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COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. :
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):

Index No.
FOR COURT USE ONLY

WV-120

: : :

Calendar No.

Plaintiff(s) -againstTELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): FAX NO. (Optional):

JUDICIAL SUBPOENA

: :

SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:

CITY AND ZIP CODE:

MAILING ADDRESS: Defendant(s) : ...................................................... BRANCH NAME:

PLAINTIFF:

THE PEOPLE OF THE STATE OF NEW YORK
DEFENDANT:

TO EMPLOYEE:
ORDER TO SHOW CAUSE TEMPORARY RESTRAINING ORDER (CLETS)
CASE NUMBER:

AND

GREETINGS:
THIS ORDER SHALL EXPIRE AT THE DATE AND THE TIME OF THE HEARING SHOWN IN THE BOX BELOW UNLESS EXTENDED BY THE COURT. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend DEFENDANT (name): 1. TOthe Honorable

before ,

at the

Court

located at County of the box in the 2. YOU ARE ORDERED to appear in this courtof the date, time,20 place shown in o'clock below to give any legal reason why the in room , on the day at , and , at noon, and at any recessed order sought and the other testify and give evidence asshould not be granted. relief requested in the petition a witness in this action on the part of the or adjourned date, to

NOTICE OF HEARING
a.

Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a is shown above is (specify): The address of the court comply. b. result of your failure towhere the hearing will be held Witness, Honorable , If you the Justices of hearing, the court 3. You have the right to attend the hearing to oppose the petition, with or without an attorney.one ofdo not attend the the may grant in requested orders without any day of notice to you. , 20 court may make these orders enforceable for a period not to the further The Court County, exceed three years, after which they may be renewed by the filing of a new petition. You should read the instructions on page 2 of this form. A complete instruction booklet (form WV-150) is available from the clerk's office located at the court shown above. (Attorney must sign above and type name below) 4. IT IS FURTHER ORDERED that
a. Plaintiff shall serve this Order to Show Cause, the attached Petition of Employer for Injunction Prohibiting Violence or Threats of Violence Against Employee (form WV-100), and any other supporting papers by (specify manner of service): no later than (date): Attorney(s) for b. Any opposition papers shall be filed and served on plaintiff by (specify manner of service): no later than (date): c. Any reply papers shall be filed and served by (specify manner of service): no later than (date): d. Proof of service of plaintiff's papers shall be delivered to the court hearing the Order to Show Cause no later Office and P.O. Address than (date): Date:

Date:

Time:

Dept.:

Room:

Form Adopted for Mandatory Use Judicial Council of California Approved by DOJ WV-120 [Rev. January 1, 2007]

Telephone No.: Facsimile No.: LAST ATTACHMENT SIGNATURE FOLLOWS Page 1 of 4 E-Mail Address: Code of Civil Proc., ORDER TO SHOW CAUSE AND TEMPORARY RESTRAINING ORDER (CLETS) 527.9; Penal Code, §§§ 527.8, 273.6(a) Mobile (Workplace Violence) Tel. No.: www.courtinfo.ca.gov
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JUDICIAL OFFICER

WV-120
PLAINTIFF (Name): DEFENDANT (Name): EMPLOYEE (Name): THE COURT FINDS 5. a. The defendant is (name): Sex: M F Ht.: Wt.:
CASE NUMBER:

TEMPORARY RESTRAINING ORDER

Hair color:

Eye color:

Race:

Age:

Date of birth:

b. The protected employee is (name): Sex: M F Date of birth:

c. Protected family or household members who reside with employee are: (1) (Name): Sex: (2) (Name): Sex: (3) (Name): Sex: M F Date of birth: Continued on Attachment 5c. M F Date of birth: M F Date of birth:

UNTIL THE TIME OF HEARING, IT IS ORDERED 6. PERSONAL CONDUCT ORDERS Defendant is prohibited from further violence or threats of violence against the protected persons and SPECIFICALLY THE COURT ORDERS THAT DEFENDANT shall not assault, batter, or stalk the employee and other protected persons a. shall not follow or stalk the employee and other protected persons to or from the place of work b. c. d. e. f. g. 7. shall not follow the employee and other protected persons during hours of employment shall not telephone or send correspondence to the employee and other protected persons by any means including, but not limited to, the use of the public or private mails, interoffice mail, fax, or computer e-mail shall not take any action to obtain the address or location of the employee or any of the employee's family members or caretakers shall not enter the workplace of the employee and other protected persons other (specify):

STAY-AWAY ORDERS yards away from the following persons and places (the Defendant is ordered to stay at least (specify): addresses of the places are optional and may be kept confidential): a. b. c. d. e. f. Employee and other protected persons named in item 5. Residence of employee and other protected persons (address optional): Place of work of employee and other protected persons (address optional): School or place of child care of children of employee and other protected persons (address optional): The employee's and other protected persons' vehicles Other (specify): (address optional):

WV-120 [Rev. January 1, 2007]

ORDER TO SHOW CAUSE AND TEMPORARY RESTRAINING ORDER (CLETS) (Workplace Violence)

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WV-120
PLAINTIFF (Name): DEFENDANT (Name): EMPLOYEE (Name): 8. 9. Contacts relating to pickup and delivery of children under a court order or a court-approved stipulation of the parties arrived at during mediation shall be permitted, unless a criminal protective or other restraining order prohibits such contacts. MANDATORY FIREARM RELINQUISHMENT ORDER The restrained person must surrender to local law enforcement or sell to a licensed gun dealer any firearms in, or subject to, his or her immediate possession or control within 24 hours of being served with this order. If the restrained person owns, possesses, or controls any firearms, he or she must file a receipt with the court showing compliance with this order within 48 hours of receiving this order. (Form WV-145 is available for this purpose.) 10. OTHER ORDERS (specify): Continued on Attachment 10. 11. SERVICE ON DEFENDANT The documents listed below must be personally served on the defendant: a. Order to Show Cause and Temporary Restraining Order (CLETS) (form WV-120) b. Petition of Employer for Injunction Prohibiting Violence or Threats of Violence Against Employee (form WV-100) c. Blank Response to Petition of Employer for Injunction Prohibiting Violence or Threats of Violence Against Employee (form WV-110) d. Blank Proof of Service by Mail of Completed Response (form WV-131) e. Blank Proof of Sale or Turning In of Firearms (form WV-145) f. Other (specify): 12. ORDER SHORTENING TIME Application for an order shortening time is granted and the documents listed in item 11 shall be personally served on the defendant by the date specified in item 4a. DELIVERY TO LAW ENFORCEMENT By the close of business on the date of this order, a copy of this order and any proof of service shall be given to the law enforcement agencies listed below as follows: a. Plaintiff shall deliver. Plaintiff's attorney shall deliver. b. Address Law enforcement agency
CASE NUMBER:

13.

Date:

JUDICIAL OFFICER SIGNATURE FOLLOWS LAST ATTACHMENT

INSTRUCTIONS FOR LAW ENFORCEMENT This order is effective when made. It is enforceable anywhere in all 50 states, the District of Columbia, all tribal lands, and all U.S. territories and shall be enforced as if it were an order of that jurisdiction by any law enforcement agency that has received the order, is shown a copy of the order, or has verified its existence on the California Law Enforcement Telecommunications System (CLETS). Violations of this restraining order are subject to criminal penalties. NOTICE REGARDING FIREARMS Any person subject to a restraining order is prohibited from owning, possessing, purchasing or attempting to purchase, receiving or attempting to receive, or otherwise obtaining a firearm. Such conduct is subject to a $1,000 fine and imprisonment. The person must surrender to local law enforcement or sell to a licensed gun dealer any firearm in or subject to his or her immediate possession or control in accordance with item 9 above.
WV-120 [Rev. January 1, 2007]

ORDER TO SHOW CAUSE AND TEMPORARY RESTRAINING ORDER (CLETS) (Workplace Violence)

Page 3 of 4

WV-120
PLAINTIFF (Name): DEFENDANT (Name): EMPLOYEE (Name):
CASE NUMBER:

INSTRUCTIONS FOR THE DEFENDANT
1. If you are served with an Order to Show Cause [OSC] (form WV-120) and a Petition of Employer for Injunction Prohibiting Violence or Threats of Violence Against Employee [Petition] (form WV-100), you should promptly seek legal advice. If you have no attorney, the attorney's reference service of your local bar association may be of assistance. 2. Read the papers served on you very carefully. The OSC tells you when to appear in court and may contain a temporary restraining order forbidding you from doing certain things. If you disobey the court's orders, criminal charges may be filed against you. 3. If you wish to oppose the Petition, or make your own request for court orders, you should file a Response to Petition of Employer for Injunction Prohibiting Violence or Threats of Violence Against Employee [Response] (form WV-110). In addition to the Response, you may file and serve declarations signed by persons who have personal knowledge of the facts. A declaration form (form MC-031) is available from the clerk's office of the court shown on page 1 of this form. If you do not know how to prepare a declaration, you should see an attorney. After you have filed the Response with the clerk of the court, a copy must be delivered personally or by mail to the plaintiff or the plaintiff's attorney. You cannot serve the plaintiff yourself. The person who serves the plaintiff should complete and sign a Proof of Service by Mail of Completed Response (form WV-131). You should take the completed form back to the court clerk or bring it with you to the hearing. 4. If you wish to oppose the petition, in addition to filing a Response you should be present at the hearing. If you have any witnesses, they must also be present. 5. An instruction booklet entitled Instructions for Petitions to Prohibit Workplace Violence (form WV-150) is available from the clerk's office at the court shown on page one of this form.

Requests for Accommodations
Assistive listening systems, computer-assisted real-time captioning, or sign language interpreter services are available if you ask at least 5 days before the hearing. Contact the clerk's office or go to www.courtinfo.ca.gov/forms for Request for Accommodations by Persons With Disabilities and Order (form MC-410). (Civil Code, § 54.8.)

WV-120 [Rev. January 1, 2007]

ORDER TO SHOW CAUSE AND TEMPORARY RESTRAINING ORDER (CLETS) (Workplace Violence)

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