HomeMy WebLinkAbout95-06711
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ATTORUL'( on t'Iln1Y YfltllOUJ ,UTUIINlY 1N1t",_ _"d Aohl/fnll
""5 ec... (\1,1- \---1,(_ ~~ '\.;'\.. \ ""'~ <;,
L\';}.~d- '?::. ~,~ ~ ,1 ~\
\..~C.I'>-%.\e.-(, ~~. '
'~~;~~;~~N;~~Ai~c~~A,~to~~N\3F~1-7J;u;:;~Cf::J;'--
SIn[[1 AUUIIUiS \U l.\'O p.v-4_ -S .
MAlllNQ ADllIlfSS
lnfl'UONE NO:
8u~
<,....\0 - \
"'dd-L
lOR COUltr 1151 ONtY
I~ lLl1....l
/1-u2()=~-
OHN A. CLARKr:. CLEP
~., . Ii
.I
C>1Y :'~~,~::'~:~: L-~:~"~(C/~~~'~~~__~,_________
PERSON TO liE PI\01ECTED: "S~o..l'\<'~ c...' ~ ,'\.,\.' ~ \i>rt"'!~
[-:J I'fIlTlONElllPlAINTIH
[,] I\ESrONDENIiDEHNDANT
I"':] PfTlTIDNEl1il'lAINTlff
l"~] 11I5PONDfNIIOHENDANI
PEI1S0N 10 liE I1ES1 I\AINED: '-:S', c:.-~( ~ ,I. s' \J...\' \.. \' , r.>-~~
_____.._._._~.__,____._._._________ "__._u_______._ ,:l:sr;ilJ;'M;I-jl-- -~_._._- .-- --~------
OR~ER TO SH~_~A~~;m~~I~ JI;;~Rp~~v~~;;:~~~~~~_OR~E~~~~~~) ,_.t!1,{? 0 (dl. O~_~___
1. PERSON TO DE PROTECTW (n;mwi:"><"C\.M_\-....- .....1, \.I:, I'-'\-"'~" Do';', (t < ,\Ii <:<C~ I r. A ,\! \....\.. \..('."".....,,)
(1lIsal' ill it.m III"'''''.' 01 all p",sall.' /<J b" pm,ec/lICllw this allier.! \" 1-< ~ '-\, \.t--l. \.A \ {>.. ~ -::, ,," ('\ ~ "'n),,"''''' oC
2. PERSON TO BE nESTRAI~ED (:~at".J: -:s::'.s:-.-~\C\\_,Sc:..~~ "t--\:. \.d:--', ~--':S___
G,ox: 0' M 0 F Ht,:'2"" Wt,:\0..~ Holr COIO"~~!~Y~~-"Ior~~ ,!~."a:~~ ~~~ Auo:!b~'__~_",l'~of birth: ~~: \'d- ~
To Porson to bo RastralnDd: -:':>0. ~..';, i Sc..b~ "-t~ .\...l:\ ""'^.:::>
You hov. tha right to ottand the court heurlno ond OppOBO tho application, with 01 without an attornay Dt tho date, tlmo, end placa
Bhown In tha baK below to give any leool reaBon why tha o.dors Ballohlln the attachad application BhOllld not ba glanlad. It you
do not ottend the court homing. the court may grunt tho requostod ordors. which may lost up to 3 year. without further notice to you.
I Dato: /J) _ / / _ 95 Tlmo: l~_~~~Pt':A!oC:.- Raoll1' // 0 ]
TEMPORARY RESTRAINING ORDER
This ordar ahall axplra at tha data and tha tlmo ollha hDorlng shown In the box above unless exlDnded by the court.
~ UNTIL THE TIME OF HEARING. IT IS OROEnED
3. ~ POf5on to be rostrainlld shull not contm:t, molust, nUnc". tiuiko. thlcotlln, suxually f1ssnult. bottor, tolephono. or disturu
tho poneo of tt~nniOq 10 hn protecteu ~ l~l unci tho fo\lowillU Inmilv ilnd houschVld nlUmbers (fl.,nw.<t):
1;>''"'''''''-<' 0,"'0. ,'c';:>.t.. .....l \,.\.\ .....,...'::,. \.\-",CZ-It....( "J '; \,,\.\ N-"-~
4. C) Person to ue restrained l1lust 11l1l111ll1in1Uly rnovu frum (mldmssJ:
and toko onlv 110rsonol c1nlhinH and olleclli ll11ndml until tho hmlllnn.
6. ~ Person 10 hu rostrnll1ll1t is olllmnd to I.aoy lit Inutil (s",!clf~'J: \ (:)0 ymdli nwny ham thu IHHfion 10 hu Plotoctcd Dnd
tho following pCfS0l16 Dml lllm;mi ,tlw mJdw,'is,,'S of lllmw f1/,'L'fJS lift! optimlll' tlml you clu not Ili1vtl to fCVI~iJI tlwm):
R. ~ Prolected pOltmn'6 family UlulllUU511hohlllltJInhl!lli (1IiIllW):
b. (re:l Proloclud IHHSOn'!; ,m,ltlolH:tl {.lclclmss tJ/J,itJtlilO:
c. ~I Proteclnct I1nnmn'li IllaclI of work (mlclw,'i.'; optiO"ilfJ:
d. ~1 Tho clllldrnn"i lidHlll1 or plncn ol.!;l1ihl carll (i1llclt.!ss fJptirmillJ: \
0, !':?J Other (S/,,!t',IVi: e (>. ._\ ...\ "\ ...." \ \ 0,.-1 \Y\ c ,'CJ ,,,- ~ \
(.Hldff~SS ol,t'fltlillJ: t~ L \ fl_ t' \ "; \':-"u "^ (. ."" ,
Vio/11t;on of tlrls tllml'omry IfJstrolillillY ardor is if mi:Hlmfll!iJllor. pHI,/shabln by a $1.000 fin". aile yenr III fiill. or both
or IIWY bo pl/llisllable liS 1I1,,'allY, Tills 0"1,,, 51101111", '1II10/CI1I1 by nlll;..v OlllOlCIII1II1II1 officnls ill II", SIDle of Cnlifomln,
Pen.11 COlla suetloll 72027y prohibit... lJlIY /Jurson subjt!cI to i' ftJ51mllling ardur from purch.lslng or .1ttumpling
to pure/JiJsll or otlwrwlsn olJliJill iI liwmm, Sue" cOIulm:t i.'i slIbjocl to if $1.000 lillo nlle/ Imprlsolllmmt.
Ih!IIII111lalV I1lllilrninilllllhllm I:OIlIIlHlilll OlllllVtll!;1!1
'mm .\.I"I'h',II'v 111.10' 1~'!lli III
J'hl" loll t',,,.... ,J "I 1:..l.t"I''',1
l~lfll\llIl1k\' .lllHIIIV' "I'HI ''''''''f, 'f""\
ORDER TO SItOW CAUSE AND
TF.MPaRARY IlESTIlAINING ORUER (ClETS)
! Il'Il11t"itlt~ \lil,I"ll"" p".It,."tlll,,1
1."",,'1 [w", \ n~l)ll 1'1 ~I'tl
PERSON TO BE PROTECTEO (Num~/: ~ """,C!)....\.AL C.' . \...~,
PER~ciN TO BE RESTRAINEO (,,!~m.I"'S,? ~:f'" .._~\_~ ~\X.'L~~_
6. . Coro. custody. and control 01 ItHI follow Inn minor children ora tcmpnrmlly nWllldlld tn Ilrotnctod purson: '5t!o." c...~~
Child'a flumu 'v.J. \ '- (" ~S
~c.'o-<"'ll:.1,- ~. '\..'\.- ~")
'\)... -:;, Q..-L<!. "....l. cod. '
7. l2t Exclusive tcmporary U5U. pos:,u5!ilon. LInd cUlltrol of tho followinu properly nrn tIIvm~to pro octod person: '~\!.(')..C'\E"~~
<<a'-\.\Q.."""'~ l>.'^-' ~<l.<~,,,o.,1o.\. 'v::..Q..\.o'(,\(;,~",\S, ,'~\\.,\.-\~:
(' ",..,\~\Q-~ 'c:>ebS ~~ l'...\t)~s.. ~:5,
~o\,,\Qo....\.\. C <:>\\-Q...C..:\==-. 0\_1., ~c>,....1 ,. D"JM
c... "'" '\.~\ "-..\'3, ')bu..~' ~(;IIv .I
8, ~ OTHER RDERS (sp"cify):
,f>. 4L . ~ ~\
N~
9, I'Sl
10.
11,
~
Oy lho closu of hlJsinlHm on tho datu of (hi:; oilier n COllY of this urelm nnd OilY proof of fiorvlcu shull ho Uivoll 10 lllU law on.
n ouondos IhHed below os follow!;:
rutoctod person shull dclivm.
Protectod porson's OtlUlIlUY Shilll dl!hvnr.
l.tll~Ottft-tih"I"'mnit,
Law onfarccmC!n!.!!ll!ln~y'
\-. p... ~ \\.H c'\ r;:-
\ 0 '0 'V...L I'<-l~.-::,
Ll>('c",-",,\..-,( ("",.
,
q~':)':->-;-
Foes for sorvice of this ardor hy law onforcnmcnt agoncles are waived.
Application for an ardor shortening tilTlo Is {Irnnted nnd Iho followinu dOClllTlunts shall be personally sOlved on tho dufondunt
no loss than (specify numbor): ~OJnys bufore Iho tlmo sot for homino:
D. Order to Show CausA and Temparmy Roslraininn Order (Oomefitlc Violence Provo 111 Ion I
b, AppllcDtlon ontl DDclorntlon 100m os tic Vlolellco Provontlon)
C".. Blank Responslvo Doclaratlon (Domestic Vio!onco Prevontlon)
d. D Income ond Expenso Doclaration
0_ D Declarolion Under Uniform CuslmJy of Minors Act
I. r l Othor (sp"cify):
",,\- ' y... Ol \ \~t
Adtlross \\
'----0\).-, 'vl b "(
~ ('\ alR~
YoL:,\c,e.
S~~'" ~~'
,
DnID:
~ m0f-!f.1..-S- ~
. j JIJlJGI 01 III' SIJl'[fIlOIl COUIlT
T/Jis ordor i.'i uff(!ctiVt! wlltm m.1Cle. It I:'i t.'IIforCfWh1/~ iUJvwhew ill CiJMwlli" by iJIIY I"w l!1lforccfTWlJt iJUf?ncy Ih,U 1101.') ICcoivml tilt..'
order. is .'ihown (1 copy of it. or Iw.'i v(!rili/~cI its t!xi.'iltmCI! Oil tlm Cali/omia lmv Eflforcl'mt!fIt rl!/l!cu",,,,u,,iclIlions Syslmu ,CLETS'.
I! proof of .'iervicl! CUI Ihemstminml IWfson h"s 1101 /lflmj 1f!c:,~ivl!tl. ilml till.' ff.'.'it",int.'ll IJtlt.'ifJfJ W':I." not pmsl.'III ill Illtl COlllt hea"'nfJ.
the law enforcement II!JCUlCY ."i/,,.,1I mlvl:'it.' tlw ff,'.'ilmifWd fwr.o;ofl of tlm It!""." of OJ!! Ofrlt!f mill tlw" sh..,III.'nfcuc:t! it.
lSrAll
CLERK'S CERTIFICATE
I certify Ihilt thu ItHf!UlIil\{J Ordm In SlIow Cfl1l5tl and 1'iHnpormy RU!ilrillninll Ordor (CLEfS) is u trim
nnd 1;IlIUlf:I copy nlll\fJ llfinilwllltl 1110 in Ihl1 cOllll.
Dutn:
Cll!lk, hV
_.-0._.____.0____uO.__4 .DtllultV
I;!nn l11lllu\I J.ln.""... I lH~I,11
ORDER TO SHOW CAUSE AND
TEMPORARY RESTRAINING ORDER (CLETS)
IOnnllJstlc Vlohmcu Prcvul1tlonJ
1'.lt!uh\,lI
'Jm.;o~~~~~~N'YQ.":'Z~~r:'L~\ ~ ~-(50C;Y""i"<<i",-;i" u\_ -'
'-\ 'O-LOd-d- ~'J ,~, ~,<'"1. f'-~ ~l....\O - G\.ddl:
'\...(:>.'('\.c. (It..~(l c.. ~ o-.~s?::>5 l~ lLJ!..A
AllOnNEYfOlliN.m.': e. L. ~~., L\..:' ~S
SUPERIOR COURT OF CALIFORNIA, COUNTY OF ~():S-AIfl?;E.Z:P-c;-'
SlIIlfT "OIllIl'5~ \0'-\0 "tl, ~~ ~- ~
".IlONO 'UU"ESS, '''\'\0 \/1. ~ q" ~
CtfY '''U,,"CIIU' Lj).~CI>o.,\e.rl '\ ,,=>o:::,~C:;;
""ANt".."" _oL+1,l, D,"";"~c:..~
PERSON TO BE pnOlECTED:'"SQ,c..<\c0.-\.R.- ~,~'. \.,\A ~
S ' \~. 1\.,\.:, ~)
fait coulfr USI ONt f
// -,;2 cr=~
OHN A, CLARKE, CLEP
'r"I;J-"j' ';
PERSON TO BE RESTRAINFD: '"S 0_ ~ , e.~(
C.J I'lllTIONER/PLAINTIFf
C:.II1lSPONDLNTlDEFEND^NT
r ~=:J I'ETlTIONER/PL^INTIFF
L:J nlSPONDENTiDEFENDANT
___'._______._ . 0'.'_- .________ .___.... ._ ~_~__ - _u ---- - --- --.----~---.-
APPLICATION AND DECLARATION FOR ORDER
IDomDstlc Violence Prevention Act)
rAM NlJP.lllUl
mDol;;;'02..~
D DECLARATION UNDER UNIFORM CUSTODY OF MINORS ACT
(THIS IS NOT AN ORDER!
Rend ,he Instructions lor ObwinilJg ardors Prohibiting Domestic Via/onel! btllora completing this form.
and Iiled with Order to Show ClIuse anel uHnporary Restraining Order (rurm 1296.10).
This form must be completed
1. PERSON TO BE PROTECTED (name!: :s e.C\.,.....~~, c-. \iJi. u.:. ~5
(Insert in Item I nnmes of all persons to be protected by this urden)
2, PERSON TO BE RESTRAINED (IIumol: -:SQ_\-(:.( ~( ';;;,. ~', LL. l'-<^-'::>
I Sex: 00 M D F Ht,~ o,,\~t.:~\9'OHOircolor:~EYOCOlo~1ioCO: ~J.~ . Ago~QDotool birth: S' -I;) -~
3. I am applying for 0 protoctive ordor nnd (check at lenst one):
a. ~ Tho person to be restrained nnd I (clwck at lenst one):
t 1) ~ arc married and n dissolution. 10001 separation, or nullity proceed inn
(al D Is pending (if known, specify casu no.) :.,
Ib) D?;;J Is not ponding,
(21 0 were formerly married to ench other.
(31 ~ orc rolatcd to ench other by blood, morrlogD, or udalltlon.
141 D live IlIgothor or coho bit,
(5) c:::J formerly lived together or coh;:lhltcd.
(61 D huvo hild n dating or ongonomont felationship.
171 D oro porents together of a child and the malo niUcnt is tho presumed lather tmdm Family Codo section 6200 ot 50Q.
tBI D hovo 0 minor child In common oml Ull iJction hilS boon filed undm tho Uniform Pmontaoo Act.
b. D I om 0 child CJ who Is n juvenile court dCptllHfenl (if known, s/wcily CiJSf~ liD.): -.-.----------
(11 D of 0 party,
(2} D who is tho SULJjf!ct of nn nClioll ulldm tlm Uniform P.ncntaun Act i1ncll1lY malo porent Is my prosumod father.
OU5CIILJc In dlltrlil tho most rm:ul1t incidonts of nhllllC. SWhl what hHPPul1ed, tho dates, and who did whut to whom. nnd do scribe
any injuries. Also describe nny hltilory of Uhu:iU. If IIUlIU splice is nlll1dnd. {IBach mldition<ll fJilJlOS and check this b~x: [QI \
-:s Q. ~(.- (-<( '( "-I~', \.\:\ ,~." I <:J,..j. -:s \,., '" C {;3 \'" c..o;;- \,/-11\.-;" '-l..\~,~y.., C. J:>!.~C
f\", fl.\ Q,o",-:l.\ "v...()'--<~\..'\ v><-' I...,-\-- p....\ Me ,-\<. '(, ~.:'c.\(,~ 6. '<Y\L.
\.......V\r.OI"\C\O\.lS:, f'-.0?\ ,~rc,-r_3,-v-r"_d rA'-\ \.A'_V"\"- -s""-v-.l.
\ k. S:, \ p,. \0 \--, ~_ d. \-\-,"'-::. \Z 0 \) "'" ('(\ ~~,e. ,-\, \.. Qyk-- \-\-:. "'^ "1 ,..J
? ... (\, (\ c-",,-\L u l'r''; \ 0-. f\">" J \~.~ -:-..,,,,I,,,~, S \\-1:' 0.; G ~, \-4--, '::> ~ I
D,^-k- \--,\~ Q, e. \-0 '{.., l,L ~ e., 1\... (k. l \--<'..a.\ VII-'~~
C I>-~""'Ic\e... o~ c\'e:,\)-..lo.- ::JO' ~(J ~ t'-.\\-"...,c\,\g,c\.
tCnrHilHlIld all IUVOfsol PaOG ono 0' 'our
~-- ----_.._--.------- --.-.._~._-_..--_..---.-._--
.------.----
1"1111 ."1,'.'1,'<1 I,~ 11,,1.. l.hlh
APPLICATION AND DECLARATION
1'.111"1.,. Cml.. '11;'00 "1'."11
PERS,ON TO BE PROTECTED IN,""./:)€ c..<\..,~ ~ c.. ~ " \.L. ~II--\~ I LA" NU""" "
PERSON!O BE RESTRAINED IN.m.I:-:':,eC-..... \-<! ~_~-"-_~_\..~L~L_ _'__
(THIS IS NOT AN ORDER)
4. Tho;son 10 bo rDslrolnod hos'lntontlonollv or rocklu.5lV (check 0'/011," or,e):
D. CDusod or attompted bodllV Injury to mo or unulhor.
b. causod or attempted 80,l(uol assDult on nllJ or unolhor.
c. made mo afraid 01 phvslcol or emotional hiUm.
d. modo 0 family or housohold member (n;J(rJosJ: Des"\ r t!..e <<. \.iJ 0 0 J nhnid of physicol or emotional horm,
6. Tho person to be restralnud nnd I (you must clwc.:k 0 or bJ:
Q. D hove no minor children.
b. l~ hovo children D who are juvenilo court dopendents (if knuwn. specify L'ilStf IIU'S.):
Child's naRlo \ k Ilinhcln!!! ~~ L.19.....L.-v--
~C'al.(.I,- S?J>.-....\ \j~',\..,\.\~ ~ l" "\ t....(
- -,---~~-_.._'-- --~
c. If you aro Boeklnu an order regDrdlng custody or visitation 01 your minor chlldron. complolo tho following:
(11 Each child I. now living wilh
D 1110 ~] purson 10 bu ,"strainod at (orldress oplioflall: '3 d. <: c, <'I~, ( S\.
\. c~, 'I>'- \ r::, '1-':\, ""0\\ '{ "::.~'~'-'" ~
(21 . Each child hos lived only with 010 or tho person 10 tm fCstrninnd or hoth durlnu tho lost livo yours,
(31 D I havn not partlclpated In i1ny litlgotion or procccdinu in nny state conccrninu custody of Ihis child.
(4) D I have no Information about ony pending custody pfococdinu or iJny person not n porty to this proceeding who
has physical custody or visitation rights concornlnu this minor child.
(51 If you have not checked a bmc In each of Items HI through (4). you mllst auach 0 cornplotcd Declaration Under Uniform
Custody of Minors Act IF arm /la Me-I50) und chuck this box: D ond tho box at tho top of Iho firsl pago.
I REQUEST THE COURT TO MAKE THE ORDERS INDICATED BY THE CHECK MARKS IN THE BOXES BELOW.
6, lI!l RESTRAINING ORDERS ~ To be ordered now and effective until the hearing,
Restrained person must not contac1. molest. attock. strike. threoton, soxually ussault, batter, telephone, or otherwise r
dlslurb mv pDDCO ~ ond IhDt or tho following lomilv or housohold mombers I""mesl: ~Q_'5,\'v_~ ".;:::. 00"';
~ \,\""'~-4 ,. l.c.\',~ ",-,,-:I..):'.~~
't--I..LL,~\ -..;'\<\C>- :o.x~C~'c:....
7, D RESIDENCE EXCLUSION AND RELATED ORDERS D To be orderad now end effective until the he.rlng,
Restrained person must Immediately move from and must not return to (address':
ond may taka onlv porsonal clothing Dnd eHocts.
I hove a legal right to live at tho ad dross abovo bocnuGo (specify f.lcts and attach any documont that supports your claim):
8, .. STAY.AWAY ORDERS "To be ordered now end effective until the heerlnll,o.,.,
Restrained parson, who rDsides Dt Istale 'l(Jrlress il knowfll:3:J. C"-"W. S>'" ~ \'l. "'-~, "'.\\'-{ ~,,~, t""l
and works at (statt! address if knownJ: \--J l ~
must stay at least (specifv): \<5'0 yards away from UlD folli1winf) pursons nnd plncos fth,~ IIddresses of the places Dre
optional and vou do not have to revelll tlwmJ:
a, Mvself
. and the following family or household members (mmwsJ: \'"')W;dtO v
\'-\I~\ ',\
"~(c\ "t,:I, ,
b, B!!l My re.idonco (",'rlres.optimfiJl/: '-\'dl!id'd
(::~ p......."').... .
c. ~ My placu of work laddress Ofllion~,\ ~
d. .. The childron's fichnol or plilGU of child cmo (.1ddrc:i,'; optiOflillJ:
"'" ,,,\ 'i';", ~ ",,\', \,L, l'-"~'
'.1-\ ~,\,~\:'~~ ;\, "c.. '0"" ""
~If>,-
e. ~ Olhor (specify):
(address optiona/}:
\'.,""}.
\2.--v---'"
c. ~,~
C', to-...~ "j,-,', co,4, "" \- 't. f'i\ 1',
,.r-.t I', 1;,.,<,: V"'-~_ 'L 0 "., ,,\
'-,0-( V-',LL V'...._.
ICulltimJUd un nuxl poool
CJ I'L-
"...{'\.~
Page two of fOUf
1;'1I0IRI'''' J,1IlIl.lly I, l!)!l.U
APPLICATION AND DECLARATION
IDomosllc Vlolenco Provontlonl
Foll1lly Coall, . 6200 III uq
"PERSON TO DE PROTECTED 1N,'m";~~ f'-(\I2.~-~. \ti' . \...\.{ ~- -[~:a;;;;;;,;o;.--__,_m' ---------J
PERSON TO BE IlESTnAINED 'N'''''''):_-::i<!.\~ e~~___ S' _~.:..\.(\ ~\.') /r] D 0 / ~ 0 2.. "
/THIS 'S NOT AN ORDER}
91Sl CHILD CUSTODY AND VISITATION
_ To be ordered now and effective until the hearing,
a,.
Custody (see InslllJcli(JIIs fm ObtiliflUlY GrcltH," pmhibiting Ocmltlstil..' Viu/m'Ct1 lor WI t!~JJ/;JlIiI(i(}t1 of physiclJ/,/eYll/, su/I1,
am/ juint custody)
I roquost tho custody oluum shown In Iho folluwillO colulTlns:
lhu thu 1ll1llH! 011110 PUIUIlI who lillllultl
01111010 phvslcol CUllOIly ullhu chilclllu.
low (if yew Wdm "hysic:",'ciISt"dy 'II bt1
_~~~;~I~_'~~~~,:r-IU:\ ~S.~~~"!~~;~~~t:c2 -~ :--,',~
W'.\.~.~.>
Un' 11\11 I\nlllU ullhu lJilllHlI who tlhlluld
nul Guld louul custody 01 tho child hu-
I"w (iI you wmU 'f'fI"1 clI!umly to IJejclitlt.
'!'!0.'!...!.!.~_~!!!f!..'.J'!.~~~C.I_______
"'SO\ ~~
c.. po c::, ~
",4 0 I
~ \..f(,.(\ (1).'. n~-
b. . VlsltDtlon
Restrained parson 6hould hnv(} tl10 flUhl lO viSit tho childron un followr.:
(11 1=:=1 Nono,
12) _ Supervlsod visitation.
(3) _ Vlsllullon wllh Iho lollowll1l1 olher rostricllons (sJl"cify):
Q.. ~ _(\0'" be:" f-\'Q..:.,~\i..:, N>".,O~ (\'e>\'n~ ~Q..~~
~,Q:\C'<L ~OS o.v...L.\'f\o.....\d\S\'),..l>---~'\(.l~, c..\'''''''' ,
,~U~\~) \\'I'--~V'- 't'\.L-. t--.-"~ ~,Q..OU~ c::,c...Y\.~\.~W~
~ e.. <;:Oil.- ~""'- ~ ~"\.\:O'-(-.l'
c. I nDO~ cUSlod'llHuJ visitation ordor bocnuso of the follawinu fncls (specify):
~-::se r>1..'J "-:,.. '\t~-\ \..\.\ ~'S'J -s.. ":. ~,~ ~'o"-"":.-<!.-~ ~ ",e.....
p.r....a: \-\-t--"::> ~Q.).- ~(J_ ~...,-e,,<'v_\. r:--..-.} c:,~C,^ 3D'y'\,cO... .
p...v...a\. ~S ~~,e..6.- ~Q_ Q...v-:.\'\...c.\t-e...~ \?.....'-( <;;; c. ''{', Q..l<'o~llO(\'
(If I'OU _.st ,n otdl, fo, child suppo,t, '/Iorn,y f.IS, 0' casls, ml,ch a camp/.e.d /ncom. ,nd EMp.nse O.chmJe/on (Form no, 7285.50),}
la,S CHILD SUPPORT c.. ~~E'_ '\':::, ~ ~'("\ ~'\ 1"\.0....' \
0, D I 0111 rocoivlno publiC 0.81S1011CO, ....) ..... \~b' V' 0 ..\ 4.-......
b. 1_ R03lroincd person should be ordered to pay support os specified. conunoncinu on (clnto): r\ .\,......... I
Child's nOlllo Birthduto Monlhly amount ~ 0..) ~
\2. c-;-.c;:~,- ') p;.:-~-<L"- ~~ 8(:;>C;-:-~ " \ 00, \ '-\ ,-",.
\J-r. L-'-' 1'<"'- d- U
,~~~\
c. D I requost that n wnuo i155lunrncnt hu ISSllUd.
11. B PROPERTY CONTROL IS! To be ordered now and effective until the hearing.
it. IW'lllOBt lhillllw uiwnlhn uxchmhm tllJlIpOfmy Will, 1}(}!,!;!H,tiion, and control 01 tllU followinu Ilropmly wu own or mo buyinu
'-,p"ci/y): \~<aC\ \Q..~..,. lw" J \Y\~\ I? 1.', ~~~o...\ 'oe~o~os,('\os>' 'ii',
Q () \'''_ c.~ OIJ. 0'- "--0 o\." '<.:>0-.\\ C ('>,,\)~<, I '"'" "\ \',:, l)'\,-1 I \-\. '-,
C. '" \\.A (("f\~ be ,-\'S 'i, r_ \(',\-......0.:.'".
h.. Tho orcler\ls nBCOS!HlrV hm:nU5t! (.'ipt!t:ifvJ: . _. , \
"l.. ......1-0. \....,,\,~, <Y\~\ ~'ov..."-,\V~ \)"''\...'J\"p.(\ 0 .
I'\.,...A -'l- ~"^' PU'l-1 f'-,"";, nc\, <1. y'(J~~ ("
O'~ -\-v-:> 0 l>- ,,...., <:t ~ ...\ e .. d ~- I::' ~( s;:..o <L-
u....l 0 Q. \L... ~ ~'^ ~ ~o(l.,.\- tA ,( ~ ""'. L'}.. I" \-( .
"-'~_'- \ \:-\ ~':;.\C') ~ (.1\ __ \ :~C(lIlU~l\ltJtllllI IllVlll~~I:) V p...~'~! ( 1."-,":'")
,
Pun" Ihrnn of 'our
!\ nfl. If" !\Tln"" ,..,'"' ....,-", "' n "..",......",
PER::ON TO BE PROTECTED INo",..i: ~- """..~~ ~. -....~. \...~ ..,..,.....~ :=J
PERSON TO BE RE'STRAINED INillllU/:-:;;se ~~, \{ c:,.... ,..... \". L.>:.. ~,
(THIS IS NOT AN ORDER)
CAS( NUMUfII
12, . AnORNEV FEES AND COSTS
Roslrainod porson should be ordered to pay ottornuy loos nnd costs 05 follows:
13, D RESTITUTION
I Fuquasl thot IDstrnil1nd purson should hu orderod to pay tho follnwino loul uarnin05 LJnd othor actual oxpons05 or cost of sorvices
cuusod directly by Iho violoncf! complainod of:
IYJlD 01 loss Pay 10 Amounl of claim
$
14. S COUNSELING
o. ~ I roquest thai fCfilrnilwd porsun be ordered 10 piUtic:iPiltc in hottmer's troatmont counseling. \00 ~ "'\ ~(a~
b. D I will continuo to livo with rustrained pcr:iOn ilnd I reqllost that we both bo ordered to participato in counseling 01
soparate tlmos and plncr!s [=:1 nnd Ihol rlIstroincd purson. who Is oblo to do so, bo ordered to pay tho costs of the
counselinG.
15. D OTHER ORDERS (specify otlwr ordur,,, vou request to help carry out the arelers previously ruquflsted):
16, I requesl Ihal caples of orders be glvon 10 the following law enforcDmont Dgonelos:
low Enlorcomenl Agene~ Address
L.. po. C,o"'-~"'{ ~~a-Cr:;..
\0 \0 ~ -:S.
L.~"'C.p.s),.("f, l'.f"-.
'\ ~'5~'-;
~. \-\--0\\--1 .~ l?'~
~oC-. L.e.. ~'L?\-.
I'<'~ ,~,\....( i? ~ .
\ n ~'5"'
17, 111 I requOBllhatllme for sarvlco ollho Ordor 10 Show Cau.e ond oecompDnylng popers bo shortenod so thetthey msy be
served no less Ihsn (specify nllmber): \ 0 dDYS bofore tho dale sol lor Ihe hearing, I need to have Ihe order
shortening time uecause 01 the fncts contained in this npplication. lAdc1additianal f.1Cts if nf,cessary) :
1a, ;IE I hovo boen Involved In olhor Delions with the restrallled person In which rcstraln~g o.'dcrs were ISSllOd, (If kno'Yn, please
specify case numbers or. if aVilil.1ble, aUaelJ copies of orders): ,~~t'"...;!A~ LL \=> f'. p....(""n ~CC'
, \'-\.'V') \ '" c
19. CJ I request 0 COllrl order waivino the leos pavaule to LI law enforcement Cloency for servino protoctivo ordors on the rostrained
person. A completed Application for Waiver of Court Fees and Costs is filed with this application.
I ceclare under penalty of porjury under tho laws of the State of California that the forogoino is Hue and correcl.
,/
Dato: 11- 2iJ '1~
,',"""', ,~~h',Q,~,?, .1',.,." ,\I'\"\.~'\!':t:':.5
tr'f'l>( tJlll'IllNl 'IAMO
~~'.:J~~~~c... \.~ '.&Sk--
, 1_ _.:)SIGNA1IJIH W I'lll!h)Pj 10 IIll'llOTlCflOI
PaOD 'our 01 'our
"
12901R.... J.lI\u.lIy 1. 1U941
APPLICATION AND DECLARATION
IOomostlc Violence Prevention)
CASI NUMIl'"
PEIlSON TO BE PIIOTECTED (N.m.l:
PEIlSON TO BE RESTRAINED (NDm.l:
7.0 "'OPE'"" CONTIIOL
I Ddo Ddonot
8. 0 ATTOIINEY FEER
I Ddo Ddonot
9. 0 IIESTITUTION
I Ddo Ddonot
10. 0 COUNIELlNG
I Ddo Ddonot
consent to the ardor ,oquesled.
con.ant to the order reque.tad.
consent to tho order roquested.
consent to tho ardor requested.
11. 0 OTHEIl OllDEIII (SH il.m 15 of the Appllc.tion .nd D.c/.""lon/
I D do D do not con.ent to the order reque.ted,
12. 0 I requeltthe court to order peyment of my
.. B .ttomey fe.. If I win. '
b. out-of-pocket e.pan.e, Incurred ., the re.ult at on e. perte temporery reotrelnlng order illued w"hout ,ufflclent
eupportlng fecte. Tho e.pan.es ere:
J!!!!L Amount
13, 0 I ..qu..t the following additional order.:
U't
~ :.~r:
:E: I~~ Y
~ s:'~, ~1;
tD "...--.-.1..1
M h....[ ...:..
~ ~~~ :~:.~;
14. 0 IUPPORTjMG INfO~ION
D con/i1rled 'In ;iht: inschod decleretlon
:Iioo ,,,,,:::'I
~ 1:10
I declare under penalty of perjury undDr the lew~ of tha Stete at CeUtornle that the foregoing I. trua end correct.
Dete:
~
........................ .......... ...... ....
ISIQNATUAEI
HVPE OR PAINT NAMU
1298.20IA.v J.nu.ry 1. 19D41
RESPONSIVE DECLARATION TO ORDER TO SHOW CAUSE
lDomutlc Violence Prevention I
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