Fillable CH-100-INFO Can a Civil Harassment Restraining Order Help (California)

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CH-100-INFO Can a Civil Harassment Restraining Order Help (California)

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CH-100-INFO
Can a Civil Harassment Restraining Order Help Me?
What is a civil harassment restraining
order?
It is a court order that helps protect people from
harassment.
Can I get a civil harassment restraining
order?
You can ask for one if you are worried about your
safety because someone:
•
Is harassing you
•
Is stalking you
•
Has committed acts of violence against you, or
•
Has threatened you with violence
How will the order help me?
The court can order a person to:
Not harass or threaten you
Not contact or go near you, and
Not have a gun
What forms do I need to get the order?
You must fill out all of Form CH-100, Request for Civil
Harassment Restraining Orders, and Form CLETS-001,
Confidential CLETS Information. If you need
attachments, you may use Form MC-025. You must also
fill out items 1 and 2 on Form CH-109, Notice of Court
Hearing, and items 1, 2, and 3 on Form CH-110,
Temporary Restraining Order (CLETS).
Where can I get these forms?
Judicial Council of California
www.courts.ca.gov
Revised July 1, 2014, Optional Form
Code of Civil Procedure, § 527.6
You can also ask for protection for people who live with
you and family members.
Can a Civil Harassment Restraining Order Help Me?
(Civil Harassment Prevention)
CH-100-INFO, Page 1 of 3
What do I need to do to get the order?
You must go to the superior court in the county where
the harassment took place or the person to be restrained
lives. At the court, ask where you should file your
request for a civil harassment restraining order. (A self-
help center or legal aid association may be able to assist
you in filing your request.)
At the court, give your forms to the clerk of the court.
The clerk will give you a hearing date on the Notice of
Court Hearing form, and if your request for immediate
orders is granted, a copy of the Temporary Restraining
Order signed by a judicial officer.
In a civil harassment case, the court cannot:
•
Order a person to move out of your residence
•
Order a person to pay child support to you
•
Make orders for custody and visitation
If you need these orders, you should proceed under the
Domestic Violence Protection Act. File Form DV-100.
The court also cannot:
If you need these remedies, you must file a civil action.
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.
•
Order a person to pay money that he or she owes
you
•
Order someone to move out of rental property
that you own
•
Order someone to stop creating a nuisance that
doesn't involve harassment
You can get the forms from legal publishers or on the
Internet at www.courts.ca.gov. You also may be able to
find them at your local courthouse or county law library.
How much does it cost?
That depends on the type of harassment. If the restrained
person has used or threatened to use violence against
you or has stalked you, you do not have to pay a filing
fee; otherwise, you must pay the fee.
If you cannot afford to pay the filing fee, ask the clerk
how to apply for a fee waiver. Form FW-001 is available
for this purpose.
If the order is based on prior acts of violence, a credible
threat of violence, or stalking, you are entitled to free
service of the order by a sheriff or marshal. Also, if you
are eligible for a fee waiver, you can ask the sheriff or
marshal to serve the order for free. If you are not eligible
for free service, you may pay the sheriff or marshal to
serve the order.
•
•
•
Do I have to go to court?
Yes. Go to court on the date the clerk gives you.
Do I need a lawyer?
Rev. July 1, 2014
Can a Civil Harassment Restraining Order Help Me?
(Civil Harassment Prevention)
CH-100-INFO, Page 2 of 3
Having a lawyer is always a good idea, but it is not
required and you are not entitled to a free court-
appointed attorney. Ask the court clerk about free and
low-cost legal services and self-help centers in your
county
.
What if the restrained person does not
obey the order?
Call the police. The restrained person can be arrested
and charged with a crime.
How soon can I get the order?
If you ask for a temporary restraining order, the court
will decide within 24 hours whether or not to make the
order. Sometimes the court decides sooner. Ask whether
you should wait or come back later to get the signed
Notice of Court Hearing and Temporary Restraining
Order.
How long does the order last?
If the court makes a temporary order, it will last until
your hearing date. At that time, the court will decide to
continue or cancel the order. The order could last for up
to five years.
How will the person to be restrained know
about the order?
Someone age 18 or older—not you or anyone else to be
protected by the order—must “serve” (give) the person
to be restrained a copy of the order. The server must then
fill out Form CH-200, Proof of Personal Service, and
give it to you to file with the court. For help with
service, ask the court clerk for Form CH-200-INFO,
What Is “Proof of Personal Service?”.
The court may or may not let witnesses speak at the
hearing. So, if possible, you should bring their written
statements under oath to the hearing. (You can use
Form MC-030, Declaration, for this.).
Do I need to bring a witness to the court
hearing?
Witnesses are not required, but it helps to have more
proof of the harassment than just your word. You can
bring:
•
Witnesses
•
Written statements from witnesses made under oath
•
Photos
•
Medical or police reports
•
Damaged property
•
Threatening letters, e-mails, or telephone messages
Will I see the restrained person at the court
hearing?
If the person comes to the hearing, yes. But that person
does not have the right to speak to you. If you are afraid,
tell the court officer.
Can I bring someone with me to court?
Yes. You can bring someone to sit with you during the
hearing. But that person cannot speak for you in court.
Only you or your lawyer (if you have one) can speak for
you.
CH-100-INFO
Can a Civil Harassment Restraining Order Help Me?
What if I am deaf or hard of hearing?
For help in your area, contact:
[Local information may be inserted.]
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.)
Can I agree with the restrained person to
cancel the order?
No. Once the order is issued, only the judge can change
or cancel it. You or the restrained person would have to
file a request with the court to cancel the order.
What if I don't speak English?
When you file your papers, ask the clerk if a court
interpreter is available. You may have to pay a fee for
the interpreter. If an interpreter is not available for your
court date, you should ask someone who is not listed as a
person to be protected on your Request and who is over
age 18 to interpret for you .
CH-100-INFO
Can a Civil Harassment Restraining Order Help Me?
Rev. July 1, 2014
Can a Civil Harassment Restraining Order Help Me?
(Civil Harassment Prevention)
CH-100-INFO, Page 3 of 3
G:\Common\Admin\!Projects\Local Forms\Packet Inserts\PI.10.doc Revised 02/25/16
HOW TO GET EMERGENCY ORDERS
You may ask for emergency orders if you feel you are in danger (restraining orders) or if
you need emergency custody orders to protect the minor children. See Local Rules on
reverse of this form.
Follow these steps to request emergency orders:
1. COMPLETE THE FORMS: You may obtain the forms from the Clerk’s Office, Family
Law Facilitator, the Court Website at www.ventura.courts.ca.gov or the Judicial Council
Website at www.courtinfo.gov.
2. PICK A DATE AND TIME FOR YOUR HEARING: See the schedule on reverse.
3. GIVE NOTICE TO THE OTHER PARTY:
You must tell the other party that you are
filing for this Emergency Hearing by 10 a.m. the court day before the hearing. In some
cases, you may not have to give notice – ask the Family Law Facilitator or an attorney if you
believe you would be in danger if you told the other party about this request.
NOTICE: If there is a restraining order issued against you in this case, you may not give
notice. Someone else must give notice.
4. FILE YOUR PAPERS: Be sure to file your papers with Clerk’s office no later than
2 hours before your hearing but, if possible, the day before the hearing to allow the judge
time to read your papers. If the papers are not filed on time, your case will not be heard.
5. ATTEND THE HEARING: If the judge grants your request, you will file the signed
temporary order and have the other party served with the filed papers and the order. These
emergency orders are made for only a short period of time. You will need to come back to
court in about 3 weeks or your orders may expire.
6. SERVE THE PAPERS AND ORDER ON THE OTHER PARTY:
Someone other than you
must give these papers and the order to the other party. Whoever does this must sign a
paper called a Proof of Service verifying that the papers were given to the other party
personally. You may ask the Sheriff’s Department to serve the papers. There may be a cost
to do this.
7. FILE THE PROOF OF SERVICE WITH THE COURT:
If you have not served the other
party or do not have proof that the other party was served, the judge will not hear your case.
Your case will be continued so that the papers can be served.
8. ATTEND THE SECOND HEARING: You should have an order prepared for the judge
to sign.
If you are low income or receive public assistance benefits, you may ask for a fee waiver
so you do not have to pay any filing fees. (For Domestic Violence cases there is no fee)
G:\Common\Admin\!Projects\Local Forms\Packet Inserts\PI.10.doc Revised 02/25/16
→ → → IMPORTANT!!! PLEASE READ THESE LOCAL RULES
Local Rule 9.04 Family Law Ex Parte Matters
A. EMERGENCY ORDER APPLICATIONS DISFAVORED
Emergency Orders applications are strongly disfavored. Whenever possible, in lieu of an
emergency order, the court will issue orders shortening time and set the matter for full hearing at
the regular family law and motion calendar. However, orders shortening time are also disfavored,
and must be supported by a substantial showing of need.
B. DETERMINATION BASED ON PLEADINGS
It is the court's policy to determine emergency orders based on the pleadings submitted. Thus,
requests for emergency orders normally will be determined without giving either party an
opportunity for oral argument or discussion with the court.
California Rule of Court 5.151 (d) (5) Contents of Application and Declaration
D. APPLICATIONS REGARDING CHILD CUSTODY OR VISITATION (PARENTING TIME)
Applications for emergency orders granting or modifying child custody or visitation (parenting time)
under Family Code section 3064 must: (A) Provide a full, detailed description of the most recent
incidents showing i) Immediate harm to the child as defined in Family Code Section 3064(b) or ii)
Immediate risk that the child will be removed from the State of California, (B) Specify the date of
each incident described in (A), (C) Advise the court of the existing custody and visitation
arrangements and how they would be changed by this emergency request, (D) Include a copy of
the current custody orders, if they are available. If no orders exist, explain where and with whom
the child is currently living and (E) include a completed UCCJEA (FL-105) if one has not been
previously filed or if information has changed since previously filed.
HOW TO GET A DATE FOR YOUR HEARING:
Emergency requests are heard Monday through Friday at 11:30 a.m. for cases assigned to
Courtrooms 31, 32, 33 and 35. You must call the secretary to make an appointment:
If your case is assigned to Courtroom 31, 32 or 35 call 289-8762
If your case is assigned to Courtroom 33 call 289-8772
For Domestic Violence, Harassment, Workplace Violence and Gun Violence restraining orders, or
if your case is assigned to Courtroom 34, you do not need to make an appointment. Your case will
be heard Monday through Friday at 1:30 p.m. in Courtroom 34. Exception: A Domestic Violence
request filed in an existing Family Law case will be assigned to and heard in the courtroom of the
Judicial Officer assigned to hear the existing case.
For Elder/Dependant Adult Abuse restraining orders you do not need to make an appointment.
Your case will be heard Monday through Friday at 11:30 a.m. in Courtroom 33.
ATTORNEY OF PARTY WITHOUT ATTORNEY (Name and Address) Telephone Number
ATTORNEY FOR (Name):
FOR COURT USE ONLY
SUPERIOR COURT OF CALIFORNIA, COUNTY OF VENTURA Limited Civil Case
800 SOUTH VICTORIA AVE. VENTURA, CA 93009
4353 VINEYARD AVE., OXNARD, CA 93036
PLAINTIFF/PETITIONER:
DEFENDANT/RESPONDENT:
DECLARATION RE EX PARTE NOTICE
Dom. Violence Restraining Order Civil Harassment Restraining order
Other Family Law / Custody Other Civil / Probate
CASE NUMBER:
Instructions: The person giving the notice must state how notice was given, where the hearing is to be held, and what
orders are requested. If notice is not being given, please advance to page two of this form.
I, , declare:
1. I informed the person listed above that an order would be sought in the Superior Court of Ventura County at
800 South Victoria Ave., Ventura 4353 Vineyard Ave., Oxnard
on: Date: Time: Courtroom:
Person informed: (Name) Date and time informed:
How Informed:
By telephone to the party attorney at (Telephone Number)
By leaving a message with (Name) relationship to party:
at (Telephone Number) In person
By leaving a message on voicemail of the party at (Telephone Number)
By personally informing: party attorney
In writing (copy must be attached).
2. I told him/her that the orders requested included, but were not limited to:
Domestic Violence Restraining Orders with move-out orders custody orders
Civil Harassment Restraining Orders
Custody / visitation orders, specifically:
Other:
and that he/she should appear at the above time and place if he/she wished to be heard by the court.
3. I do do not expect the other party to oppose my request.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Dated:
Signature of Declarant
DECLARATION RE EXPARTE NOTICE
VN028
Optional form
VN028 (Rev.01/14)
Page 1 of 2
DECLARATION RE: EXPARTE NOTICE - NO NOTICE GIVEN
Dom. Violence Restraining Order
Other Family Law / Custody
Civil Harassment Restraining order
Other Civil / Probate
Instructions: Notice must be given for all Ex Parte requests unless the person requesting the order can establish
exceptional circumstances to excuse notice.
1. I,
, am requesting Ex Parte orders as stated below. I am requesting that notice be
excused in this matter.
2. Ex Parte hearing is set at
800 South Victoria Ave., Ventura
3855-F Alamo St., Simi Valley
4353 Vineyard Ave., Oxnard
on: Date: Time: Courtroom:
3. I am requesting the following orders:
Domestic Violence Restraining Orders with move-out orders custody orders
Civil Harassment Restraining Orders
Custody / visitation orders, specifically:
Other Civil/Probate orders, specifically:
4.
Notice should be excused because (provide details as to why the other party should not be told, in advance, of your
request for emergency orders)
I do not have any way to give notice to the other party because:
If notice is given, I, or the children, will suffer immediate harm, specifically:
Giving notice would frustrate the purpose of this order because:
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Dated:
DECLARATION RE EXPARTE NOTICE
Optional form
VN028 (Rev.01/14)
Page 2 of 2
VN028
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address) Telephone Number
E-MAIL ADDRESS
ATTORNEY FOR (Name):
FOR COURT USE ONLY
SUPERIOR COURT OF CALIFORNIA, COUNTY OF VENTURA
800 SOUTH VICTORIA AVE. VENTURA, CA 93009
3855 – F ALAMO ST. SIMI VALLEY, CA 93063-2110
PETITIONER:
RESPONDENT:
CONSENT FOR COURT ASSIGNMENT
(FAMILY LAW)
CASE NUMBER:
The undersigned hereby consents that the cause titled and numbered above may be tried by ____________________,
Court Commissioner of the Ventura County Superior Court, as temporary judge, in accordance with Article 6, Section 21
of the Constitution of the State of California.
It is understood by the undersigned that by order of the Presiding Judge of the Ventura County Superior Court,
Commissioner ______________________ has been appointed to act as temporary judge to try the above referenced
case, hear and decide all motions and make any orders including sentencing connected with this case. It is understood
that Commissioner JoAnn Johnson, has been appointed to try the case referred to, and has taken the necessary oath of
office to try the case as temporary judge.
Dated: _____________________ Signature of litigant or attorney
___________________________________
___________________________________
___________________________________
___________________________________
VN189
CONSENT FOR COURT ASSIGNMENT
(FAMILY LAW)
Mandatory Form
VN189 (Rev. 07/12)
CH-100
Request for Civil Harassment
Restraining Orders
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California, County of
Court fills in case number when form is filed.
Case Number:
Read Can a Civil Harassment Restraining Order Help Me? (form CH-100-
INFO) before completing this form. Also fill out Confidential CLETS
Information (form CLETS-001) with as much information as you know.
Person Seeking Protection
a.
Your Full Name:
Age:
Your Lawyer (if you have one for this case)
Name: State Bar No.:
Firm Name:
b.
Your Address (If you have a lawyer, give your lawyer’s
information. If you do not have a lawyer and want to keep your
home address private, you may give a different mailing address
instead. You do not have to give telephone, fax, or e-mail.)
Address:
City: State: Zip:
Telephone: Fax:
E-Mail Address:
2
Person From Whom Protection Is Sought
Full Name: Age:
Address (if known):
City: State: Zip:
3
Additional Protected Persons
a. Are you asking for protection for any other family or household members?
Yes
No
If yes, list them:
Full Name Sex Age Lives with you? How are they related to you?
Yes
No
Yes
No
Yes
No
Yes
No
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.
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):
This is not a Court Order.
Judicial Council of California, www.courts.ca.gov
Revised January 1, 2018, Mandatory Form
Code of Civil Procedure, §§ 527.6 and 527.9
Request for Civil Harassment Restraining Orders
(Civil Harassment Prevention)
CH-100, Page 1 of 6
1
4
2
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.
5
The person in lives in this county.
I was harassed by the person in in this county.
Other (specify):
2
2
6
3
2
3
2
7
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.
2
(1)
When did it happen? (provide date or estimated date):
(2)
Who else was there?
b.
Are there now any protective or restraining orders in effect relating to you or any of the persons in and the
person in ?
Other Court Cases
a.
Have you or any of the persons named in been involved in another court case with the person in ?
How do you know the person in ? (Explain below):
Relationship of Parties
Why are you filing in this county? (Check all that apply):
b.
c.
a.
Venue
(If yes, attach a copy if you have one.)
Yes
No
This is not a Court Order.
Revised January 1, 2018
Request for Civil Harassment Restraining Orders
(Civil Harassment Prevention)
CH-100, Page 2 of 6
(1)
Civil Harassment
Domestic Violence
Divorce, Nullity, Legal Separation
Paternity, Parentage, Child Custody
Elder or Dependent Adult Abuse
Eviction
Guardianship
Workplace Violence
Small Claims
Criminal
Other (specify):
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
Kind of Case Filed in (County/State)
(If yes, check each kind of case and indicate where and when each was filed.)
Yes No
Year Filed
Case Number (if known)
Case Number:
(3)
How did the person in harass you? (Explain below):
2
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(3)—Describe Harassment” for a title.
(4) Did the person in use or threaten to use a gun or any other weapon?
2
(If yes, explain below):
NoYes
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?
(If yes, explain below):
Yes
No
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.
Did the police come?
Yes
No
If yes, did they give you or the person in an Emergency Protective Order?
2
Yes
No
If yes, the order protects (check all that apply):
Me
The person in
2
The persons in
3 .
(Attach a copy of the order if you have one.)
b. Has the person in harassed you at other times?
2
Yes No (If yes, describe prior incidents and provide dates of harassment below):
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.
This is not a Court Order.
Revised January 1, 2018
Request for Civil Harassment Restraining Orders
(Civil Harassment Prevention)
CH-100, Page 3 of 6
(6)
Case Number:
7
a.
8
Personal Conduct Orders
Harass, intimidate, molest, attack, strike, stalk, threaten, assault (sexually or otherwise), hit, abuse, destroy
personal property of, or disturb the peace of the person.
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.
Other (specify):
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 8c—Other Personal Conduct Orders,” for a
title.
9
10
Yes No I don’t know
If 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.
Does the person in own or possess any guns or other firearms?
Check the orders you want.
c.
I ask the court to order the person in not to do any of the following things to me or to any person to be
protected listed in :
a.
b.
The person in will be ordered not to take any action to get the addresses or locations of any protected person
unless the court finds good cause not to make the order.
Guns or Other Firearms and Ammunition
Request for Civil Harassment Restraining Orders
(Civil Harassment Prevention)
CH-100, Page 4 of 6
This is not a Court Order.
2
3
2
2
2
2
I ask the court to order the person in to stay at least yards away from (check all that apply):
Me.
The other persons listed in .
3
My home.
My job or workplace.
My school.
My children’s school.
My children’s place of child care.
My vehicle.
Other (specify):
If the court orders the person in to stay away from all the places listed above, will he or she still be able
to get to his or her home, school, or job?
(If no, explain below):
b.
a.
(3)
(4)
(5)
(6)
(8)
(9)
(1)
(2)
(7)
2
2
Yes No
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.
Stay-Away Orders
Case Number:
Revised January 1, 2018
Has the person in been told that you were going to go to court to seek a TRO against him/her?
11
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.
2
12
Request to Give Less Than Five Days' Notice of Hearing
2
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 12—Request to Give Less Than Five Days’ Notice” for a title.
13
No Fee for Filing or Service
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 .)
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.
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.
2
2
2
14
Lawyer's Fees and Costs
lawyer’s fees
Court costs.
$ $
$ $
$ $
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.
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 answered no, explain why below):
a.
b.
c.
If you want there to be fewer than five days between service and the hearing, explain why below:
I ask the court to order payment of my
Item Amount Item Amount
Request for Civil Harassment Restraining Orders
(Civil Harassment Prevention)
CH-100, Page 5 of 6
This is not a Court Order.
Yes
No
The amounts requested are:
Case Number:
Revised January 1, 2018
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.
2
15
Possession and Protection of Animals
17
Number of pages attached to this form, if any:
Date:
Lawyer’s name (if any)
Lawyer’s signature
Sign your name
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.
I ask the court to order the following:
Request for Civil Harassment Restraining Orders
(Civil Harassment Prevention)
CH-100, Page 6 of 6
This is not a Court Order.
Date:
Type or print your name
Case Number:
a. 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.)
b.
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.
2
Revised January 1, 2018
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.
I request sole possession of the animals because (specify good cause for granting order):
16
Additional Orders Requested
I ask the court to make the following additional orders (specify):
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 16—Additional Orders Requested,” for a title.
Form Approved for Optional Use
Judicial Council of California
MC-031 [Rev. July 1, 2005]
ATTACHED DECLARATION
PLAINTIFF/PETITIONER:
CASE NUMBER:
DEFENDANT/RESPONDENT:
MC-031
(This form must be attached to another form or court paper before it can be filed in court.)
DECLARATION
Date:
(SIGNATURE OF DECLARANT)
(TYPE OR PRINT NAME)
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Plaintiff
Other (Specify):
Defendant
Attorney for
Petitioner
Respondent
Page 1 of 1
To keep other people from seeing what you entered on your form, please press the Clear This Form button at the end of
the form when finished.
Print This Form
Clear This Form
For your protection and privacy, please press the Clear
This Form button after you have printed the form.
JUDICIAL SUBPOENA
GREETINGS:
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
Courtat thethe Honorable
located at
County of
o'clock in theday of noon, and at any recessedin room , on the , 20 , at
or adjourned date, to testify and give evidence as a witness in this action on the part of the
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result of your failure to comply.
(Attorney must sign above and type name below)
Attorney(s) for
Office and P.O. Address
Telephone No.:
Facsimile No.:
E-Mail Address:
I
Calendar No.
THE PEOPLE OF THE STATE OF NEW YORK
TO
Index No.
,
American LegalNet, Inc.
www.USCourtForms.com
Court in
Witness, Honorable , one of the Justices of the
day of , 20County,
COURT
COUNTY OF
Plaintiff(s)
-against-
Defendant(s)
:
:
:
:
:
:
:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Mobile Tel. No.:
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):
Notice of Hearing
A court hearing is scheduled on the request for restraining orders against the person in :
Your Full Name:
Your Address (If you have a lawyer, give your lawyer’s information.
If you do not have a lawyer and want to keep your home address
private, you may give a different mailing address instead. You do not
have to give telephone, fax, or e-mail.)
Person Seeking Protection
Your Lawyer (if you have one for this case):
Name: State Bar No.:
Firm Name:
Address:
City: State: Zip:
Telephone: Fax:
E-Mail Address:
Person From Whom Protection Is Sought
Full Name:
Date: Time:
Room:Dept.:
Hearing
Date
Name and address of court if different from above:
a.
b.
a
.
(1)
(2)
(3)
Temporary Restraining Orders (Any orders granted are on form CH-110, served with this notice.)
The court will complete the rest of this form.
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California, County of
Court fills in case number when form is filed.
Case Number:
All GRANTED until the court hearing.
All DENIED until the court hearing. (Specify reasons for denial in b, below.)
Partly GRANTED and partly DENIED until the court hearing. (Specify reasons for denial in b, below.)
CH-109
Notice of Court Hearing
Judicial Council of California, www.courts.ca.gov
Revised January 1, 2019, Mandatory Form
Code of Civil Procedure, § 527.6
Approved by DOJ
Notice of Court Hearing
(Civil Harassment Prevention)
CH-109, Page 1 of 3
2
1
2
3
4
At least 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
along with a copy of all the forms indicated below:
Service of Documents for the Person in
CH-100, Request for Civil Harassment Restraining Orders (file-stamped)a.
CH-120, Response to Request for Civil Harassment Restraining Orders (blank form)c.
e.
CH-120-INFO, How Can I Respond to a Request for Civil Harassment Restraining Orders?
Other (specify):
g.
d.
2
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:
b
.
(1)
(2)
1
CH-250, Proof of Service of Response by Mail (blank form)
Date:
Judicial Officer
As set forth on Attachment 4b.
The facts as stated in form CH-100 do not sufficiently show acts of violence, threats of violence, or a
course of conduct that seriously alarmed, annoyed, or harassed the person in and caused substantial
emotional distress.
Other (specify):
five
CH-110, Temporary Restraining Order (file-stamped) IF GRANTED
Rev. January 1, 2019
Notice of Court Hearing
(Civil Harassment Prevention)
CH-109, Page 2 of 3
1
Case Number:
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
Confidential Information Regarding Minor
a.
A Request to Keep Minor’s Information Confidential (form CH-160) was made and GRANTED. (See form
CH-165, Order on Request to Keep Minor's Information Confidential, served with this form.)
If the request was granted, the information described in item on the order (form CH-165) must be
kept CONFIDENTIAL. The disclosure or misuse of the information is punishable as contempt of court,
with a fine of up to $1000 or possible sanctions.
b.
8
5
6
—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, by
, Deputy
(Clerk will fill out this part.)
Date:
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.)
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 .
•
•
•
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.
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.
1
•
Clerk’s Certificate
[seal]
•
Rev. January 1, 2019
Notice of Court Hearing
(Civil Harassment Prevention)
CH-109, Page 3 of 3
To the Person in :
2
Case Number:
2
•
If you are unable to serve the person in 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.
•
For information about service, read form CH-200-INFO, What Is “Proof of Personal Service”?
The court cannot make the restraining orders after the court hearing unless the person in has been personally given
(served) a copy of your request and any temporary orders. To show that the person in 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.
•
2
To the Person in :
1
2
Description:
Protected Person
Restrained Person
Your Full Name:
Name: State Bar No.:
Firm Name:
Address:
City: State: Zip:
Telephone: Fax:
E-Mail Address:
Person in must complete items , , and only.
In addition to the person named in , the following family or household members of that person are protected by
the temporary orders indicated below:
Sex:
Full Name:
F
M
Height: Weight:
Race:Hair Color:
Date of Birth:
Eye Color: Age:
Home Address (if known):
State:
City:
Zip:
Relationship to Protected Person:
Date: Time:
Expiration Date
This Order expires at the end of the hearing scheduled for the date and time below:
The court will complete the rest of this form.
Full Name
Your Address (If you have a lawyer, give your lawyer’s information.
If you do not have a lawyer and want to keep your home address
private, you may give a different mailing address instead. You do not
have to give telephone, fax, or e-mail.):
Your Lawyer (if you have one for this case):
a.
b.
Yes No
Yes No
Yes No
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.
Yes No
Sex Age Household Member? Relation to Protected Person
a.m. p.m.
Additional Protected Persons
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California, County of
Court fills in case number when form is filed.
Case Number:
DRAFT
Not approved by
the Judicial Council
CH-110
Temporary Restraining Order
2
3
4
1
Judicial Council of California, www.courts.ca.gov
Rev. March 15, 2019, Mandatory Form
Code of Civil Procedure, §§ 527.6 and 527.9
Approved by DOJ
Temporary Restraining Order (CLETS-TCH)
(Civil Harassment Prevention)
CH-110, Page 1 of 6
This is a Court Order.
1
1 1 2 3
3
(3)
(4)
(1)
(2)
and to the other protected persons listed in :
Other (specify):
Harass, intimidate, molest, attack, strike, stalk, threaten, assault (sexually or otherwise), hit, abuse,
destroy personal property of, or disturb the peace of the person.
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.
Take any action to obtain the person’s address or location. If this item (3) is not checked, the court has
found good cause not to make this order.
Personal Conduct Orders
You must not do the following things to the person named in
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.
Other personal conduct orders are attached at the end of this Order on Attachment 5a(4).
1
No 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.
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 .
Stay-Away Order
5
7
6
a.
You must stay at least yards away from (check all that apply):
1
1
1
1
3
1
1
1
(1)
(2)
(3)
(4)
(6)
(7)
(8)
(9)
Each person in
The home of the person in
The job or workplace of the person
in
The school of the children of the
person in
The place of child care of the children of
the person in
The vehicle of the person in
Other (specify):
The person in
(5)
The school of the person in
This stay-away order does not prevent you from going to or from your home or place of employment.
b.
a.
b.
You must:
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.
b.
(1)
1
Case Number:
Not Requested
Denied Until the Hearing
Granted as Follows:
Not Requested Denied Until the Hearing
Granted as Follows:
To the Person in :
2
Rev. March 15, 2019
Temporary Restraining Order (CLETS-TCH)
(Civil Harassment Prevention)
CH-110, Page 2 of 6
This is a Court Order.
Case Number:
File a receipt with the court within 48 hours of receiving this Order that proves that your guns or
firearms have been turned in, sold, or stored. (You may use form CH-800, Proof of Firearms Turned In,
Sold, or Stored, for the receipt.)
c.
(2)
The court has received information that you own or possess a firearm.
Possession and Protection of Animals
8
Not Requested Denied Until the Hearing
Granted as Follows (specify):
a. The person in is given the sole possession, care, and control of the animals listed below, which are
owned, possessed, leased, kept, or held by him or her, or reside in his or her household.
(Identify animals by, e.g., type, breed, name, color, sex.)
1
b. 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.
2
Other Orders
9
Not Requested Denied Until the Hearing
Granted as Follows (specify):
Additional orders are attached at the end of this Order on Attachment 9.
Mandatory Entry of Order Into CARPOS Through CLETS
b.
a.
c.
This Order must be entered into the California Restraining and Protective Order System (CARPOS) through the
California Law Enforcement Telecommunications System (CLETS). (Check one):
10
1
To the Person in :
1
The clerk will enter this Order and its proof-of-service form into CARPOS.
The clerk will transmit this Order and its proof-of-service form to a law enforcement agency to be entered
into CARPOS.
By the close of business on the date that this Order is made, the person in or his or her lawyer should
deliver a copy of the Order and its proof-of-service form to the law enforcement agency listed below to
enter into CARPOS:
Name of Law Enforcement Agency
Address (City, State, Zip)
Additional law enforcement agencies are listed at the end of this Order on Attachment 10.
Rev. March 15, 2019
Temporary Restraining Order (CLETS-TCH)
(Civil Harassment Prevention)
CH-110, Page 3 of 6
This is a Court Order.
No Fee to Serve (Notify) Restrained Person
The sheriff or marshal will serve this Order without charge because:
a.
b.
Judicial Officer
1
11
12
Ordered
Not Ordered
The Order is based on unlawful violence, a credible threat of violence, or stalking.
The person in is entitled to a fee waiver.
Number of pages attached to this Order, if any:
Date:
Case Number:
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 .
Notice Regarding Nonappearance at Hearing and Service of Order
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.
2
Warnings and Notices to the Restrained Person in
You Cannot Have Guns or Firearms
2
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 above. The court will require you to prove that you did so.
7
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.
•
You must have form CH-120 served by mail on the person in 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.
•
1
After You Have Been Served With a Restraining Order
Obey all the orders.
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 .
•
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.
•
1
•
Rev. March 15, 2019
Temporary Restraining Order (CLETS-TCH)
(Civil Harassment Prevention)
CH-110, Page 4 of 6
This is a Court Order.
Case Number:
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.
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.
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 on
page 1.
4
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.
•
Whether or not you file a response, you should attend the hearing. If you have any witnesses, they must also go to the
hearing.
•
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).)
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.
Rev. March 15, 2019
Temporary Restraining Order (CLETS-TCH)
(Civil Harassment Prevention)
CH-110, Page 5 of 6
This is a Court Order.
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.
Conflicting Orders—Priorities for Enforcement
(Clerk will fill out this part.)
—Clerk's Certificate—
I certify that this Temporary Restraining Order is a true and correct copy of the
original on file in the court.
Clerk’s Certificate
[seal]
Clerk, by
, Deputy
Date:
Case Number:
Rev. March 15, 2019
Temporary Restraining Order (CLETS-TCH)
(Civil Harassment Prevention)
CH-110, Page 6 of 6
This is a Court Order.
CH-200-INFO, Page 1 of 2
What Is ''Proof of Personal Service''?
(Civil Harassment Prevention)
CH-200-INFO
What Is “Proof of Personal Service”?
What is “Service”?
Service is the act of giving your legal papers to the other party. There are many kinds of service—in person, by mail, and
others. This form is about personal or “in-person” service. The Request for Civil Harassment Restraining Orders (Form
CH-100), the Notice of Court Hearing (Form CH-109), and the Temporary Restraining Order (Form CH-110) must be
served “in person.” That means that someone must personally “serve” (give) a copy of the forms to the person to be
restrained. These forms cannot be served by mail.
Judicial Council of California, www.courts.ca.gov
Revised January 1, 2012, Optional Form
Service lets the other person know:
What orders you are asking for
The hearing date
How to respond
Who can serve?
Ask someone you know, a process server, or a law enforcement agency to
personally serve (give) a copy of the forms to the person to be restrained. You
cannot send the forms to that person by mail.
The server must:
Be 18 years of age or older
The sheriff or marshal may be authorized to serve the court’s orders for free if the
orders are based on claims of stalking, unlawful violence, or a credible threat of
violence, or if you are entitled to a fee waiver.
A “registered process server” is a business you pay to deliver court forms. Look for
“Process Serving” in the Yellow Pages or on the Internet.
Don’t serve it by mail!
(If a law enforcement agency or the process server uses a different proof-of-service
form, make sure it lists the forms served.)
How to serve
Ask the server to:
Walk up to the person to be served.
Make sure it is the right person. Ask the person’s name.
Give the person copies of all papers checked on Form CH-200, Proof of Personal Service.
Fill out and sign the Proof of Personal Service form.
Give the signed Proof of Personal Service to you.
Not be you or anyone whom you are asking to be protected by the orders
Why do I have to get the orders served?
The police cannot arrest anyone for violating an order unless that person knows about the order.
The judge cannot make the orders permanent unless the restrained person was served.
•
•
•
•
•
•
•
•
•
•
•
•
What if the person won’t take the papers or tears them up?
If the person won’t take the papers, just leave them near him or her.
It doesn’t matter if the person tears them up. Service is still complete.
•
•
.
It depends. To know the exact date, you have to look at two things on Form CH-109, Notice of Court Hearing:
First, look at the hearing date on page 1 of Form
CH-109.
When do the orders have to be served?
Look at a calendar. Subtract the number of days in from the hearing date. That is the final date to have the orders
served. It is always OK to serve earlier than that date.
If nothing is checked or written in , you must serve the orders at least five days before the hearing.
What do I do with the completed Proof of Personal Service?
Make several copies.
File the original with the court before your hearing
.
Ask the clerk to enter it into the California Law Enforcement Telecommunications System (CLETS), a special
computer system that lets police all over the state find out about the orders protecting you.
If the clerk tells you that the court cannot enter it into the computer, take a copy of the Temporary Restraining
Order (Form CH-110) and Proof of Personal Service (Form CH-200) to your local police. They will put the
information into the state computer system. That way, police all over the state will know that your restraining
order has been served.
Bring a copy of the completed Proof of Personal Service to your hearing.
CH-200-INFO, Page 2 of 2
Always keep an extra copy of the restraining orders with you for your safety.
Revised January 1, 2012
Notice of Hearing
Date: ________
Dept.: ________
Hearing
Date
3
Next, look at the number of days in item on page 2 of
Form CH-109.
What Is ''Proof of Personal Service''?
(Civil Harassment Prevention)
Who signs the Proof of Personal Service?
Only the person who serves the forms can sign Form CH-200, Proof of Personal Service. You do not sign it; the
restrained person does not need to sign it.
If someone other than the sheriff serves the papers, you should:
If the sheriff serves the papers, he or she will send the proof of service to the court and CLETS for you.
5
5
5
•
•
•
•
•
•
What happens if I can't get the orders served before the hearing date?
Before your hearing, fill out and file Form CH-115, Request to Continue Court Hearing and to Reissue Temporary
Restraining Order. This form asks the court for a new hearing date and makes your orders last until then. Ask the clerk
for the form. After the court has reissued the orders, attach a copy of Form CH-116, Notice of New Hearing Date and
Order on Reissuance, to a copy of your original orders. Ask the clerk to enter Form CH-116 into CLETS, or the clerk
may ask you or your attorney to deliver a copy to the police. That way, the police will know your orders are still in
effect.
At least five days before the hearing,
Service of Documents By the Person in
1
5
CH-200-INFO
What Is “Proof of Personal Service”?
Save This Form
Print This Form
CH-200
Proof of Personal Service
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California, County of
Court fills in case number when form is filed.
Case Number:
Notice to Server
The server must:
Be 18 years of age or older.
Not be listed in items or
of Form CH-100.
1
3
I gave the person in a copy of the forms checked below:
Give a copy of all documents checked in to the person in .
(You cannot send them by mail.) Then complete and sign this
form and give or mail it to the person in .
a.
c.
f.
g.
I personally gave copies of the documents checked above to the person in :
Zip:
State:
Server's Information
Name:
Address:
Zip:
City:
Telephone:
(If you are a registered process server):
Registration number:
County of registration:
State:
I declare under penalty of perjury under the laws of the State of California that the information above is true and
correct.
CH-200, Page 1 of 1
Proof of Personal Service
(Civil Harassment Prevention)
d.
h.
e.
•
•
•
PROOF OF PERSONAL SERVICE
3
6
4
5
2
2
1
4
b.
2
1
2
Person From Whom Protection Is Sought
Person Seeking Protection
Name:
Name:
CH-109, Notice of Court Hearing
CH-110, Temporary Restraining Order
CH-120, Response to Request for Civil Harassment Restraining Orders (blank form)
CH-100, Request for Civil Harassment Restraining Orders
CH-120-INFO, How Can I Respond to a Request for Civil Harassment Restraining Orders?
CH-800, Proof of Firearms Turned In, Sold, or Stored (blank form)
CH-130, Civil Harassment Restraining Order After Hearing
Other
(specify):
Server to sign here
Date:
Type or print server’s name
a.
b.
On (date):
At (time):
At this address:
City:
Judicial Council of California, www.courts.ca.gov
Revised July 1, 2014, Optional Form
Code of Civil Procedure, § 527.6
a.m.
p.m.
c.
THIS FORM IS TO BE USED FOR YOUR
‘PERMANENT RESTRAINING ORDER’
Prepare this form and bring it with you to the second
hearing. If the Judge grants your request for a
permanent restraining order, you must file the signed
original with the clerk and take a copy to the local
law enforcement agency.
Keep a copy with you at all times.
G:\COMMON\Admin\Family Law\Packet Instructions & Forms\Civl Harassment permanent restraining order.doc
CH-130, Page 1 of 6
Civil Harassment Restraining Order After Hearing
(CLETS-CHO)
(Civil Harassment Prevention)
Your Full Name:
Name:
State Bar No.:
Firm Name:
Your Address (If you have a lawyer, give your lawyer’s information.
If you do not have a lawyer and want to keep your home address
private, you may give a different mailing address instead. You do not
have to give telephone, fax, or e-mail.)
Address:
City: State: Zip:
Telephone: Fax:
E-Mail Address:
Your Lawyer (if you have one for this case)
a.
Full Name:
b.
Additional Protected Persons
Yes
No
Yes
No
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.
Yes
No
Yes
No
Judicial Council of California, www.courts.ca.gov
Rev. March 15, 2019, Mandatory Form
Code of Civil Procedure, §§ 527.6 and 527.9
Approved by DOJ
This Order, except for any award of lawyer’s fees, expires at
(date):
Time:
midnight onp.m.a.m.
Expiration Date
If no expiration date is written here, this Order expires three years from the date of issuance.
Height:
Weight:
Race:
Hair Color:
Date of Birth:
Eye Color:
Age:
Home Address (if known):
State:City: Zip:
Relationship to Protected Person:
M FSex:
Description:
Restrained Person
Person in must complete items , , and only.
1
1
2
3
How are they related to you?AgeSex Lives with you?
In addition to the person named in , the following family or household members of that person are protected by
the orders indicated below:
Protected Person
1
1
2
3
4
CH-130
Civil Harassment Restraining
Order After Hearing
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California, County of
Court fills in case number when form is filed.
Case Number:
DRAFT
Not approved by
the Judicial Council
Full Name
This is a Court Order.
CH-130, Page 2 of 6
Rev. March 15, 2019
Civil Harassment Restraining Order After Hearing
(CLETS-CHO)
(Civil Harassment Prevention)
This is a Court Order.
(date): at (time): in Dept.: Room:
(Name of judicial officer):
The person in .
1
The lawyer for the person in
1
(name):
The person in .
2
The lawyer for the person in
2
(name):
Additional persons present are listed at the end of this Order on Attachment 5.
The hearing is continued. The parties must return to court on (date): at (time):
These people were at the hearing:
(1)
(2)
(3)
(4)
Hearing
There was a hearing on
made the orders at the hearing.
a.
b.
c.
.
The court has granted the orders checked 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.
You must not do the following things to the person named in
3
(3)
(4)
(1)
(2)
and to the other protected persons listed in :
Harass, intimidate, molest, attack, strike, stalk, threaten, assault (sexually or otherwise), hit, abuse,
destroy personal property of, or disturb the peace of the person.
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.
Take any action to obtain the person’s address or location. If this item (3) is not checked, the court has
found good cause not to make this order.
Other (specify):
1
a.
Personal Conduct Orders
Other personal conduct orders are attached at the end of this Order on Attachment 6a(4).
5
6
7
Stay-Away Orders
a.
You must stay at least yards away from (check all that apply):
1
1
1
1
3
1
1
(1)
(2)
(3)
(4)
(6)
(7)
(8)
(9)
Each person in .
The home of the person in .
The job or workplace of the person
in .
The school of the children of the
person in .
The place of child care of the children of
the person in .
The vehicle of the person in .
Other (specify):
The person in .
1
(5) The school of the person in .
To the Person in :
2
Peaceful written contact through a lawyer or process server or other person for service of legal papers related to
a court case is allowed and does not violate this Order.
b.
Case Number:
This stay-away order does not prevent you from going to or from your home or place of employment.
b.
The court has made the necessary findings and applies the firearm relinquishment exemption under Code of
Civil Procedure section 527.9(f). Under California law, the person in is not required to relinquish this
firearm (specify make, model, and serial number of firearm(s)):
The firearm must be in his or her physical possession only during scheduled work hours and during travel to
and from his or her place of employment. Even if exempt under California law, the person in may be
subject to federal prosecution for possessing or controlling a firearm.
Lawyer's Fees and Costs
The person in must pay to the person in the following amounts for
lawyer’s fees
costs:
$
$
$
$
Additional items and amounts are attached at the end of this Order on Attachment 9.
Item
Amount Item Amount
If you have not already done so, you must:
Within 24 hours of being served with this Order, 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.
File a receipt with the court within 48 hours of receiving this Order that proves that your guns or firearms
have been turned in, sold, or stored. (You may use form CH-800, Proof of Firearms Turned In, Sold, or
Stored, for the receipt.)
b.
•
•
No 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.
8
9
Case Number:
10
a.
The person in is given the sole possession, care, and control of the animals listed below, which are
owned, possessed, leased, kept, or held by him or her, or reside in his or her household.
(Identify animals by, e.g., type, breed, name, color, sex.)
1
b.
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.
2
Other Orders (specify):
11
CH-130, Page 3 of 6
Rev. March 15, 2019
Civil Harassment Restraining Order After Hearing
(CLETS-CHO)
(Civil Harassment Prevention)
This is a Court Order.
Additional orders are attached at the end of this Order on Attachment 11.
Possession and Protection of Animals
d.
2
2
The court has received information that you own or possess a firearm.c.
CH-130, Page 4 of 6
Rev. March 15, 2019
Civil Harassment Restraining Order After Hearing
(CLETS-CHO)
(Civil Harassment Prevention)
This is a Court Order.
12
The clerk will enter this Order and its proof-of-service form into CARPOS.
The clerk will transmit this Order and its proof-of-service form to a law enforcement agency to be entered
into CARPOS.
By the close of business on the date that this Order is made, the person in or his or her lawyer should
deliver a copy of the Order and its proof-of-service form to the law enforcement agency listed below to
enter into CARPOS:
b.
a.
c.
1
Name of Law Enforcement Agency
Address (City, State, Zip)
Additional law enforcement agencies are listed at the end of this Order on Attachment 12.
Mandatory 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):
To the Person in :
1
Case Number:
13
The person in personally attended the hearing. No other proof of service is needed.
The person in did not attend the hearing.
a.
b.
Service of Order on Restrained Person
The judge’s orders in this form are different from the temporary restraining orders in form CH-110.
Someone—but not anyone in or —must personally serve a copy of this Order on the person
in .
Proof of service of form CH-110, Temporary Restraining Order, was presented to the court. The
judge’s orders in this form are the same as in form CH-110 except for the expiration date. The person in
must be served with this Order. Service may be by mail.
2
2
2
1
3
2
(2)
(1)
No Fee to Serve (Notify) Restrained Person
The Order is based on unlawful violence, a credible threat of violence, or stalking.
The person in is entitled to a fee waiver.
1
The sheriff or marshal will serve this Order without charge because:
a.
b.
14
Number of pages attached to this Order, if any:
Date:
15
Judicial Officer
You Cannot Have Guns or Firearms
CH-130, Page 5 of 6
Rev. March 15, 2019
This is a Court Order.
Civil Harassment Restraining Order After Hearing
(CLETS-CHO)
(Civil Harassment Prevention)
Unless item 8d is checked, 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 above. The court will require you to prove that you did so.
8
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 Order System (CARPOS). If the law enforcement
agency has not received proof of service on the restrained person, and the restrained person was not present at the court
hearing, 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.
Warning and Notice to the Restrained Person in :
2
Case Number:
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 it, 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 at the restraining order hearing or 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 and the restrained person was not present at the court hearing, the agency must
advise the restrained person of the terms of the order and then enforce it.
•
•
Start Date and End Date of Orders
This Order starts on the date next to the judge’s signature on page 4 and ends on the expiration date in item on page 1.
4
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 orders can be changed only by another court order. (Pen. Code, § 13710(b).)
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.
—Clerk's Certificate—
I certify that this Civil Harassment Restraining Order After Hearing is a true and
correct copy of the original on file in the court.
Clerk’s Certificate
[seal]
Clerk, by
, Deputy
(Clerk will fill out this part.)
CH-130, Page 6 of 6
Rev. March 15, 2019
Civil Harassment Restraining Order After Hearing
(CLETS-CHO)
(Civil Harassment Prevention)
This is a Court Order.
Conflicting Orders—Priorities of Enforcement
Date:
Case Number:
This is not a Court Order—Do not place in court file.
CLETS Information
Person to Be Protected (Name):
Eye Color: Date of Birth:
Hair Color:
Age:
Confidential CLETS Information
Judicial Council of California, www.courts.ca.gov
New January 1, 2012, Mandatory Form
Cal. Rules of Court, rule 1.51
F
Sex:
Height:
Weight:
Race:
M
Person to Be Restrained (Name):
Describe any marks, scars, or tattoos:
Other names used by the restrained person:
Describe any guns or firearms that you believe the person in owns or has access to
(Number, types, and locations):
1
CLETS-001, Page 1 of 1
Eye Color: Date of Birth: Hair Color:
Age:
F
Sex:
Height:
Weight:
Race:
M
4
Other People to Be Protected
Sex
Name Date of Birth
CONFIDENTIAL
CLETS-001
Additional persons to be protected are listed on Attachment 4.
Guns or Firearms
3
2
California Law Enforcement Telecommunications System (CLETS)
Information Form
Important: This form MUST NOT become part of the public court file. It is confidential and private.
Case Number (if you know it):
This form is submitted with the initial filing (date):
This is an amended form (date):
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.
1
Race
Driver’s License Number and State:
Social Security Number:
Vehicle (Type, Model, Year):
(License Number and State):
Vehicle (Type, Model, Year):
(License Number and State):
Mailing Address (listed on restraining order):
Zip:State:
City:
Telephone (optional):
Employer:
Occupation/Title:
Work Hours:
Residence Address:
Zip:State:City:
Telephone:
Business Address:
Zip:State:City:
Telephone:
Relation to
Person in
2
To keep other people from seeing what you
entered on your form, please press the Clear This
Form button at the end of the form when finished.
For your protection and privacy, please press the Clear This Form
button after you have printed the form.
Save This Form
Print This Form
Clear This Form
CH-260, Page 1 of 1
Proof of Service of Order After Hearing by Mail
(Civil Harassment Prevention)
CH-260
Proof of Service of Order
After Hearing by Mail
a. Form CH-130, Civil Harassment Restraining Order After Hearing
b. Other (specify):
I placed copies of the documents above in a sealed envelope and mailed them as described below:
Clerk stamps date here when form is filed.
PROOF OF SERVICE BY MAIL
Fill in court name and street address:
Superior Court of California, County of
Case Number:
Fill in case number:
Name:
1
Protected Person
2
Restrained Person
Name:
4
You may serve Form CH-130, Civil Harassment Restraining Order After
Hearing, on the restrained person by mail if the restrained person was not at
the hearing and:
Before the hearing, the restrained person was personally served with Form
CH-110, Temporary Restraining Order, and proof of service of Form
CH-110 was presented to the court at the hearing; and
The judge’s orders in Form CH-130 are the same as in Form CH-110
except for the expiration date.
Server’s Information
Name:
Address:
Zip:
State:City:
Telephone:
(If you are a registered process server):
Registration number:
County of registration:
5
I declare under penalty of perjury under the laws of the State of California that the information above is true and
correct.
Date:
Type or print server’s name
Server to sign here
•
•
Judicial Council of California, www.courts.ca.gov
New January 1, 2012, Optional Form
Code of Civil Procedure, § 527.6
I am 18 years of age or older and not a party to this proceeding or a person listed in item of Form CH-130. I live
or am employed in the county where the mailing took place. I mailed the restrained person a copy of:
3
3
Zip:
State:
City:
Mailed to (name):
On (date): Mailed from:
City:
State:
To this address:
a.
c.
b.
To keep other people from
seeing what you entered on
your form, please press the
Clear This Form button at the
end of the form when finished.
For your protection and privacy, please press the Clear This Form
button after you have printed the form.
Save This Form
Print This Form
Clear This Form
NOTICE
LEAVE THESE FORMS BLANK AND SERVE
ON THE DEFENDANT ALONG WITH A COPY
OF THE PETITION AND TEMPORARY
RESTRAINING ORDERS.
IF THE SHERIFF IS SERVING YOUR PAPERS,
BE SURE TO GIVE THE SHERIFF THESE
BLANK FORMS ALSO.
G:\COMMON\Admin\Family Law\Packet Instructions & Forms\Civil Harassment Notice.doc
How Can I Respond to a Request for
Civil Harassment Restraining Orders?
What is a civil harassment restraining
order?
What does the order do?
Not contact the person who asked for the order
Stay away from that person and the person’s home
and workplace
Not have any guns as long as the order is in effect
Who can ask for a civil harassment
restraining order?
Stalked
Harassed
Assaulted, including sexually, or
What if I don't obey the order?
Do I have to serve the other person with a
copy of my response?
Should I go to the court hearing?
Yes. You should go to court on the date listed on Form
CH-109, Notice of Court Hearing. If you do not go to
the hearing, the judge can make orders against you
without hearing from you.
How Can I Respond to a Request for Civil
Harassment Restraining Orders
(Civil Harassment Prevention)
CH-120-INFO, Page 1 of 2
Judicial Council of California, www.courts.ca.gov
Revised July 1, 2014, Optional Form
Code of Civil Procedure, § 527.6
•
•
•
•
•
•
•
What if I don't agree with what the order
says?
You still must obey the order until the hearing. If you
disagree with the orders the person is asking for, fill out
Form CH-120, Response to Request for Civil
Harassment Restraining Orders, before your hearing
date and file it with the court. If you need to include
attachments, you can use Form MC-025. You can get
the forms from legal publishers or on the Internet at
www.courts.ca.gov. You also may be able to find them
at your local courthouse or county law library.
Yes. Have someone age 18 or older—not you—mail a
copy of completed Form CH-120 to the person who
asked for the order (or that person’s lawyer). (This is
called “service by mail.”)
The person who serves the form by mail must fill out
Form CH-250, Proof of Service of Response by Mail.
Have the person who did the mailing sign the original.
Take the completed form back to the court clerk or bring
it with you to the hearing.
Threatened with violence
CH-120-INFO
It is a court order that prohibits you from doing certain
things and going to certain places.
A person who is worried about safety because he or she
has been or is being:
The court can order you to:
The police can arrest you. You can go to jail and pay a
fine.
I've been served with a request for civil
harassment restraining orders. What do I
do now?
Read the papers served on you very carefully. The
Notice of Court Hearing tells you when to appear in
court. There may also be a Temporary Restraining
Order forbidding you from doing certain things. You
must obey the order until the hearing.
Will I see the person who asked for the
order at the court hearing?
Can I bring a witness to the court hearing?
What if I don't speak English?
When you file your papers, ask the clerk if a court
interpreter is available. You may have to pay a fee for
the interpreter. If an interpreter is not available for your
court date, bring someone to interpret for you. You
should ask someone age 18 or older to interpret for you.
Do I need a lawyer?
Having a lawyer is always a good idea, but it is not
required, and you are not entitled to a free court-
appointed attorney. Ask the court clerk about free and
low-cost legal services and self-help centers in your
county.
What if I have a gun?
If a restraining order is issued, you cannot own, possess,
or have a gun, other firearm, or ammunition while the
order is in effect. If you have a gun or other firearm in
your immediate possession or control, you must sell it to
or store it with a licensed gun dealer, or turn it in to a
law enforcement agency.
Can I agree with the protected person to
cancel the order?
Yes. Assume that the person who is asking for the order
will attend the hearing. Do not talk to him or her unless
the judge or that person’s attorney says that you can.
Yes. You can bring witnesses or documents that support
your case to the hearing. But if possible, you should also
bring the witnesses’ written statements of what they saw
or heard. Their statements must be made under penalty
of perjury. You can use Form MC-030 for this.
If the court issued a temporary restraining order before
the hearing, it will last until your hearing date. At that
time, the court will decide to continue or cancel the
order. Any order issued at the hearing can last for up to
five years.
How long does the order last?
For help in your area, contact:
[Local information may be inserted.]
What if I am deaf or hard of hearing?
Assistive listening systems, computer-
assisted real-time captioning, or sign
language interpreter services are
available if you ask at least five court
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.)
No. Once the order is issued, only the judge can change
or cancel it. You or the protected person would have to
file a request with the court to cancel the order.
How Can I Respond to a Request for
Civil Harassment Restraining Orders?
CH-120-INFO
How Can I Respond to a Request for Civil
Harassment Restraining Orders
(Civil Harassment Prevention)
CH-120-INFO, Page 2 of 2
Revised July 1, 2014
Present your response and any opposition at the
hearing. Write your hearing date, time, and place
from form CH-109 item here:
If you were served with a Temporary
Restraining Order, you must obey it until the
hearing. At the hearing, the court may make
orders against you that last for up to five years.
3
Hearing
Date
Date:
Time:
Dept.: Room:
CH-120
Response to Request for Civil
Harassment Restraining Orders
a.
b.
a.
b.
CH-120, Page 1 of 4
Response to Request for Civil Harassment
Restraining Orders
(Civil Harassment Prevention)
Judicial Council of California, www.courts.ca.gov
Revised January 1, 2018, Mandatory Form
Code of Civil Procedure, §§ 527.6 and 527.9
c.
c.
Use this form to respond to the Request (form CH-100)
Read How Can I Respond to a Request for Civil Harassment
Restraining Orders? (form CH-120-INFO) to protect your rights.
Fill out this form and take it to the court clerk.
Have someone age 18 or older—not you—serve the person in or
his or her lawyer by mail with a copy of this form and any attached
pages. (Use form CH-250, Proof of Service of Response by Mail.)
•
•
•
Your Lawyer (if you have one for this case)
Person Seeking Protection
Person From Whom Protection Is Sought
Your Address (If you have a lawyer, give your lawyer’s information.
If you do not have a lawyer and want to keep your home address
private, you may give a different mailing address instead. You do not
have to give telephone, fax, or e-mail.)
a.
b.
1
2
3
4
5
1
1
3
3
I agree that the persons listed in item of form CH-100 may be protected by the order requested.
I do not agree that the persons listed in item of form CH-100 may be protected by the order requested.
a.
b
.
Full name of person seeking protection (see form CH-100, item ):
Your Name:
Name: State Bar No.:
Firm Name:
Address:
City:
State:
Zip:
Telephone: Fax:
E-mail Address:
I do not agree to the orders requested.
(Specify why you disagree in item on page 3.)
I agree to the orders requested.
I agree to the following orders (Specify below or in item on page 3.)
I do not agree to the orders requested. (Specify why you disagree in item on page 3.)
I agree to the orders requested.
Stay-Away Orders
I agree to the following orders (specify below or in item on page 3):
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California, County of
Court fills in case number when form is filed.
Case Number:
Additional Protected Persons
Personal Conduct Orders
11
11
11
11
A copy of the receipt
c.
I have turned in my guns and firearms to the police or sold them to or stored them with a licensed gun dealer.
is attached.
has already been filed with the court.
a.
b.
c.
I agree to the orders requested.
I do not agree to the orders requested. (Specify why you disagree in item on page 3.)
I agree to the following orders (specify below or in item on page 3):
Possession and Protection of Animals
7
11
11
I did not do anything described in item of form CH-100. (Skip to .)
7
Denial
9
Guns or Other Firearms and Ammunition
If you were served with form CH-110, Temporary Restraining Order, you cannot own or possess any guns,
other firearms, or ammunition. (See item of form CH-110.) You must 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 within 24 hours of being served with form CH-110. You must file a receipt with the court. You may
use form CH-800, Proof of Firearms Turned In, Sold or Stored, for the receipt.
7
Case Number:
a. I do not own or control any guns or firearms.
a.
b.
c.
8
I do not agree to the orders requested. (Specify why you disagree in item on page 3.)
I agree to the orders requested.
I agree to the following orders (specify below or in item on page 3):
Other Orders
11
11
6
b.
Check here if there is not enough space below for your answer. Put your complete answer on an attached
sheet of paper and write “Attachment 6b—Firearms Surrender Exemption” as a title. You may use form
MC-025, Attachment.
I ask for an exemption from the firearms prohibition under Code of Civil Procedure section 527.9(f) because
carrying a firearm is a condition of my employment, and my employer is unable to reassign me to another
position where a firearm is unnecessary. (Explain):
CH-120, Page 2 of 4
Response to Request for Civil Harassment
Restraining Orders
(Civil Harassment Prevention)
Revised January 1, 2018
11
Case Number:
If I did some or all of the things that the person in has accused me of, my actions were justified or excused for
the following reasons (explain):
1
Justification or Excuse
Check here if there is not enough space below for your answer. Put your complete answer on an attached sheet
of paper and write “Attachment 10—Justification or Excuse” as a title. You may use form MC-025, Attachment.
10
Explain your answers to each order requested that you do not agree with.
11
Reasons I Do Not Agree to the Orders Requested
Check here if there is not enough space below for your answer. Put your complete answer on an attached sheet
of paper and write “Attachment 11—Reasons I Disagree” as a title. You may use form MC-025, Attachment.
CH-120, Page 3 of 4
Response to Request for Civil Harassment
Restraining Orders
(Civil Harassment Prevention)
Revised January 1, 2018
CH-120, Page 4 of 4
Response to Request for Civil Harassment
Restraining Orders
(Civil Harassment Prevention)
Revised January 1, 2018
Case Number:
14
Date:
Lawyer’s name (if any)
Lawyer’s signature
Sign your name
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:
Type or print your name
Number of pages attached to this form, if any:
13
1
I request that I not be required to pay the filing fee because the person in claims in form CH-100
item to be entitled to free filing.
I request that I not be required to pay the filing fee because I am eligible for a fee waiver. (Form FW-001,
Request to Waive Court Fees, must be filed separately.)
a.
13
The amounts requested are:
I ask the court to order payment of my
Lawyer’s fees
Court costs.
$
$ $
$ $
Check here if there are more items. Put the items and amounts on the attached sheet of paper and write
“Attachment 13—Lawyer’s Fees and Costs” for a title. You may use or form MC-025, Attachment.
$
Item Amount Item Amount
12
a.
b.
No Fee for Filing
Lawyer's Fees and Costs
b. I ask the court to deny the request of the person asking for protection that I pay his or her lawyer’s fees
and costs.
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address) Telephone Number
E-MAIL ADDRESS
ATTORNEY FOR (Name):
FOR COURT USE ONLY
SUPERIOR COURT OF CALIFORNIA, COUNTY OF VENTURA
800 SOUTH VICTORIA AVE. VENTURA, CA 93009
3855 – F ALAMO ST. SIMI VALLEY, CA 93063-2110
PETITIONER:
RESPONDENT:
CONSENT FOR COURT ASSIGNMENT
(FAMILY LAW)
CASE NUMBER:
The undersigned hereby consents that the cause titled and numbered above may be tried by ____________________,
Court Commissioner of the Ventura County Superior Court, as temporary judge, in accordance with Article 6, Section 21
of the Constitution of the State of California.
It is understood by the undersigned that by order of the Presiding Judge of the Ventura County Superior Court,
Commissioner ______________________ has been appointed to act as temporary judge to try the above referenced
case, hear and decide all motions and make any orders including sentencing connected with this case. It is understood
that Commissioner JoAnn Johnson, has been appointed to try the case referred to, and has taken the necessary oath of
office to try the case as temporary judge.
Dated: _____________________ Signature of litigant or attorney
___________________________________
___________________________________
___________________________________
___________________________________
VN189
CONSENT FOR COURT ASSIGNMENT
(FAMILY LAW)
Mandatory Form
VN189 (Rev. 07/12)
3
CH-250, Page 1 of 1
Proof of Service of Response by Mail
(Civil Harassment Prevention)
CH-250
Proof of Service of Response by
Mail
Judicial Council of California, www.courts.ca.gov
Rev. January 1, 2012, Optional Form
Code of Civil Procedure, § 527.6
The server must:
Be 18 years of age or older.
Mail a copy of all documents
checked in to the person in .
Complete and sign this form and give
it to the person in .
•
•
Notice to Server
I am 18 years of age or older and not a party to this proceeding. I live or am employed in the county where the
mailing took place. I mailed the person in a copy of all documents checked below:
a. Form CH-120, Response to Request for Civil Harassment Restraining Orders
I declare under penalty of perjury under the laws of the State of California that the information above is true and
correct.
b. Other (specify):
Clerk stamps date here when form is filed.
•
PROOF OF SERVICE BY MAIL
3
4
14
2
1
Fill in court name and street address:
Superior Court of California, County of
Case Number:
Fill in case number:
Server’s Information
Name:
Address:
Zip:
State:City:
Telephone:
(If you are a registered process server):
Registration number:
County of registration:
6
Date:
Type or print server’s name
Server to sign here
Live or be employed in the county
where the mailing took place.
Name:
1
2
Person From Whom Protection Is Sought
Your Name:
Person Seeking Protection
•
I placed copies of the documents checked above in a sealed envelope and mailed them as described below:
5
Zip:
State:
City:
Mailed to (name):
On (date): Mailed from:
City:
State:
Not be listed in items or of Form
CH-100.
1
To this address:
a.
c.
b.
•
To keep other people from
seeing what you entered on
your form, please press the
Clear This Form button at the
end of the form when finished.
For your protection and privacy, please press the Clear This Form
button after you have printed the form.
Save This Form
Print This Form
Clear This Form
CH-800-INFO, Page 1 of 1
Judicial Council of California, www.courts.ca.gov
Rev. July 1, 2014, Optional Form
How Do I Turn In, Sell, or Store My Firearms?
(Civil Harassment Prevention)
What is a firearm?
• Rifle
• Shotgun
• Assault weapon
• Handgun
A firearm is a:
1
If you own or have a firearm you must:
• Sell it to a licensed firearms dealer, or
2
• Store it with a licensed firearms dealer
How do I sell or store my firearm?
Look under “Firearms Dealers” in your local Yellow Pages or on the Internet. Make sure the dealer is licensed.
Find a California licensed firearms dealer in your area.
3
If I turn my firearm in to law enforcement, how long will they keep it?
Ask the law enforcement agency.
5
After I give my firearm to law enforcement, can I
change my mind?
Yes. You are allowed to make one sale through a licensed gun
dealer. To do this, a licensed gun dealer must present a bill of
sale to your local law enforcement agency. The law
enforcement agency will give the licensed gun dealer the
firearm you are selling.
6
Do I have to pay the law enforcement agency to
keep my firearm?
You may have to pay the agency for keeping your firearm.
Contact your local law enforcement agency and ask if a fee is
charged. The agency will tell you how much you need to pay.
7
Call your local law enforcement agency:
(Insert local information here.)
Questions?
8
How do I take my firearm to law enforcement?
Call your local law enforcement agency to ask about their procedures. Take a copy of the restraining order with you.
Go directly to the law enforcement agency. Do not go anywhere else with firearms in your vehicle!
4
CH-800-INFO
How Do I Turn In, Sell, or Store My Firearms?
• Turn it in to local law enforcement
Signature of law enforcement agent
If the court has ordered you to turn in, sell, or store your firearms, you may use this form to prove to the court that
you have obeyed its orders. When you deliver your unloaded weapons, ask the law enforcement officer or the
licensed gun dealer to complete item or and item . After the form is signed, file it with the court clerk.
Keep a copy for yourself. For help, read Form CH-800-INFO, How Do I Turn in, Sell, or Store My Firearms?
To Law Enforcement
5
Fill out items and of this form. Keep a
copy and give the original to the person who sold
you the firearms or stored them with you.
Fill out items and of this form. Keep a
copy and give the original to the person who
turned in the firearms.
The firearms listed in were
The firearms listed in were turned in on:
To:
To:
I declare under penalty of perjury under the laws
of the State of California that the information
above is true and correct.
I declare under penalty of perjury under the laws
of the State of California that the information
above is true and correct.
CH-800, Page 1 of 2
Proof of Firearms Turned In, Sold, or Stored
(Civil Harassment Prevention)
Judicial Council of California, www.courts.ca.gov
Revised July 1, 2014, Optional Form
Code of Civil Procedure, § 527.9,
Penal Code § 29830
3
4
4 5
CH-800
Proof of Firearms Turned In, Sold,
or Stored
6
4 6
6
5
6
6
1
Protected Person
2
Restrained Person
To the Restrained Person:
Your Lawyer (if you have one for this case):
Your Address (If you have a lawyer, give your lawyer’s information.
If you do not have a lawyer and want to keep your home address
private, you may give a different mailing address instead. You do not
have to give telephone, fax, or e-mail.):
a.
b
.
Name and title of law enforcement agent
Name:
Your Name
Name: State Bar No.:
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California, County of
Court fills in case number when form is filed.
Case Number:
Firm Name:
Address:
City: State: Zip:
Telephone:
Fax:
Date: at:
a.m.
p.m.
Date: at:
a.m. p.m.
Name of law enforcement agency
Address
Name of licensed gun dealer
License number
Telephone
E-Mail Address:
To Licensed Gun Dealer
Address
Signature of gun dealer
sold to me transferred to me for storage on:
I filed a Proof of Firearms Turned In, Sold, or Stored for those firearms with the court on (date):
I am filing the proof for those firearms along with this proof.
I have not yet filed the proof for the other firearms. (Explain why not):
Revised July 1, 2014
CH-800, Page 2 of 2
Firearms
Do you have, own, possess, or control any other firearms besides the firearms listed in ?
If you answered yes, have you turned in, sold, or stored those other firearms?
If yes, check one of the boxes below:
I declare under penalty of perjury under the laws of the State of California that the information above is true and
correct.
6
7
6
Serial NumberModel
b.
c.
d.
e.
Make
a.
b.
c.
a.
Check here if you turned in, sold, or stored more firearms. Attach a sheet of paper and write “CH-800,
Item 6—Firearms Turned In, Sold, or Stored” for a title. Include make, model, and serial number of each
firearm. You may use Form MC-025, Attachment.
Yes
No
Yes
No
Check here if there is not enough space below for your answer. Put your complete answer on
the attached sheet of paper or Form MC-025 and write “Attachment 7c” for a title.
Case Number:
Date:
Type or print your name
Sign your name
Proof of Firearms Turned In, Sold, or Stored
(Civil Harassment Prevention)
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CH-100-INFO Can a Civil Harassment Restraining Order Help (California)

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Completed 9 March 2021

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