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Petition For Private Postsecondary School Violence Restraining Orders SV-100 - California
| Petition For Private Postsecondary School Violence Restraining Orders Form. This is a California form and can be used in School Violence Prevention Judicial Council . |
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SV-100 Petition for Private Postsecondary School Violence Restraining Orders Clerk stamps date here when form is filed. Read How Do I Get a Private Postsecondary School Violence Restraining Order? (Form SV-100-INFO) before completing this form. Also fill out Confidential CLETS Information (Form CLETS-001) with as much information as you know. 1 Petitioner (Educational Institution Officer or Employee) a. Name: is the chief administrative officer an officer or employee designated by the chief administrative officer to maintain order on the campus or facility of (name of private postsecondary educational institution): Fill in court name and street address: Superior Court of California, County of and is filing this petition on behalf of the student in 2 . b. Lawyer for Petitioner (if any for this case): State Bar No.: Name: Firm Name: Court fills in case number when form is filed. Case Number: c. Petitioner's Address (If the petitioner has a lawyer, give the lawyer's information): Address: City: Telephone: 2 Fax: State: E-Mail Address: Zip: Student in Need of Protection Full Name: Sex: M F Age: 3 Respondent (Person From Whom Protection Is Sought) Full Name: Address (if known): City: State: Zip: Age: 4 Additional Protected Persons a. Are you asking for protection for any family or household members or any other students at the campus or facility who are similarly in need of protection? Yes No If yes, list them: Full Name Sex Age Household Member? Relationship to Student Yes Yes Yes Additional protected persons are listed in Attachment 4a. No No No This is not a Court Order. Judicial Council of California, www.courts.ca.gov Revised January 1, 2012, Mandatory Form Code of Civil Procedure, ยงยง 527.85 and 527.9 Petition for Private Postsecondary School Violence Restraining Orders (Private Postsecondary School Violence Prevention) SV-100, Page 1 of 6 American LegalNet, Inc. www.FormsWorkFlow.com Case Number: b. Why do these people need protection? (Explain): Response is stated in Attachment 4b. 5 Relationship of Student and Respondent a. How does the student know the respondent? (Describe): Response is stated in Attachment 5a. b. Respondent is is not a current student of petitioner's institution. (Explain any decision to retain, expel, or otherwise discipline the respondent.) Response is stated in Attachment 5b. 6 Venue Why are you filing in this county? (Check all that apply): a. The respondent lives in this county. b. c. The respondent has caused physical or emotional injury to the student in this county. Other (specify): 7 Other Court Cases a. Has the student or any of the persons named in 4 been involved in another court case with the respondent? No Yes If yes, check each kind of case and indicate where and when each was filed: (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) Kind of Case Postsecondary School Violence Civil Harassment Domestic Violence Divorce, Nullity, Legal Separation Paternity, Parentage, Child Support Eviction Guardianship Workplace Violence Small Claims Criminal Other (specify): Filed in (County/State) Year Filed Case Number (if known) b. Are there now any restraining orders or criminal protective orders in effect relating to the student or any of the persons in 4 and the respondent? No Yes If yes, attach a copy if you have one. This is not a Court Order. Revised January 1, 2012 Petition for Private Postsecondary School Violence Restraining Orders (Private Postsecondary School Violence Prevention) SV-100, Page 2 of 6 Case Number: 8 Description of Respondent's Conduct a. Respondent has (check one or more): (1) Assaulted, battered, or stalked the student (2) Made a credible threat of violence against the student by making knowing or willful statements or engaging in a course of conduct that served no legitimate purpose and that would place a reasonable person in fear for his or her safety or the safety of his or her immediate family b. One or more of these acts were made off the school campus or facility and can reasonably be understood (check either or both): (1) To have been carried out at the school campus or facility (2) To be carried out in the future at the school campus or facility Address of campus or facility: c. Describe what happened. (Provide details; include the dates of all incidents beginning with the most recent; tell who did what to whom; identify any witnesses): Response is stated in Attachment 8c. d. Was the student harmed or injured? Response is stated in Attachment 8d. Yes No If yes, describe harm or injuries: e. Did the respondent use or threaten to use a gun or any other weapon? Response is stated in Attachment 8e. Yes No If yes, describe: This is not a Court Order. Revised January 1, 2012 Petition for Private Postsecondary School Violence Restraining Orders (Private Postsecondary School Violence Prevention) SV-100, Page 3 of 6 Case Number: f. For any of the incidents described above, did the police come? Yes No I don't know If yes, did the student or the respondent receive an Emergency Protective Order? Yes No I don't know If yes: The order protects (check all that apply): (3) (2) (1) The respondent One or more of the persons in 4 The student Attach a copy of the order if you have one. Check the orders you want. 9 Personal Conduct Orders I ask the court to order the respondent not to do any of the following things to the student or to any person to be protected listed in 4 : a. b. c. d. Harass, intimidate, molest, attack, strike, stalk, threaten, assault (sexually or otherwise), hit, abuse, destroy personal property of, or disturb the peace of the person. Make threats of violence to the person. Follow or stalk the person during school hours or to or from the school campus or facility. Contact the person, directly or indirectly, by any means, including but not limited to, in person, by telephone, in writing, by public or private mail, by interoffice mail, by e-mail, by text message, by fax, or by other electronic means. Enter the person's school campus or facility. Other (specify): As stated in Attachment 9f. e. f. The respondent will be ordered not to take any action to get the addresses or locations of any protected person unless the court finds good cause not to make the order. 10 Stay-Away Order a. I ask the court to order the respondent to stay at least (1) (2) (3) (4) (5) (6) The student The other persons listed in 4 The school The student's home The student's job or workplace The school of the student's children (7) (8) (9) yards away
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