Free WV-110.v4.040804.ofm - California

WV-110
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, state bar number, and address): FOR COURT USE ONLY

TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name):

FAX NO. (Optional):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME:

PLAINTIFF: DEFENDANT: EMPLOYEE:

RESPONSE TO PETITION OF EMPLOYER FOR INJUNCTION PROHIBITING VIOLENCE OR THREATS OF VIOLENCE AGAINST EMPLOYEE (Workplace Violence)

CASE NUMBER:

This response will be considered by the judge at the court hearing. You must still obey any orders granted until the hearing. Read the Instructions for Petitions to Prohibit Workplace Violence (form WV-150) before completing this form. I respond to the Petition of Employer for Injunction Prohibiting Violence or Threats of Violence Against Employee as follows: 1. PERSONAL CONDUCT ORDERS a. I consent to the order requested. I do not consent to the order requested. b. I consent to the following order (specify): c.

2.

STAY-AWAY ORDERS I consent to the orders requested. a. I do not consent to the orders requested. b. I consent to the following orders (specify): c.

3.

FIREARMS PROHIBITION AND RELINQUISHMENT ORDER I do not own, possess, or control any firearms. a. I consent to the orders requested. b. I do not consent to the orders requested. c. I consent to the following orders (specify): d.

4.

OTHER ORDERS I consent to the other orders requested in the petition. a. b. I do not consent to the other orders requested in the petition. I consent to the following orders (specify): c.

5.

DENIAL a. I deny doing all of the acts stated in item 5 of the petition. I deny doing some of the acts stated in item 5 of the petition. (Specify the acts you deny doing): b.

Form Adopted for Mandatory Use Judicial Council of California WV-110 [Rev. July 1, 2004]

RESPONSE TO PETITION OF EMPLOYER FOR INJUNCTION PROHIBITING VIOLENCE OR THREATS OF VIOLENCE AGAINST EMPLOYEE (Workplace Violence)

Page 1 of 2 Code of Civil Procedure, § 527.8

American LegalNet, Inc. www.USCourtForms.com

PLAINTIFF (Name): DEFENDANT(Name):

CASE NUMBER:

6. a.

JUSTIFICATION OR EXCUSE I have done some or all of the acts of which I am accused, but the actions are justified or excused for the following reasons: My acts were lawful acts of self-defense or defense of others (specify):

b.

My acts served a legitimate purpose (specify):

c.

My acts were constitutionally protected (specify):

7.

INJUNCTION An injunction should not be granted for the following additional reasons (specify):

(If more space is needed, check the box and add additional pages as Attachment 7.) 8. EXPENSES AND COSTS I request the court to order a. expenses incurred as the result of the issuance of a temporary restraining order without sufficient supporting facts. The expenses are as follows: Item Amount

b. c. 9.

costs. Additional relief as may be proper.

NO FILING FEE I am not required to pay a filing fee for this response because the petition alleges that I have inflicted or threatened violence against an employee of the plaintiff, or stalked the employee, or acted or spoke in any other manner that has placed the employee in reasonable fear of violence, and seeks protective or restraining orders or injunctions restraining stalking or future violence or threats of violence under Code of Civil Procedure section 527.8

(Signature of attorney, if any):

(TYPE OR PRINT NAME OF ATTORNEY)

(SIGNATURE OF ATTORNEY)

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:

(TYPE OR PRINT NAME) WV-110 [Rev. July 1, 2004]

(SIGNATURE OF DEFENDANT)

Page 2 of 2

RESPONSE TO PETITION OF EMPLOYER FOR INJUNCTION PROHIBITING VIOLENCE OR THREATS OF VIOLENCE AGAINST EMPLOYEE (Workplace Violence)