Clerk stamps date here when form is Md. Request for Civil Harassment CH-100 ii ing Orders Restraining FILED, - i ia ‘Read Can a Civil Harassment Restraining Order Help Me? (form CH-100- Superior Court of Califor INFO) before paar this form. Also fill out Confidential CLETS County of Los Angeles Information (form CLETS-001) with as much information as you know. JUL 23 2018 ri t, wutive Uificer/Clerk @ Person Seeking Protection a ,pacotve iced . ll Name: “a Deputy * Geese Aas 0 ii Your Lawyer (ifyou have one for this case) rene an lo Nang, NA so seo cunce State Bar Nos Superior Court of California, County of FimName: NA Ls Angeles b. Your Address (Ifyou have a lawyer, give your lawyer's bola canoes in If you do not have a lawyer and want to keep your 3 eee ema Burbank, CA 91502 ‘home address private, you may give a different mailing address instead. You do not have to give telephone, fax, or e-mail.) ‘Address: P.O. BOX 6935 ‘Gaur fia case muriberwhon form is ed. City: Burbank State: CA_ Zip: 91510 ‘Case Number: : Telephone: (215) 026595 Fax —— SPDR o-01062 E-Mail Address: Person From Whom Protection Is Sought Full Name: Michael (Yahziel) Archangel Age! 4s Address (if known): None City: None State: Zip: Additional Protected Persons a. Are you asking for protection for any other family or household members? [] Yes [x] No Ifyes, list them: Full Name Sex Age Lives with you? How are they related to you? 0 Yes [] No 0 Yes (] No Oo Yes [] No 1 Yes [] No C1 Check here if there are more persons. Attach a sheet of paper and write “Attachment 3a—Additional Protected Persons” for a title. You may use form MC-025, Attachment, iy do these people need protection? (Explain below): ‘ 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 3>—Why Others Need Protection” fora title eRe oe ‘idl Coe f Cla, coat. gor OO Seen aan Request for Civil Harassment Restraining Orders (CH-100, Page 1 of (Civil Harassment Prevention) >TREK O- 01062 Relationship of Partie: How do you know the person in (2)? (Explain below): OO 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 4—Relationship of Parties” for a title. ‘Unknown Vagabond tried to befriend me in Starbucks parking lot thereafter began stalking me at nearby Walmart Venue Why are you filing in this county? (Check all that apply) a. The person in @) lives in this county. \. [&] I was harassed by the person in(2)in this county. ¢. KK Other (specify): Police Officer J. Doble said use his given alias & file for TRO at the Burbank Courthouse Other Court Cases ‘a. Have you or any of the persons named in 3)been involved in another court case with the person in @ CO Yes No (ifyes, check each kind of case and indicate where and when each was filed.) Kind of Case Filed in (County/State) Year Filed Case Number (if }nown) (1) © Civil Harassment (2) © Domestic Violence @) CO Divorce, Nullity, Legal Separation (4) ( Patemity, Parentage, Child Custody ()_ C1 Elder or Dependent Adult Abuse (© O Eviction (7) O Guardianship (8) CJ Workplace Violence 9) © Small Claims (10) CO Criminal (11) O Other (specify): i b. Are there now any protective of restraining orders in effect relating to you or any of the persons in @) and the person in(@2)? [| No [J Yes (ifyes, attach a copy if you have one.) @ Description of Harassment Harassment 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 (2) harassed you. (1) When did it happen? (provide date or estimated date): Yuly 142018 (2) Who else was there? Starbucks Employees Ashely & others; Customers, Gus, Alisa, Evelyn, Shanovi and others. Th ot a Court Order. ee Request for Civil Harassment Restraining Orders {Civil Harassment Prevention)@ . (3) How did the person in (2) harass you? (Explain below): @ (6) © Ca 0-01062 (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. Did the person in @) use or threaten to use a gun or any other weapon? & Yes (1) No (ifyes, explain below) O. 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(4)—Use of Weapons” for a title. ‘The Stalker uses a wicked looking stick to perform his personal form of Martial Arts, which he calls "Tae Kan Kick Yo Ass" or Tae Kick Yo Ass." The Stick is deadly looking, intimidating and threatening to me. He did his Martial Arts Movements in the parking lot near Starbucks while Petitioner was in her vehicle completing assignments after hours. (See Attachment 7a(4) Use of Weapons=> Photos) ‘Were you harmed or injured because of the harassment? & Yes 1 No (Ifyes, explain below): LA 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 ttle. Did the police come? [] Yes [| No If yes, did they give you or the person in (2) an Emergency Protective Order? [] Yes [] No Ifyes, the order protects (check all that apply) (J Me (1) Thepersonin@) (The persons in @). (Attach a copy of the order if you have one.) . Has the person in (2) harassed you at other times? HH Yes (No (ifyes, describe prior incidents and provide dates of harassment below): ~C Check here if there is not enough space for your answer. Put your complete answer on the attacl paper or form MC-025 and write “Attachment 7b—Previous Harassment” for a title. ‘peed eum 1.20 eek koe Request for Civil Harassment Restraining Orders (Civil Harassment Prevention) (CH-100, Page 3046 >