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.
è
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.
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