 Other petitian nof specified above 43 Wrongfui termination 36 Writ of mandate 02 Petition far Name Change Other empioyment 15 Other udicial review 39 X 2 This case is is not complex under rule 3 400 of the California Rules of Court If the case is complex mark the factors requiring exceptional judicial management a 0 Large number of separately represented parties d Large number of witnesses b 0 Extensive motion practice raising difficult or novel e Coordination with related actians pending in one ar more courts issues that will be time consuming to resolve in other counties states or countries or in a federal court Substantial amount of f Substantial postjudgment judicial supervision c documentary evidence 3 Remedies sought check a l thaf apply a monetary b nonmonetary declaratory or injunctive relief c punitive 4 Number of causes of action specify 1 5 This case is is not a class action suit 6 If there are any known related cases file and serve a notice of related case You mayu Date CARLOS ARIK CHAVEZ II TYPE OR PRINT NAAiE tSIGNAT OF PART ATTORNEY F4R PARTY NOTICE Plaintiff must file this cover sheet with the irst paper filed in the action or ceeding exc t small claims cas ses filed under the Probate Code Family Code or Welfare and Institutions Code Cal Rules of Cou Failure to file may result in sanctions File this cover sheet in addition to any cover sheet required by local court rule If this case is complex under rule 3 400 et seq of the California Rules of Court you must serve a copy af this cover sheet on ali other parties to the action or proceeding Unless this is a collectians case under rule 3 740 or a complex case this cover sheet will be used for statistical purposes on a e1of2 Form Adopted for Mandatory Use Cal Ruies of Court rules 2 30 3 220 3 400 3 463 3 740 CIVIL CASE COVER SHEET CaI Standards of Judicial Administration std 3 70 Judicial Council of California GM 010 Rev July 1 2007J www couNnfo ca gov CM 010 iNSTRUCTIONS ON HOW TO COMPLETE THE COVER SHEET To Plaintiffsand Others Filing First Papers If you are filing a first paper for example a complaint in a civil case you must complete and file along with your first paper the Civi1 Case Cover Sheef contained on page 1 This information will be used to compile statistics about the types and numbers of cases filed You must complete items 1 through 6 on the sheet In item 1 you must check one box for the case type that best describes the case If the case fits both a general and a more specific type of case listed in item 1 check the more speci ic one If the case has multiple causes of action check the box that best indicates the primary cause of action To assist you in completing the sheet examples of the cases that belong under each case type in item 1 are provided below A cover sheet must be filed only with your initial paper Failure to file a cover sheet with the first paper filed in a civil case may subject a party its counsel or both to sanctions under rules 2 30 and 3 220 of the California Rules of Court To Parties in Ruie 3 740 Collections Cases A collections case under rule 3 740 is defined as an action for recovery of money owed in a sum stated to be certain that is not more than 25 000 exclusive of interest and attorney s fees arising from a transaction in which property services or money was acquired on credit A collections case does not include an action seeking the following 1 tort damages 2 punitive damages 3 recovery of real property 4 recovery of personal property or 5 a prejudgment writ of attachment The identification of a case as a rule 3 740 collections case on this form means that it will be exempt from the general time for service requirements and case management rules unless a defendant files a responsive pleading A rule 3 740 collections case will be subject to the requirements for service and obtaining a judgment in rule 3 740 To Parties in Complex Cases In complex cases only parties must also use the Civi1 Case Cover Sheet to designate whether the case is complex If a plaintiff believes the case is corriplex under rule 3 400 of the California Rules of Court this must be indicated by completing the appropriate boxes in items 1 and 2 If a plaintiff designates a case as complex the cover sheet must be served with the complaint on all parties to the action A defendant may file and serve no later than the time of its first appearance a joinder in the plaintiffs designation a counter designation that the case is not complex or if the plaintiff has made no designation a designation that the case is complex CASE TYPES AND EXAMPLES Auto Tort Contract Provisionally Complez Civil Litigation Cal Auto 22 Personal Injury Property Breach Contract d6 Rules Court Rutes 3 400 403 of Warranty of Damage Wrongful Death Breach of Rental Lease AntitrustiTrade Regulation 03 Contrect not unlawfui detainer Construction Defect 10 Uninsured Motorist 46 if the invofves insured or wrongful eviction Claims Involving Mass Tort 40 case an w Contract Warranty Breach Seller Securities Litigation 28j motorrst claim subject to Plaintiff not fraud or neglrgerce EnvironmentaVToxic Tort 30 arbitration check this item instead ofAuto Negligent Breach of ContracU Insurance Coverage Claims Other PI PDlWD Personal Injury Warranty arising from provrsional y complex Other Breach of ContractM arranty case type listed above 41 Praperty Damage Wrongful Death Tort Colleciions e g money owed open Enforcement of Judgment book accounts 09 Enforcement of Judgment 20 Asbestos 04 Collection Case eller Plaintiff Abstract of Judgment Out of Asbestos Property Damage Asbestos Personal Injury Other Promissory NotelCollections County Case Confession of Judgment non Wrongful Death Insurance Coverage not provrsional y domesfic relations Product Liability not asbestos or comp ex 18 Sister State Judgment toxic nvrronmental 24 Auto Subrogation Administrative Agency Award Medical Malpractice 45 Medical Malpractice Other Coverage not unpaid taxes Physicians Surgeons Other Contract 37 Petition Certification of Entry of Contractual Fraud Judgment on Unpaid Taxes Other Professional Health Care Other Enforcement of Judgment Malpractice Other Contract Dispute Case Other PI PD WD 23 Real Rroperty Miscellaneous Civil Complaint Premises Liability e g slip Eminent Domainllnverse Condemnation RICO 27 and fall 14 Other Complaint not specified Intentional Bodily Injury PD WD Wrongful Eviction 33 above 42 e g assault vandalism Oiher Real title 26 Property e g quiet Declaratory Relief Only Intentional Infliction of Writ of Possession of Real Property Emotional Distress Mortgage Foreclosure Injunctive Relief Only non harassment Negligent Infliction of Quiet Title Mechanics ien Emotional Distress Other Real Property not eminent Other Commercial Complaint Other PI PD WD domain IandlordRenant or Case non tort non complex Non PI PD WD Other Tort foreclosure Other Civil Complaint Business TortlUnfair Business Unlawful Detainer non tort non complex Practice 07 Commercial 31 Miscellaneous Civil Petition Civil Rights e g discrimination Residential 32 Partnership and Corporate false arrest not civil Drugs 38 if the case involves illegal Governance 21 harassment 08 drugs check this item othenvise Other Petition nof specified Defamation e g slander libel report as Commercral or Resrdenfral a6ove 43 13 Judicial Review Civil Harassment Fraud 16 Asset Forfeiture 05 Workplace Violence Intellectual Property 19 Petition Re Arbitration Award 11 Elder Dependent Adult Professional Negligence 25 Writ of Mandate 02 Abuse Legal Malpractice Writ Administrative Mandamus Election Contest Other Professional Malpractice Writ Mandamus on Limited Court Petition for Name Change nof inedica or legal Case Matter Petition for Relief From Late Other Non PIlPD WD Tort 35 Writ Other Limited Court Case Claim Employment Review Other Civil Petition Wrongful Termination 36 Other Judicial Review 39 Other Employment 15 Review of Healih Officer order Notice of Appeal abor Commissioner Appeals CPd 010 Rev July1 Page2of2 2007J CIVIL CASE COVER SHEET