Amador — CH-109

Source: https://amador.courts.ca.gov/system/files/forms-and-filings/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. If Fill in court name and street address:
you do not have a lawyer and want to keep your home address private, Superior Court of California, County of
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:

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.)

www.courts.ca.govJudicial Council of California, Page 1 of 3Rev. September 1, 2022, Mandatory Form Notice of Court Hearing CH-109,

Code of Civil Procedure, § 527.6 (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 set forth on Attachment 4b.

5 Confidential Information Regarding Minor a. A Request to Keep Minor’s Information Confidential (form CH-160) was made 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 penalities.

6 Service of Documents for the Person in 1 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-250, Proof of Service by Mail (blank form) f. 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 g. Other (specify):

Date: Judicial Officer

Rev. September 1, 2022 Notice of Court Hearing CH-109, Page 2 of 3 (Civil Harassment Prevention)

Case Number:

To the Person in 1 :

• The court cannot make the restraining orders after the court hearing unless the person in 2 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”? • If you are unable to serve the person in 2 in time, you may ask for more time to serve the documents. Use form CH-115, Request to Continue Court Hearing and to Reissue Temporary Restraining Order. To the Person in 2 : • 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 that you own or possess.

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
www.courts.ca.gov/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
[seal]

Date:

Clerk, by , Deputy

Rev. September 1, 2022 Notice of Court Hearing CH-109, Page 3 of 3 (Civil Harassment Prevention) For your protection and privacy, please press the Clear This Form button after you have printed the form. Print this form Save this form Clear this form