Civil Harassment Packet Form – Fill Out and Use This PDF

SUPERIOR COURT OF CALIFORNIA

COUNTY OF SAN DIEGO

CIVIL HARASSMENT

PETITIONER PACKET

FORMS INCLUDED IN THIS PACKET

PKT-002 A (Rev. 9/21)

CH-100-INFO Can a Civil Harassment Restraining Order Help Me?

These instructions cannot cover all of the questions that may arise in a particular case. If you do not know what to do to protect your rights, you should see a lawyer.

CH-100-INFO Can a Civil Harassment Restraining Order Help Me?

(Civil Harassment Prevention)

CH-100-INFO Can a Civil Harassment Restraining Order Help Me?

(Civil Harassment Prevention)

□ Check here ifthere 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):

DCheck here ifthere 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.

This is not a Court Order.

I Case Number:

0 Relationship of Parties

How do you know the person in @? (Explain below):

D Check here ifthere 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.

0 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):

(2)Who else was there?

I Case Number:

(6) Did the police come? D Yes D No

If yes, did they give you or the person in@ an Emergency Protective Order? D Yes D No If yes, the order protects (check all that apply):

D Me D The person in@ D The persons in @.

(Attach a copy of the order ifyou have one.)

b. Has the person in@harassed you at other times?

D Yes D No (Ifyes, describe prior incidents and provide dates of harassment below):

D Check here ifthere 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.

This is not a Court Order.

I Case Number:

Check the orders you want. ® □ Personal Conduct Orders @

sheet of paper or form MC-025 and write "Attachment Be-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 unless the courtfinds good cause not to make the order.

□Stay-Away Orders

a. I ask the court to order the person in@ to stay at least __ yards away from (check all that apply):

(3)D My home.

(4)D My job or workplace.

(5)D My school.

(6)D My children's school.

(7)D My children's place of child care.

b. If the court orders the person in@ to stay away from all the places listed above, will he or she still be able D Yes D No (Ifno, explain below):to get to his or her home, school, or job?

D Check here ifthere 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@ own or possess any guns or other firearms? D Yes D No D I don't know

Ifthejudge grants a protective order, the person in @ will be prohibitedfrom owning, possessing, purchasing, receiving, or attempting to purchase or receive a gun, otherfirearm, 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 orfirearms within his or her immediate possession or control.

This is not a Court Order.

I Case Number:

@□ 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 Order, for the court's signature together with this Request.

Has the person in® been told that you were going to go to court to seek a TRO against him/her? D Yes D No (Ifyou answered no, explain why below):

D Check here ifthere is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write "Attachment]]-Temporary Restraining Order" for a title.

@□ Request to Give Less Than Five Days' Notice of Hearing

You must have your papers personally served on the person in @ at leastfive 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:

DCheck here ifthere 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.

@□ No Fee for Filing or Service

a. D There should be no filing fee because the person in @ 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. D 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 of violence, or 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 must complete andfile form FW-001, Application for Waiver of Court Fees and Costs.)

@□ Lawyer's Fees and Costs

DCheck here ifthere 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.

I Case Number:

@□ 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 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):

DCheck here ifthere is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write "Attachment l5a-Possession of Animals"for a title.

b.D 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.

@□ Additional Orders Requested

I ask the court to make the following additional orders (specify):

DCheck here ifthere is not enough space for your answer. Put your complete answer on the attached sheet of paper or form MC-025 and write "Attachment 16-Additional Orders Requested, "for a title.

@Number of pages attached to this form, if any: Date:

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:

(Civil Harassment Prevention)

ATTACHED DESCRIPTIONS - ADDITIONAL RESPONDENTS

INSTRUCTIONS FOR USE

This form should be used as an attachment to list additional persons to be restrained on:

Address:________________________________________________________________ City:________________________ State:________ Zip Code:__________________

b. Name:

Address:________________________________________________________________ City:________________________ State:________ Zip Code:__________________

c. Name:

Address:________________________________________________________________ City:________________________ State:________ Zip Code:__________________

d. Name:

Address:________________________________________________________________ City:________________________ State:________ Zip Code:__________________

e. Name:

Address:________________________________________________________________ City:________________________ State:________ Zip Code:__________________

f.Name:

Address:________________________________________________________________ City:________________________ State:________ Zip Code:__________________

g. Name:

Address:________________________________________________________________ City:________________________ State:________ Zip Code:__________________

ATTACHMENT - ADDITIONAL PROTECTED PERSONS

INSTRUCTIONS FOR USE

This form should be used as an attachment to list additional protected persons on:

a. Name:

b. Name:

c. Name:

d. Name:

e. Name:

f.Name:

g. Name:

MC-030

SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO

CENTRAL DIVISION, HALL OF JUSTICE, 330 W. BROADWAY, SAN DIEGO, CA 92101

EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020

NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081

SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910

PLAINTIFF/PETITIONER:

DEFENDANT/RESPONDENT:

CASE NUMBER:

DECLARATION

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Date:

1Protected Person a. Your Full Name:

Your Lawyer (if you have one for this case):

Check here if there are additional persons. List them on an attached sheet of paper and write “Attachment 3— Additional Protected Persons” as a title. You may use form MC-025, Attachment.

This Order expires at the end of the hearing scheduled for the date and time below:

This is a Court Order.

Case Number:

To the Person in 2 :

The court has granted the temporary orders checked as granted below. If you do not obey these orders, you can be arrested and charged with a crime. You may be sent to jail for up to one year, pay a fine of up to $1,000, or both.

b.Peaceful written contact through a lawyer or a process server or other person for service of legal papers related to a court case is allowed and does not violate this order. However, you may have your papers served by mail on the person in 1 .

(6) The school of the children of the person in 1

b.This stay-away order does not prevent you from going to or from your home or place of employment.

7No Guns or Other Firearms and Ammunition

a.You cannot own, possess, have, buy or try to buy, receive or try to receive, or in any other way get guns, other firearms, or ammunition.

b.You must:

(1)Sell to or store with a licensed gun dealer, or turn in to a law enforcement agency, any guns or other firearms in your immediate possession or control. This must be done within 24 hours of being served with this Order.

Case Number:

Additional orders are attached at the end of this Order on Attachment 9.

To the Person in 1 :

10Mandatory Entry of Order Into CARPOS Through CLETS

This Order must be entered into the California Restraining and Protective Order System (CARPOS) through the California Law Enforcement Telecommunications System (CLETS). (Check one):

(Civil Harassment Prevention)

Case Number:

The sheriff or marshal will serve this Order without charge because:

12Number of pages attached to this Order, if any: Date:

Judicial Officer

Warnings and Notices to the Restrained Person in 2

You Cannot Have Guns or Firearms

You cannot own, have, possess, buy or try to buy, receive or try to receive, or otherwise get guns, other firearms, or ammunition while this Order is in effect. If you do, you can go to jail and pay a $1,000 fine. You must sell to or store with a licensed gun dealer, or turn in to a law enforcement agency, any guns or other firearms that you have or control as stated in item 7 above. The court will require you to prove that you did so.

Notice Regarding Nonappearance at Hearing and Service of Order

If you have been personally served with this Temporary Restraining Order and form CH-109, Notice of Court Hearing, but you do not appear at the hearing either in person or by a lawyer, and a restraining order that is the same as this Temporary Restraining Order except for the expiration date is issued at the hearing, a copy of the order will be served on you by mail at the address in item 2 .

If this address is not correct or you wish to verify that the Temporary Restraining Order was converted into a restraining order at the hearing without substantive change, or to find out the duration of the order, contact the clerk of the court.

After You Have Been Served With a Restraining Order

•Obey all the orders.

•Read form CH-120-INFO, How Can I Respond to a Request for Civil Harassment Restraining Orders?, to learn how to respond to this Order.

•If you want to respond, fill out form CH-120, Response to Request for Civil Harassment Restraining Orders, and file it with the court clerk. You do not have to pay any fee to file your response if the Request claims that you inflicted or threatened violence against or stalked the person in 1 .

• You must have form CH-120 served by mail on the person in 1 or that person’s attorney. You cannot do this yourself. The person who does the mailing should complete and sign form CH-250, Proof of Service of Response by Mail. File the completed proof of service with the court clerk before the hearing date or bring it with you to the hearing.

•In addition to the response, you may file and have declarations served, signed by you and other persons who have personal knowledge of the facts. You may use form MC-030, Declaration, for this purpose. It is available from the clerk’s office at the court shown on page 1 of this form or at www.courts.ca.gov/forms. If you do not know how to prepare a declaration, you should see a lawyer.

This is a Court Order.

(Civil Harassment Prevention)

Case Number:

•Whether or not you file a response, you should attend the hearing. If you have any witnesses, they must also go to the hearing.

•At the hearing, the judge can make restraining orders against you that last for up to five years. Tell the judge why you disagree with the orders requested.

Instructions for Law Enforcement

Enforcing the Restraining Order

This order is enforceable by any law enforcement agency that has received the order, is shown a copy of the order, or has verified its existence on the California Restraining and Protective Orders System (CARPOS). If the law enforcement agency has not received proof of service on the restrained person, the agency must advise the restrained person of the terms of the order and then must enforce it. Violations of this order are subject to criminal penalties.

Start Date and End Date of Orders

This order starts on the date next to the judge’s signature on page 4. The order ends on the expiration date in item 4 on page 1.

Arrest Required if Order Is Violated

If an officer has probable cause to believe that the restrained person had notice of the order and has disobeyed the order, the officer must arrest the restrained person. (Pen. Code, §§ 836(c)(1), 13701(b).) A violation of the order may be a violation of Penal Code section 166 or 273.6. Agencies are encouraged to enter violation messages into CARPOS.

Notice/Proof of Service

The law enforcement agency must first determine if the restrained person had notice of the order. Consider the restrained person “served” (given notice) if (Pen. Code, § 836(c)(2)):

•The officer sees a copy of the Proof of Service or confirms that the Proof of Service is on file; or

•The restrained person was informed of the order by an officer.

An officer can obtain information about the contents of the order and proof of service in CARPOS. If proof of service on the restrained person cannot be verified, the agency must advise the restrained person of the terms of the order and then enforce it.

If the Protected Person Contacts the Restrained Person

Even if the protected person invites or consents to contact with the restrained person, this order remains in effect and must be enforced. The protected person cannot be arrested for inviting or consenting to contact with the restrained person. The order can be changed only by another court order. (Pen. Code, § 13710(b).)

This is a Court Order.

(Civil Harassment Prevention)

Case Number:

Conflicting Orders—Priorities for Enforcement

If more than one restraining order has been issued, the orders must be enforced according to the following priorities (see Pen. Code, § 136.2; Fam. Code, §§ 6383(h)(2), 6405(b)):

1.EPO: If one of the orders is an Emergency Protective Order (form EPO-001) and is more restrictive than other restraining or protective orders, it has precedence in enforcement over all other orders.

2.No Contact Order: If there is no EPO, a no-contact order that is included in a restraining or protective order has precedence over any other restraining or protective order.

3.Criminal Order: If none of the orders includes a no contact order, a domestic violence protective order issued in a

criminal case takes precedence in enforcement over any conflicting civil court order. Any nonconflicting terms of the civil restraining order remain in effect and enforceable.

4.Family, Juvenile, or Civil Order: If more than one family, juvenile, or other civil restraining or protective order has been issued, the one that was issued last must be enforced.

(Civil Harassment Prevention)

ATTACHED DESCRIPTIONS - ADDITIONAL RESPONDENTS

INSTRUCTIONS FOR USE

This form should be used as an attachment to list additional persons to be restrained on:

a. Name:

Address:________________________________________________________________ City:________________________ State:________ Zip Code:__________________

b. Name:

Address:________________________________________________________________ City:________________________ State:________ Zip Code:__________________

c. Name:

Address:________________________________________________________________ City:________________________ State:________ Zip Code:__________________

d. Name:

Address:________________________________________________________________ City:________________________ State:________ Zip Code:__________________

e. Name:

Address:________________________________________________________________ City:________________________ State:________ Zip Code:__________________

f.Name:

Address:________________________________________________________________ City:________________________ State:________ Zip Code:__________________

g. Name:

Address:________________________________________________________________ City:________________________ State:________ Zip Code:__________________

ATTACHMENT - ADDITIONAL PROTECTED PERSONS

INSTRUCTIONS FOR USE

This form should be used as an attachment to list additional protected persons on:

a. Name:

b. Name:

c. Name:

d. Name:

e. Name:

f.Name:

g. Name:

The court will complete the rest of this form.

3Notice of Hearing

A court hearing is scheduled on the request for restraining orders against the person in 2 :

Name and address of court if different from above:

4Temporary Restraining Orders (Any orders granted are on form CH-110, served with this notice.)

a. Temporary Restraining Orders for personal conduct and stay-away orders as requested in form CH-100, Request for Civil Harassment Restraining Orders, are (check only one box below):

(1) All GRANTED until the court hearing.

(2) All DENIED until the court hearing. (Specify reasons for denial in b, below.)

(3) Partly GRANTED and partly DENIED until the court hearing. (Specify reasons for denial in b, below.)

Case Number:

b. Reasons for denial of some or all of those personal conduct and stay-away orders as requested in form CH-100, Request for Civil Harassment Restraining Orders, are:

5Confidential Information Regarding Minor

b.If the request was granted, the information described in item 7 on the order (form CH-165) must be kept CONFIDENTIAL. The disclosure or misuse of the information is punishable as a sanction, with a fine of up to $1,000 or other court penalities.

6Service of Documents for the Person in 1

days before the hearing, someone age 18 or older—not you or anyone to be protected—must personally give (serve) a court’s file-stamped copy of this form CH-109 to the person in 2 along with a copy of all the forms indicated below:

a.CH-100, Request for Civil Harassment Restraining Orders (file-stamped)

b. CH-110, Temporary Restraining Order (file-stamped) IF GRANTED

c.CH-120, Response to Request for Civil Harassment Restraining Orders (blank form)

d.CH-120-INFO, How Can I Respond to a Request for Civil Harassment Restraining Orders?

e.CH-250, Proof of Service of Response by Mail (blank form)

f. CH-170, Notice of Order Protecting Information of Minor and CH-165, Order on Request to Keep Minor’s Information Confidential (file-stamped) IF GRANTED

g. Other (specify):

Date:

Judicial Officer

Case Number:

To the Person in 1 :

• The court cannot make the restraining orders after the court hearing unless the person in 2 has been personally given (served) a copy of your request and any temporary orders. To show that the person in 2 has been served, the person who served the forms must fill out a proof of service form. Form CH-200, Proof of Personal Service, may be used.

•For information about service, read form CH-200-INFO, What Is “Proof of Personal Service”?

•If you are unable to serve the person in 2 in time, you may ask for more time to serve the documents. Use form CH-115, Request to Continue Court Hearing and to Reissue Temporary Restraining Order.

To the Person in 2 :

•If you want to respond to the request for orders in writing, file form CH-120, Response to Request for Civil Harassment Restraining Orders, and have someone age 18 or older—not you or anyone to be protected—mail it to

the person in 1 .

•The person who mailed the form must fill out a proof of service form. Form CH-250, Proof of Service of Response by Mail, may be used. File the completed form with the court before the hearing and bring a copy with you to the court

hearing.

•Whether or not you respond in writing, go to the hearing if you want the judge to hear from you before making an order. You may tell the judge why you agree or disagree with the orders requested.

•You may bring witnesses and other evidence.

•At the hearing, the judge may make restraining orders against you that could last up to five years and may order you to turn in to law enforcement, or sell to or store with a licensed gun dealer, any firearms that you own or possess.

Request for Accommodations

Assistive listening systems, computer-assisted real-time captioning, or sign language interpreter services are available if you ask at least five days before the hearing. Contact the clerk’s office or go to www.courts.ca.gov/forms for Request for Accommodations by Persons with Disabilities and Response (form MC-410). (Civ. Code, § 54.8.)

(Clerk will fill out this part.)

—Clerk's Certificate—

I certify that this Notice of Court Hearing is a true and correct copy of the original on file in the court.

Clerk’s Certificate

[seal]

Date:

(Civil Harassment Prevention)

ATTACHED DESCRIPTIONS - ADDITIONAL RESPONDENTS

INSTRUCTIONS FOR USE

This form should be used as an attachment to list additional persons to be restrained on:

a. Name:

Address:________________________________________________________________ City:________________________ State:________ Zip Code:__________________

b. Name:

Address:________________________________________________________________ City:________________________ State:________ Zip Code:__________________

c. Name:

Address:________________________________________________________________ City:________________________ State:________ Zip Code:__________________

d. Name:

Address:________________________________________________________________ City:________________________ State:________ Zip Code:__________________

e. Name:

Address:________________________________________________________________ City:________________________ State:________ Zip Code:__________________

f.Name:

Address:________________________________________________________________ City:________________________ State:________ Zip Code:__________________

g. Name:

Address:________________________________________________________________ City:________________________ State:________ Zip Code:__________________

California Law Enforcement Telecommunications System (CLETS)

Information Form

This form is submitted with the initial filing (date):

This is an amended form (date):

Important: This form MUST NOT become part of the public court file. It is confidential and private.

Fill out as much of this form as you can and give it to the court clerk. If the court issues a restraining order, this form will provide law enforcement with information that will help them enforce it. If any of this information changes, fill out a new (amended) form.

Case Number (if you know it):

1Person to Be Protected (Name):

2Person to Be Restrained (Name):

3Guns or Firearms Describe any guns or firearms that you believe the person in 2 owns or has access to (Number, types, and locations):

Additional persons to be protected are listed on Attachment 4.

This is not a Court Order—Do not place in court file.

ATTACHMENT - ADDITIONAL PROTECTED PERSONS

INSTRUCTIONS FOR USE

This form should be used as an attachment to list additional protected persons on:

a. Name:

b. Name:

c. Name:

d. Name:

e. Name:

f.Name:

g. Name:

CM-010

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):

FOR COURT USE ONLY

Items 1–6 below must be completed (see instructions on page 2).

1. Check one box below for the case type that best describes this case:

factors requiring exceptional judicial management:

6.If there are any known related cases, file and serve a notice of related case. (You may use form CM-015.)

Date: