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Here is the text we could read:

Clerk stamps date here when form is filed.

CH-120

Response to Request for Civil
Harassment Restraining Orders

Use this form to respond to the Request (form CH-100)
• Read How Can I Respond to a Request for Civil Harassment

Restraining Orders? (form CH-120-INFO) to protect your rights.

• Fill out this form and take it to the court clerk.
• Have someone age 18 or older—not you—serve the person in or
his or her lawyer by mail with a copy of this form and any attached
pages. (Use form CH-250, Proof of Service by Mail.)

1 Person Seeking Protection

Full name of person seeking protection (see form CH-100, item ):1

2 Person From Whom Protection Is Sought

a. Your Name:

Your Lawyer (if you have one for this case)
Name:
Firm Name:

State Bar No.:

b. Your Address (If you have a lawyer, give your lawyer’s information.
If you do not have a lawyer and want to keep your home address
private, you may give a different mailing address instead. You do not
have to give telephone, fax, or email.)
Address:

City:

Telephone:

Email Address:

State:

Zip:

Fax:

Personal Conduct Orders

I agree to the orders requested.

I do not agree to the orders requested.
(Specify why you disagree in item on page 3.)

I agree to the following orders (Specify below or in item on page 3.)

Fill in court name and street address:

Superior Court of California, County of

Court fills in case number when form is filed.

Case Number:

Present your response and any opposition at the
hearing. Write your hearing date, time, and place
from form CH-109 item here:
3

Hearing
Date

Ł Date:
Dept.:

Time:

Room:

If you were served with a Temporary
Restraining Order, you must obey it until the
hearing. At the hearing, the court may make
orders against you that last for up to five years.

Stay-Away Orders

I agree to the orders requested.
I do not agree to the orders requested. (Specify why you disagree in item on page 3.)

I agree to the following orders (specify below or in item on page 3):

a.
b.

Additional Protected Persons

I agree that the persons listed in item of form CH-100 may be protected by the order requested.

I do not agree that the persons listed in item of form CH-100 may be protected by the order requested.

Judicial Council of California,
Rev. January 1, 2023, Mandatory Form
Code of Civil Procedure, §§ 527.6 and 527.9

Response to Request for Civil Harassment
Restraining Orders
(Civil Harassment Prevention)

CH-120, Page 1 of 4

Case Number:

Firearms (Guns), Firearm Parts, and Ammunition
If you were served with form CH-110, Temporary Restraining Order, you cannot own or possess any firearms
(guns), firearm parts, or ammunition. This includes firearm receivers and frames, and any item that may be
used as or easily turned into a receiver or frame (see Penal Code section 16531). (See item of form
CH-110.) You must sell to or store with a licensed gun dealer, or turn in to a law enforcement agency, any
firearms (guns) or firearm parts in your immediate possession or control within 24 hours of being served
with form CH-110. You must file a receipt with the court. You may use Receipt for Firearms and Firearm
Parts (form CH-800) for the receipt.
a.

I do not own or control any firearms (guns), firearm parts, or ammunition.

I ask for an exemption from the firearms prohibition under Code of Civil Procedure section 527.9(f) because
carrying a firearm is a condition of my employment, and my employer is unable to reassign me to another
position where a firearm is unnecessary. (Explain):

Check here if there is not enough space below for your answer. Put your complete answer on an attached
sheet of paper and write “Attachment 6b—Firearms Surrender Exemption” as a title. You may use form
MC-025, Attachment.

I have turned in my firearms (guns) and firearm parts to the police or sold them to or stored them with a
licensed gun dealer.
A copy of the receipt

has already been filed with the court.

is attached.

Possession and Protection of Animals

I agree to the orders requested.
I do not agree to the orders requested. (Specify why you disagree in item on page 3.)
I agree to the following orders (specify below or in item on page 3):

Other Orders

I agree to the orders requested.
I do not agree to the orders requested. (Specify why you disagree in item on page 3.)
I agree to the following orders (specify below or in item on page 3):

a.
b.
c.

I did not do anything described in item of form CH-100. (Skip to .)

Denial

Rev. January 1, 2023

Response to Request for Civil Harassment
Restraining Orders
(Civil Harassment Prevention)

CH-120, Page 2 of 4

Case Number:

Justification or Excuse

If I did some or all of the things that the person in has accused me of, my actions were justified or excused for
the following reasons (explain):

Check here if there is not enough space below for your answer. Put your complete answer on an attached sheet
of paper and write “Attachment 10—Justification or Excuse” as a title. You may use form MC-025, Attachment.

Reasons I Do Not Agree to the Orders Requested

Explain your answers to each order requested that you do not agree with.

Check here if there is not enough space below for your answer. Put your complete answer on an attached sheet
of paper and write “Attachment 11—Reasons I Disagree” as a title. You may use form MC-025, Attachment.

Rev. January 1, 2023

CH-120, Page 3 of 4

Response to Request for Civil Harassment
Restraining Orders
(Civil Harassment Prevention)

Case Number:

No Fee for Filing

I request that I not be required to pay the filing fee because the person in claims in form CH-100
item to be entitled to free filing.

I request that I not be required to pay the filing fee because I am eligible for a fee waiver. (Form FW-001,
Request to Waive Court Fees, must be filed separately.)

Lawyer's Fees and Costs

I ask the court to order payment of my
The amounts requested are:

Lawyer’s fees

Court costs.

Item

Amount

Item

Amount

$
$
$

Check here if there are more items. Put the items and amounts on the attached sheet of paper and write
“Attachment 13—Lawyer’s Fees and Costs” for a title. You may use form MC-025, Attachment.

I ask the court to deny the request of the person asking for protection that I pay his or her lawyer’s fees
and costs.

14 Number of pages attached to this form, if any:

Lawyer’s name (if any)

Lawyer’s signature

I declare under penalty of perjury under the laws of the State of California that the information above and on all
attachments is true and correct.

Type or print your name

Sign your name

Date:

Rev. January 1, 2023

CH-120, Page 4 of 4

Response to Request for Civil Harassment
Restraining Orders
(Civil Harassment Prevention)

Response to Request for Civil Harassment Restraining Orders

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the California state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from selfhelp.courts.ca.gov (2023-03)
Page(s): 4
Fields(s): 84
Average fields per page: 21
Reading Level: Grade 6
LIST Grouping(s): Unknown

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

c_h_page_sf_county_info was CH-120[0].Page1[0].Caption_sf[0].County[0].CourtInfo_ft[0] (0.49 conf)
c_h_page_sf_n_number_ft was CH-120[0].Page1[0].Caption_sf[0].CN[0].CaseNumber_ft[0] (0.41 conf)
c_page_list_item_full_name was CH-120[0].Page1[0].List1[0].item1[0].ProtectedFullName_ft[0] (0.36 conf)
c_page_list_restrained_full_name was CH-120[0].Page1[0].List2[0].Lia[0].RestrainedFullName_ft[0] (0.39 conf)
c_page_list_restrained_lawyer_name was CH-120[0].Page1[0].List2[0].Lia[0].RestrainedLawyerName_ft[0] (0.40 conf)
c_page_list_restrained_lawyer_bar was CH-120[0].Page1[0].List2[0].Lia[0].RestrainedLawyerBar_no[0] (0.36 conf)
c_h_page_list_lawyer_firm was CH-120[0].Page1[0].List2[0].Lia[0].RestrainedLawyerFirm_ft[0] (0.37 conf)
c_h_page_list_lib_street was CH-120[0].Page1[0].List2[0].Lib[0].RestrainedStreet_ft[0] (0.37 conf)
c_h_page_list_lib_city was CH-120[0].Page1[0].List2[0].Lib[0].RestrainedCity_ft[0] (0.37 conf)
c_h_page_list_lib_state was CH-120[0].Page1[0].List2[0].Lib[0].RestrainedState_ft[0] (0.40 conf)
c_h_page_list_lib_ft was CH-120[0].Page1[0].List2[0].Lib[0].RestrainedZip_ft[0] (0.32 conf)
c_h_page_list_lib_phone was CH-120[0].Page1[0].List2[0].Lib[0].RestrainedPhone_ft[0] (0.37 conf)
c_h_page_list_lib_restrained was CH-120[0].Page1[0].List2[0].Lib[0].RestrainedFax_ft[0] (0.40 conf)
c_h_page_list_lib_mail was CH-120[0].Page1[0].List2[0].Lib[0].RestrainedE-Mail_ft[0] (0.40 conf)
c_h_page_list_conduct_cb was CH-120[0].Page1[0].List3[0].Conduct_cb[0] (0.36 conf)
c_h_page_list_lia_conduct_agree_cb was CH-120[0].Page1[0].List3[0].Lia[0].ConductAgree_cb[0] (0.37 conf)
c_h_page_list_lib_agree__1 was CH-120[0].Page1[0].List3[0].Lib[0].ConductAgree_cb[0] (0.37 conf)
c_h_page_list_lic_conduct_following_cb was CH-120[0].Page1[0].List3[0].Lic[0].ConductFollowing_cb[0] (0.38 conf)
c_page_list_multi_line_following was CH-120[0].Page1[0].List3[0].Lic[0].MultiLine_Field[0].ConductFollowing_ft[0] (0.37 conf)
c_h_page_hearing_info_date_dt was CH-120[0].Page1[0].HearingInfo_sf[0].HearingDate_dt[0] (0.40 conf)
c_h_page_hearing_info_time_dt was CH-120[0].Page1[0].HearingInfo_sf[0].HearingTime_dt[0] (0.38 conf)
c_h_page_hearing_info_dept_ft was CH-120[0].Page1[0].HearingInfo_sf[0].HearingDept_ft[0] (0.38 conf)
c_h_page_hearing_info_room_ft was CH-120[0].Page1[0].HearingInfo_sf[0].HearingRoom_ft[0] (0.35 conf)
c_h_page_list_stay_away_cb was CH-120[0].Page1[0].List4[0].StayAway_cb[0] (0.34 conf)
c_h_page_list_stay_away_agree was CH-120[0].Page1[0].List4[0].Lia[0].StayAwayAgree_cb[0] (0.34 conf)
c_h_page_lib_stay_away_agree was CH-120[0].Page1[0].List4[0].Lib[0].StayAwayAgree_cb[0] (0.34 conf)
c_h_page_list_lic_stay_away_following_cb was CH-120[0].Page1[0].List4[0].Lic[0].StayAwayFollowing_cb[0] (0.35 conf)
page_list_line_stay_away_following was CH-120[0].Page1[0].List4[0].Lic[0].MultiLine_Field[0].StayAwayFollowing_ft[0] (0.39 conf)
c_h_page_list_protected_cb was CH-120[0].Page1[0].List5[0].OtherProtected_cb[0] (0.40 conf)
c_h_page_list_protected_agree was CH-120[0].Page1[0].List5[0].Lia[0].OtherProtectedAgree_cb[0] (0.38 conf)
c_h_page_list_lib_agree__2 was CH-120[0].Page1[0].List5[0].Lib[0].OtherProtectedAgree_cb[0] (0.38 conf)
c_h_page_sf_case_number__1 was CH-120[0].Page2[0].PxCaption_sf[0].CaseNumber_ft[0] (0.39 conf)
c_h_page_list_lia_guns_cb was CH-120[0].Page2[0].List6[0].Lia[0].GunsNo_cb[0] (0.38 conf)
c_h_page_list_lib_guns__1 was CH-120[0].Page2[0].List6[0].Lib[0].GunsExemption_ft[0] (0.38 conf)
c_h_page_list_lib_guns__2 was CH-120[0].Page2[0].List6[0].Lib[0].GunsExemption_cb[0] (0.38 conf)
c_h_list_lib_guns_f was CH-120[0].Page2[0].List6[0].Lib[0].GunsExemption_OF_cb[0] (0.38 conf)
c_h_list_guns_surrendered_cb was CH-120[0].Page2[0].List6[0].Lic[0].GunsSurrendered_cb[0] (0.38 conf)
c_h_list_guns_receipt_cb__1 was CH-120[0].Page2[0].List6[0].Lic[0].GunsReceipt_cb[0] (0.36 conf)
c_h_list_guns_receipt_cb__2 was CH-120[0].Page2[0].List6[0].Lic[0].GunsReceipt_cb[1] (0.36 conf)
c_h_page_list_animals_cb was CH-120[0].Page2[0].List7[0].Animals_cb[0] (0.36 conf)
c_h_page_list_orders_agree__1 was CH-120[0].Page2[0].List7[0].Lia[0].AnimalOrdersAgree_cb[0] (0.37 conf)
c_h_page_list_lib_agree__3 was CH-120[0].Page2[0].List7[0].Lib[0].AnimalOrdersAgree_cb[0] (0.37 conf)
c_h_page_list_lic_animal_orders_following_cb was CH-120[0].Page2[0].List7[0].Lic[0].AnimalOrdersFollowing_cb[0] (0.35 conf)
c_h_page_list_orders_following__1 was CH-120[0].Page2[0].List7[0].Lic[0].AnimalOrdersFollowing_ft[0] (0.35 conf)
c_h_page_list_orders_agree__2 was CH-120[0].Page2[0].List8[0].Lia[0].OtherOrdersAgree_cb[0] (0.36 conf)
c_h_page_list_lib_agree__4 was CH-120[0].Page2[0].List8[0].Lib[0].OtherOrdersAgree_cb[0] (0.36 conf)
c_h_page_list_lic_orders_following_cb was CH-120[0].Page2[0].List8[0].Lic[0].OtherOrdersFollowing_cb[0] (0.36 conf)
c_h_page_list_orders_following__2 was CH-120[0].Page2[0].List8[0].Lic[0].OtherOrdersFollowing_ft[0] (0.36 conf)
c_h_page_list_orders_cb was CH-120[0].Page2[0].List8[0].OtherOrders_cb[0] (0.38 conf)
c_h_page_list_item_denial_cb was CH-120[0].Page2[0].List9[0].item9[0].Denial_cb[0] (0.33 conf)
c_h_page_sf_case_number__2 was CH-120[0].Page3[0].PxCaption_sf[0].CaseNumber_ft[0] (0.39 conf)
c_h_page_list_item_excuse_cb was CH-120[0].Page3[0].List10[0].item10[0].Excuse_cb[0] (0.33 conf)
c_h_page_list_item_excuse was CH-120[0].Page3[0].List10[0].item10[0].ExcuseOverflow_cb[0] (0.36 conf)
c_h_list_item_multi_line was CH-120[0].Page3[0].List10[0].item10[0].MultiLine_Field[0].Excuse_ft[0] (0.39 conf)
c_h_page_list_disagree_cb was CH-120[0].Page3[0].List11[0].Disagree_cb[0] (0.34 conf)
c_h_page_list_disagree_overflow_cb was CH-120[0].Page3[0].List11[0].DisagreeOverflow_cb[0] (0.34 conf)
c_h_page_list_disagree_ft was CH-120[0].Page3[0].List11[0].Disagree_ft[0].Disagree_ft22[0] (0.33 conf)
c_h_page_sf_case_number__3 was CH-120[0].Page4[0].PxCaption_sf[0].CaseNumber_ft[0] (0.39 conf)
c_h_page_list_lia_fee_cb was CH-120[0].Page4[0].List12[0].Lia[0].NoFeeOther_cb[0] (0.38 conf)
c_h_page_list_lib_fee_waiver was CH-120[0].Page4[0].List12[0].Lib[0].NoFeeWaiver_cb[0] (0.37 conf)
c_h_page_list_fee_cb was CH-120[0].Page4[0].List12[0].NoFee_cb[0] (0.34 conf)
c_h_page_list_fees_costs_cb was CH-120[0].Page4[0].List13[0].FeesCosts_cb[0] (0.39 conf)
c_h_list_fees_costs_pay_cb was CH-120[0].Page4[0].List13[0].Lia[0].FeesCostsPayMe_cb[0] (0.37 conf)
c_h_page_list_lia_fees_costs_lawyer_cb was CH-120[0].Page4[0].List13[0].Lia[0].FeesCostsLawyerFees_cb[0] (0.38 conf)
c_h_list_lia_costs_crt_cb was CH-120[0].Page4[0].List13[0].Lia[0].FeesCostsCrtCosts_cb[0] (0.32 conf)
c_h_page_list_lia_costs_ft__1 was CH-120[0].Page4[0].List13[0].Lia[0].FeesCosts1_ft[0] (0.36 conf)
c_list_fees_costs_amount_dc__1 was CH-120[0].Page4[0].List13[0].Lia[0].FeesCostsAmount1_dc[0] (0.39 conf)
c_h_page_list_lia_costs_ft__2 was CH-120[0].Page4[0].List13[0].Lia[0].FeesCosts2_ft[0] (0.36 conf)
c_list_fees_costs_amount_dc__2 was CH-120[0].Page4[0].List13[0].Lia[0].FeesCostsAmount2_dc[0] (0.39 conf)
c_h_page_list_lia_costs_ft__3 was CH-120[0].Page4[0].List13[0].Lia[0].FeesCosts3_ft[0] (0.36 conf)
c_list_fees_costs_amount_dc__3 was CH-120[0].Page4[0].List13[0].Lia[0].FeesCostsAmount3_dc[0] (0.39 conf)
c_h_page_list_lia_costs_ft__4 was CH-120[0].Page4[0].List13[0].Lia[0].FeesCosts4_ft[0] (0.36 conf)
c_list_fees_costs_amount_dc__4 was CH-120[0].Page4[0].List13[0].Lia[0].FeesCostsAmount4_dc[0] (0.39 conf)
c_h_page_list_lia_costs_ft__5 was CH-120[0].Page4[0].List13[0].Lia[0].FeesCosts5_ft[0] (0.36 conf)
c_list_fees_costs_amount_dc__5 was CH-120[0].Page4[0].List13[0].Lia[0].FeesCostsAmount5_dc[0] (0.39 conf)
c_h_page_list_lia_costs_ft__6 was CH-120[0].Page4[0].List13[0].Lia[0].FeesCosts6_ft[0] (0.36 conf)
c_list_fees_costs_amount_dc__6 was CH-120[0].Page4[0].List13[0].Lia[0].FeesCostsAmount6_dc[0] (0.39 conf)
c_h_list_fees_costs_cb was CH-120[0].Page4[0].List13[0].Lia[0].FeesCostsOverflow_cb[0] (0.39 conf)
c_h_list_lib_fees_costs_pay was CH-120[0].Page4[0].List13[0].Lib[0].FeesCostsDontPay_cb[0] (0.42 conf)
c_h_page_list_pages_attached was CH-120[0].Page4[0].List14[0].PagesAttached_no[0] (0.35 conf)
c_h_page_list_lawyer_dt was CH-120[0].Page4[0].List14[0].LawyerSignature_dt[0] (0.36 conf)
c_h_page_list_lawyer_name_ft was CH-120[0].Page4[0].List14[0].LawyerName_ft[0] (0.33 conf)
c_h_page_list_party_dt was CH-120[0].Page4[0].List14[0].PartySignature_dt[0] (0.36 conf)
c_h_page_list_party_name_ft was CH-120[0].Page4[0].List14[0].PartyName_ft[0] (0.36 conf)

We've done our best to group similar variables togther to avoid overwhelming the user.

Suggested Screen 0:

c_page_list_item_full_name
c_page_list_restrained_full_name
c_page_list_restrained_lawyer_name
c_page_list_restrained_lawyer_bar

Suggested Screen 1:

c_h_page_list_lib_street
c_h_page_list_lib_city
c_h_page_list_lib_state
c_h_page_list_lib_ft
c_h_page_list_lib_phone
c_h_page_list_lib_restrained
c_h_page_list_lib_mail
c_h_list_lib_guns_f
c_h_page_list_party_dt

Suggested Screen 2:

c_h_page_sf_county_info
c_h_page_hearing_info_date_dt
c_h_page_hearing_info_time_dt
c_h_page_hearing_info_dept_ft
c_h_page_hearing_info_room_ft

Suggested Screen 3:

c_h_page_list_stay_away_agree
c_h_page_lib_stay_away_agree
page_list_line_stay_away_following
c_h_page_list_protected_agree

Suggested Screen 4:

c_h_page_list_conduct_cb
c_h_page_list_lia_conduct_agree_cb
c_h_page_list_stay_away_cb
c_h_page_list_protected_cb
c_h_page_list_lia_guns_cb
c_h_page_list_animals_cb
c_h_page_list_disagree_cb
c_h_page_list_disagree_overflow_cb
c_h_page_list_lawyer_dt

Suggested Screen 5:

c_h_list_guns_surrendered_cb
c_h_list_guns_receipt_cb__1
c_h_list_guns_receipt_cb__2

Suggested Screen 6:

c_h_page_list_lawyer_firm
c_page_list_multi_line_following
c_h_page_list_orders_agree__1
c_h_page_list_orders_following__1
c_h_page_list_orders_agree__2
c_h_page_list_orders_following__2
c_h_page_list_lib_fee_waiver
c_h_page_list_pages_attached

Suggested Screen 7:

c_h_page_list_lib_agree__1
c_h_page_list_lib_agree__2
c_h_page_list_lib_guns__1
c_h_page_list_lib_guns__2
c_h_page_list_lib_agree__3
c_h_page_list_lib_agree__4

Suggested Screen 8:

c_h_page_list_lic_conduct_following_cb
c_h_page_list_lic_stay_away_following_cb
c_h_page_list_lic_animal_orders_following_cb
c_h_page_list_lic_orders_following_cb
c_h_page_list_orders_cb
c_h_page_list_lia_fee_cb
c_h_page_list_fee_cb

Suggested Screen 9:

c_h_page_list_item_denial_cb
c_h_page_list_item_excuse_cb
c_h_page_list_item_excuse
c_h_list_item_multi_line

Suggested Screen 10:

c_h_page_sf_case_number__1
c_h_page_sf_case_number__2
c_h_page_sf_case_number__3

Suggested Screen 11:

c_h_page_list_fees_costs_cb
c_h_list_fees_costs_pay_cb
c_h_page_list_lia_fees_costs_lawyer_cb
c_h_list_fees_costs_cb
c_h_list_lib_fees_costs_pay

Suggested Screen 12:

c_h_list_lia_costs_crt_cb
c_h_page_list_lia_costs_ft__1
c_h_page_list_lia_costs_ft__2
c_h_page_list_lia_costs_ft__3
c_h_page_list_lia_costs_ft__4
c_h_page_list_lia_costs_ft__5
c_h_page_list_lia_costs_ft__6

Suggested Screen 13:

c_list_fees_costs_amount_dc__1
c_list_fees_costs_amount_dc__2
c_list_fees_costs_amount_dc__3
c_list_fees_costs_amount_dc__4
c_list_fees_costs_amount_dc__5
c_list_fees_costs_amount_dc__6

Suggested Screen 14:

c_h_page_sf_n_number_ft
c_h_page_list_disagree_ft
c_h_page_list_lawyer_name_ft
c_h_page_list_party_name_ft

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Response to Request for Civil Harassment Restraining Orders

About This Form:

Identified Data Fields:

Create an Interactive Version of this Form:

The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02