Superior Court of California, County of Sacramento

Civil Support Section

Request for a Civil Harassment Restraining Order (Step 1) Page 1 of 2 CV\E-CH-01 (Rev. 03/05/2018)

REQUEST FOR A CIVIL HARASSMENT RESTRAINING ORDER (Step 1)

OVERVIEW: Civil Harassment Restraining Orders differ from Family Law Domestic Violence Restraining Orders in that the person doing the harassing has no close family or domestic relationship with the victim. For example, a Civil Harassment Restraining Order applies to a neighbor, roommate or stranger. A Domestic Violence Restraining Order is filed in the Family Court and applies to a current or former: husband, wife, boyfriend, girlfriend or other relative. You may seek protection if you are worried about your safety because you are being stalked, threatened, harassed or sexually assaulted.

See the CH-100-INFO - Can a Civil Harassment Restraining Order Help Me? for more information.

______________________________________________________________________ REQUIRED FORMS: CH-100 Request for Civil Harassment Restraining Orders

MC-025 Attachment (if needed)

CH-109 Notice of Court Hearing

CH-110 Temporary Restraining Order (Please complete items 1, 2, & 3 only)

CLETS-001 Confidential CLETS Information

CH-130 Civil Harassment Restraining Order After Hearing (Please complete items 1, 2, & 3 only)

CM-010 Civil Case Cover Sheet

______________________________________________________________________ COPIES: One (1) original and one (1) copy of all documents are required at the time of filing.

FILING: Present completed forms to the Civil Front Counter Window 14 at the Gordon D. Schaber Sacramento County Courthouse, 720 9th Street, Room 102, Sacramento, CA 95814. The hours of operation are 8:30 a.m. to 4:00 p.m., Monday through Friday.

______________________________________________________________________ NOTE: If your forms are completed and filed by 11:30 a.m. you will receive your Order at 4:00 p.m. the same day. If the forms are filed after 11:30 a.m., then the Order will be ready for pick-up after 4:00 p.m. the next business day. The forms will be returned to you in the 1st Floor Lobby outside of Room 102 at the Gordon D. Schaber Sacramento County Courthouse, 720 9th Street, Sacramento, CA 95814.

http://www.sdcourt.ca.gov/pls/portal/url/page/sdcourt/familyandchildren2/domesticviolence

Superior Court of California, County of Sacramento

Civil Support Section

Request for a Civil Harassment Restraining Order (Step 1) Page 2 of 2 CV\E-CH-01 (Rev. 03/05/2018)

______________________________________________________________________ FILING FEE: A mandatory filing fee is required, unless filed under Code of Civil Procedure Section 527.6(x). The filing fee amount can be found at: http://saccourt.ca.gov/indexes/fees-forms.aspx. Acceptable payment types: Check, Cash, Cashiers Check, Money Order and Credit Card (Visa and MasterCard).

If you are unable to pay the filing fee, you may request a waiver of the fee by completing and filing the following forms: FW-001 Request to Waive Court Fees FW-003 Order on Court Fee Waiver (Superior Court) Fee Waiver Packets are available upon request or you may access these forms online at https://www.saccourt.ca.gov/fees/fee-waiver.aspx.

IMPORTANT INFORMATION ABOUT FILING FEE! Code of Civil Procedure Section 527.6(x) states that there is no filing fee for a petition that alleges that a person has inflicted or threatened violence against the petitioner, or stalked the petitioner, or acted or spoken in any other manner that has placed the petitioner in reasonable fear of violence, and that seeks a protective or restraining order restraining stalking or future violence or threats of violence, in any action brought pursuant to this section. No fee shall be paid for a subpoena filed in connection with a petition alleging these acts. No fee shall be paid for filing a response to a petition alleging these acts.

http://saccourt.ca.gov/indexes/fees-forms.aspxhttps://www.saccourt.ca.gov/fees/fee-waiver.aspx

CH-100 Request for Civil HarassmentRestraining OrdersClerk 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 lawyers 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 SoughtFull Name: Age:

Address (if known):

City: State: Zip:

3 Additional Protected Personsa. 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 ofpaper or form MC-025 and write Attachment 3bWhy Others Need Protection for a title.

Check here if there are more persons. Attach a sheet of paper and write Attachment 3aAdditional 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.govRevised 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

SacramentoGordon D. Schaber SacramentoCounty Courthouse720 9th StreetSacramento, CA 95814

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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 4Relationship 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

63 2

32

7 Description of HarassmentHarassment 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 theperson in ?

Other Court Casesa. 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.)YesNo

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 AbuseEviction

Guardianship

Workplace Violence

Small Claims

CriminalOther (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:

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(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):NoYesCheck 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 ord