Mendocino — CH-109

Source: http://www.courts.ca.gov/documents/ch109.pdf

CH-109 Notice of Court Hearing Clerk stamps date here when form is filed.

1 Person Seeking Protection a. Your Full Name:

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. Fill in court name and street address:
If you do not have a lawyer and want to keep your home address
Superior Court of California, County of private, you may give a different mailing address instead. You do not
have to give telephone, fax, or email.)
Address:
City: State: Zip:
Telephone: Fax: Court fills in case number when form is filed.
Email Address: Case Number:

2 Person From Whom Protection Is Sought Full Name:

The court will complete the rest of this form.

3 Notice of Hearing A court hearing is scheduled on the request for restraining orders against the person in 2 :

Name and address of court if different from above:
Hearing Date: Time:
Date Dept.: Room:

To the person in 2 : If you attend the hearing (in person, by phone, or by videoconference) and the judge grants a restraining order against you, the order will be effective immediately, and you could be arrested if you violate the order. If you do not attend the hearing, the judge may still grant the restraining order that could last up to five years. After you receive a copy of the order, you could be arrested if you violate the order.

4 Temporary Restraining Orders (Any orders granted are on form CH-110, served with this notice.) a. 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): (1) All GRANTED until the court hearing. (2) All DENIED until the court hearing. (Specify reasons for denial in b, below.) (3) Partly GRANTED and partly DENIED until the court hearing. (Specify reasons for denial in b, below.)

Judicial Council of California, courts.ca.gov Page 1 of 3Rev. January 1, 2026, Mandatory Form Notice of Court Hearing CH-109, Code Civ. Proc., §§ 527.6, 527.9 (Civil Harassment Prevention)Approved by DOJ

Case Number:

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:

(1) 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 1 and caused substantial
emotional distress.
(2) Other (specify): As stated on Attachment 4b.

5 Confidential Information Regarding Minor a. A request to keep minor’s information confidential was made (see form CH-160) and GRANTED. (See form CH-165, Order on Request to Keep Minor's Information Confidential, served with this form.) b. If the request was granted, the information described in item 7 on the order (form CH-165) must be kept CONFIDENTIAL. The disclosure or misuse of the information is punishable as a sanction, with a fine of up to $1,000 or other court penalties.

6 Service of Documents for the Person in 11 At least five 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 2 along with a copy of all the forms indicated below:

a. CH-100, Request for Civil Harassment Restraining Orders (file-stamped)
b. CH-110, Temporary Restraining Order (file-stamped) IF GRANTED
c. CH-120, Response to Request for Civil Harassment Restraining Orders (blank form)
d. CH-120-INFO, How Can I Respond to a Request for Civil Harassment Restraining Orders?
e. 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
f. Other (specify):

Date:
Judicial Officer

Rev. January 1, 2026 Notice of Court Hearing CH-109, Page 2 of 3 (Civil Harassment Prevention)

Case Number:

To the Person in 11 :

The court cannot make the restraining orders after the court hearing unless the person in 22 has been personally given (served) a copy of your request and any temporary orders. To show that the person in 2 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. For information about service, read form CH-200-INFO, What Is “Proof of Personal Service”? You may ask to reschedule the hearing if you are unable to find the person in 2 and need more time to serve the documents, or for other good reasons. Read form CH-115-INFO, How to Ask for a New Hearing Date. You must attend the hearing if you want the judge to make any of the orders you requested on form CH-100, Request for Civil Harassment Restraining Orders. Bring any evidence or witnesses you have. For more information, read form CH-100-INFO, Can a Civil Harassment Restraining Order Help Me? To the Person in 22 : 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 1 . The person who mailed the form must fill out a proof of service form. Form CH-250, Proof of Service 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. 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 (guns), firearm parts, and ammunition that you own or possess. This includes firearm receivers and frames, and any item that may be used as or easily turned into a receiver or frame (see Penal Code section 16531). If an order is granted, you will also be prohibited from owning, possessing, or buying body armor and will have to relinquish any body armor you have. If you are unable to attend your court hearing or need more time to prepare your case, you may ask to reschedule your court date. Read form CH-115-INFO, How to Ask for a New Hearing 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
courts.ca.gov/rules-forms/find-your-court-forms for Disability Accommodation Request (form
MC-410). (Civ. Code, § 54.8.)
(Clerk will fill out this part.)

—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’s Certificate
Date: [seal]

Clerk, by , Deputy

Rev. January 1, 2026 Notice of Court Hearing CH-109, Page 3 of 3 (Civil Harassment Prevention) For your protection and privacy, please press the Clear button after you have printed the form. Print Save Clear