Form Ch-120 - Response To Request For Civil Harassment Restraining Orders Page 3
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9Clerk stamps date here when form is filed.
Response to Request for Civil
CH-120
Harassment Restraining Orders
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
1
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.)
Person Seeking Protection
1
Name of person seeking protection (see form CH-100, item
1
):
Fill in court name and street address:
Superior Court of California, County of
Nevada
Person From Whom Protection Is Sought
2
201 Church Street
Your Name:
a.
Nevada City, CA 95959
Your Lawyer (if you have one for this case):
Name:
State Bar No.:
Firm Name:
Court fills in case number when form is filed.
Your Address (If you have a lawyer, give your lawyer's information.
.
b
Case Number:
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:
Present your response and any opposition at the
hearing. Write your hearing date, time, and place
City:
State:
Zip:
from form CH-109 item
here:
3
Telephone:
Fax:
Date:
Time:
Hearing
E-Mail Address:
Dept.:
Room:
Date
Personal Conduct Orders
3
If you were served with a Temporary
a.
I agree to the orders requested.
Restraining Order, you must obey it until the
hearing. At the hearing, the court may make
b.
I do not agree to the orders requested.
orders against you that last for up to five years.
I agree to the following orders (specify):
c.
4
Stay-Away Orders
a.
I agree to the orders requested.
b.
I do not agree to the orders requested.
c.
I agree to the following orders (specify):
Additional Protected Persons
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a.
I agree that the persons listed in item
3
of form CH-100 may be protected by the order requested.
3
b.
I do not agree that the persons listed in item
of form CH-100 may be protected by the order requested.
Judicial Council of California,
Response to Request for Civil Harassment
CH-120,
Page 1 of 3
Revised January 1, 2017, Mandatory Form
Code of Civil Procedure, §§ 527.6 and 527.9
Restraining Orders
(Civil Harassment Prevention)
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