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Here is the text we could read:

WV-120

Response to Petition for Workplace
Violence Restraining Orders

Clerk stamps date here when form is filed.

•

a.
b.

Use this form to respond to the Petition (form WV-100)

Read How Can I Respond to a Petition for Workplace Violence
Restraining Orders? (form WV-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 petitioner or the
petitioner’s lawyer by mail with a copy of this form and any attached
pages. (Use form WV-250, Proof of Service of Response by Mail.)

Petitioner (Employer)
Name:

Employee Seeking Protection
Full Name:

Respondent (Person From Whom Protection Is Sought)
a. Your Name:

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

State Bar No.:

Your Address (You may give a mailing address if you want
to keep your street address private; skip this if you have a
lawyer.)

Fill in court name and street address:

Superior Court of California, County of

Fill in case number:
Case Number:

Address:
City:
Telephone:
Email Address:

The court will consider your response at the
hearing. Write your hearing date, time, and place
from form WV-109, item here:

State:

Zip:

Fax:

Hearing
Date

Date:
Dept.:

Time:
Room:

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.)
11
I agree to the following orders (specify below or in item on page 3):

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 three 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):

Judicial Council of California,
Rev. January 1, 2023, Mandatory Form
Code of Civil Procedure, §§ 527.8 and 527.9

Response to Petition for Workplace Violence
Restraining Orders
(Workplace Violence Prevention)

WV-120, Page 1 of 4

Case Number:

Additional Protected Persons

I agree that the persons listed in item of the Petition may be protected by the order requested.

I do not agree that the persons listed in item of the Petition may be protected by the order requested.

7 Firearms (Guns), Firearm Parts, and Ammunition

If you were served with form WV-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
WV-110.) You must sell to or store with a licensed gun dealer, or turn in to a law enforcement agency, any
firearms (guns) and firearm parts in your immediate possession or control within 24 hours of being served
with form WV-110. You must file a receipt with the court. You may use Receipt for Firearms and Firearm
Parts (form WV-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 7b—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.

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):

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

Rev. January 1, 2023

WV-120, Page 2 of 4

Response to Petition for Workplace Violence
Restraining Orders
(Workplace Violence Prevention)

Case Number:

Justification or Excuse

If I did some or all of the things that the petitioner 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

WV-120, Page 3 of 4

Response to Petition for Workplace Violence
Restraining Orders
(Workplace Violence Prevention)

Case Number:

No Fee for Filing

I ask the court to waive the filing fee because the petitioner claims in form WV-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.)

Costs

I ask the court to order the petitioner to pay my court costs. The amounts requested are:

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—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:

Date:

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 is true and
correct.

}

Type or print your name

Sign your name

Rev. January 1, 2023

WV-120, Page 4 of 4

Response to Petition for Workplace Violence
Restraining Orders
(Workplace Violence Prevention)

Response to Petition for Workplace Violence 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): 78
Average fields per page: 19
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.

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w_v_page_p_case_number__1 was WV-120[0].Page1[0].P1Caption[0].#subform[2].CaseNumber_ft[0] (0.34 conf)
w_v_page_item_name_ft was WV-120[0].Page1[0].Item1[0].PetitionerName_ft[0] (0.28 conf)
w_v_page_item_student_name was WV-120[0].Page1[0].Item2[0].StudentName_ft[0] (0.38 conf)
w_v_page_hearing_da was WV-120[0].Page1[0].Hearing[0].Hearing_da[0] (0.30 conf)
w_v_page_hearing_tm was WV-120[0].Page1[0].Hearing[0].Hearing_tm[0] (0.30 conf)
w_v_page_hearing_dept_ft was WV-120[0].Page1[0].Hearing[0].HearingDept_ft[0] (0.37 conf)
w_v_page_hearing_room_ft was WV-120[0].Page1[0].Hearing[0].HearingRoom_ft[0] (0.33 conf)
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w_v_page_list_city_ft was WV-120[0].Page1[0].List3[0].#subform[0].RespondentCity_ft[0] (0.35 conf)
w_v_page_list_state was WV-120[0].Page1[0].List3[0].#subform[0].RespondentState_ft[0] (0.37 conf)
w_v_page_list_subform_respondent_zip_ft was WV-120[0].Page1[0].List3[0].#subform[0].RespondentZip_ft[0] (0.29 conf)
w_v_page_list_phone was WV-120[0].Page1[0].List3[0].#subform[0].RespondentPhone_ft[0] (0.30 conf)
w_v_page_list_fax_ft was WV-120[0].Page1[0].List3[0].#subform[0].RespodentFax_ft[0] (0.37 conf)
v_page_list_e_mail_ft was WV-120[0].Page1[0].List3[0].#subform[0].RespondentE-Mail_ft[0] (0.38 conf)
w_v_page_list_name_ft was WV-120[0].Page1[0].List3[0].#subform[1].RespondentName_ft[0] (0.28 conf)
v_page_list_attorney_name_ft was WV-120[0].Page1[0].List3[0].#subform[1].AttorneyName_ft[0] (0.31 conf)
w_v_page_list_attorney_ft was WV-120[0].Page1[0].List3[0].#subform[1].AttorneyBarNo_ft[0] (0.30 conf)
v_page_list_attorney_firm_ft was WV-120[0].Page1[0].List3[0].#subform[1].AttorneyFirm_ft[0] (0.35 conf)
w_v_page_list_check_box__1 was WV-120[0].Page1[0].List4[0].CheckBox01[0] (0.34 conf)
w_v_page_list_subform_conduct_cb__1 was WV-120[0].Page1[0].List4[0].#subform[0].Conduct_cb[0] (0.32 conf)
w_v_page_list_subform_conduct_cb__2 was WV-120[0].Page1[0].List4[0].#subform[1].Conduct_cb[1] (0.32 conf)
page_line_stay_away_following__1 was WV-120[0].Page1[0].List4[0].#subform[2].MultiLine_Field[0].StayAwayFollowing_ft[0] (0.37 conf)
v_page_list_stay_away_following__1 was WV-120[0].Page1[0].List4[0].#subform[2].StayAwayFollowing_cb[0] (0.33 conf)
w_v_page_list_stay_away__1 was WV-120[0].Page1[0].List5[0].#subform[0].StayAway_cb[0] (0.33 conf)
w_v_page_list_stay_away__2 was WV-120[0].Page1[0].List5[0].#subform[1].StayAway_cb[1] (0.33 conf)
v_page_list_stay_away_following__2 was WV-120[0].Page1[0].List5[0].#subform[2].StayAwayFollowing_cb[0] (0.33 conf)
page_line_stay_away_following__2 was WV-120[0].Page1[0].List5[0].#subform[2].MultiLine_Field[0].StayAwayFollowing_ft[0] (0.37 conf)
w_v_page_list_check_box__2 was WV-120[0].Page1[0].List5[0].CheckBox23[0] (0.34 conf)
w_v_page_p_case_number__2 was WV-120[0].Page2[0].P2Caption[0].CaseNumber_ft[0] (0.34 conf)
w_v_page_list_check_box__3 was WV-120[0].Page2[0].List6[0].CheckBox05[0] (0.34 conf)
w_v_page_list_li_additional_cb was WV-120[0].Page2[0].List6[0].Li6A[0].Additional_cb[0] (0.31 conf)
w_v_page_list_li_b_additional_cb was WV-120[0].Page2[0].List6[0].Li6B[0].Additional_cb[0] (0.31 conf)
w_v_page_list_li_guns_cg was WV-120[0].Page2[0].List7[0].Li7A[0].GunsNo_cg[0] (0.36 conf)
w_page_list_b_orders_following was WV-120[0].Page2[0].List7[0].Li7B[0].OtherOrdersFollowing_ft[0] (0.31 conf)
w_v_page_list_li_b_excuse_overflow_cb__1 was WV-120[0].Page2[0].List7[0].Li7B[0].ExcuseOverflow_cb[0] (0.35 conf)
w_v_page_list_li_b_excuse_overflow_cb__2 was WV-120[0].Page2[0].List7[0].Li7B[0].ExcuseOverflow_cb[1] (0.35 conf)
w_v_page_list_li_c_guns_surrender_cb was WV-120[0].Page2[0].List7[0].Li7C[0].GunsSurrender_cb[0] (0.36 conf)
w_v_page_list_li_c_guns_receipt_cb__1 was WV-120[0].Page2[0].List7[0].Li7C[0].GunsReceipt_cb[0] (0.35 conf)
w_v_page_list_li_c_guns_receipt_cb__2 was WV-120[0].Page2[0].List7[0].Li7C[0].GunsReceipt_cb[1] (0.35 conf)
w_v_page_list_check_box__4 was WV-120[0].Page2[0].List8[0].CheckBox09[0] (0.34 conf)
w_v_page_list_li_orders_cb was WV-120[0].Page2[0].List8[0].Li8A[0].OtherOrders_cb[0] (0.33 conf)
w_v_page_list_li_b_orders_cb was WV-120[0].Page2[0].List8[0].Li8B[0].OtherOrders_cb[0] (0.33 conf)
w_v_page_list_li_c_orders_following_cb was WV-120[0].Page2[0].List8[0].Li8C[0].OtherOrdersFollowing_cb[0] (0.31 conf)
w_c_multi_line_orders_following was WV-120[0].Page2[0].List8[0].Li8C[0].MultiLine_Field[0].OtherOrdersFollowing_ft[0] (0.33 conf)
w_v_page_item_denial_cb was WV-120[0].Page2[0].Item9[0].Denial_cb[0] (0.25 conf)
w_v_page_p_case_number__3 was WV-120[0].Page3[0].P3Caption[0].CaseNumber_ft[0] (0.34 conf)
w_v_page_item_excuse_cb was WV-120[0].Page3[0].Item10[0].Excuse_cb[0] (0.30 conf)
w_v_page_item_excuse_overflow was WV-120[0].Page3[0].Item10[0].ExcuseOverflow_cb[0] (0.36 conf)
w_v_page_item_area_excuse_ft was WV-120[0].Page3[0].Item10[0].#area[1].Excuse_ft[0] (0.30 conf)
w_v_page_item_disagree_cb was WV-120[0].Page3[0].Item11[0].Disagree_cb[0] (0.30 conf)
w_v_page_item_disagree_overflow_cb was WV-120[0].Page3[0].Item11[0].DisagreeOverflow_cb[0] (0.31 conf)
v_page_item_multi_line_disagree was WV-120[0].Page3[0].Item11[0].MultiLine_Field[0].Disagree_ft[0] (0.33 conf)
w_v_page_p_case_number__4 was WV-120[0].Page4[0].P4Caption[0].Header[0].CaseNumber_ft[0] (0.36 conf)
w_v_page_list_fee_cb was WV-120[0].Page4[0].List12[0].NoFee_cb[0] (0.33 conf)
w_v_page_list_li_noa_fee_cb was WV-120[0].Page4[0].List12[0].Li12A[0].NoaFeeOther_cb[0] (0.35 conf)
w_v_page_list_li_b_fee_waiver_cb was WV-120[0].Page4[0].List12[0].Li12B[0].NoFeeWaiver_cb[0] (0.38 conf)
w_v_page_list_costs_cb was WV-120[0].Page4[0].List13[0].Costs_cb[0] (0.28 conf)
w_v_page_list_li_costs_pay_cb was WV-120[0].Page4[0].List13[0].Li13A[0].CostsPayMe_cb[0] (0.37 conf)
w_page_list_amount_requests_costs__1 was WV-120[0].Page4[0].List13[0].Li13A[0].AmountRequests[0].Amount1[0].Costs1_ft[0] (0.33 conf)
w_page_list_amount_requests_costs__2 was WV-120[0].Page4[0].List13[0].Li13A[0].AmountRequests[0].Amount1[0].CostsAmount1_ft[0] (0.35 conf)
w_page_list_amount_requests_costs__3 was WV-120[0].Page4[0].List13[0].Li13A[0].AmountRequests[0].Amount1[0].Costs4_ft[0] (0.33 conf)
w_page_list_amount_requests_costs__4 was WV-120[0].Page4[0].List13[0].Li13A[0].AmountRequests[0].Amount1[0].CostsAmount4_ft[0] (0.35 conf)
w_page_list_amount_requests_costs__5 was WV-120[0].Page4[0].List13[0].Li13A[0].AmountRequests[0].Amount2[0].Costs2_ft[0] (0.33 conf)
w_page_list_amount_requests_costs__6 was WV-120[0].Page4[0].List13[0].Li13A[0].AmountRequests[0].Amount2[0].CostsAmount2_ft[0] (0.35 conf)
w_page_list_amount_requests_costs__7 was WV-120[0].Page4[0].List13[0].Li13A[0].AmountRequests[0].Amount2[0].Costs5_ft[0] (0.33 conf)
w_page_list_amount_requests_costs__8 was WV-120[0].Page4[0].List13[0].Li13A[0].AmountRequests[0].Amount2[0].CostsAmount5_ft[0] (0.35 conf)
w_page_list_amount_requests_costs__9 was WV-120[0].Page4[0].List13[0].Li13A[0].AmountRequests[0].Amount3[0].Costs3_ft[0] (0.33 conf)
w_page_list_amount_requests_costs__10 was WV-120[0].Page4[0].List13[0].Li13A[0].AmountRequests[0].Amount3[0].CostsAmount3_ft[0] (0.35 conf)
w_page_list_amount_requests_costs__11 was WV-120[0].Page4[0].List13[0].Li13A[0].AmountRequests[0].Amount3[0].Costs6_ft[0] (0.33 conf)
w_page_list_amount_requests_costs__12 was WV-120[0].Page4[0].List13[0].Li13A[0].AmountRequests[0].Amount3[0].CostsAmount6_ft[0] (0.35 conf)
w_v_page_list_li_costs_f_cb was WV-120[0].Page4[0].List13[0].Li13A[0].CostsOF_cb[0] (0.36 conf)
w_v_list_b_costs_dont_pay was WV-120[0].Page4[0].List13[0].Li14B[0].CostsDontPay_cb[0] (0.35 conf)
w_v_page_item_pages_ft was WV-120[0].Page4[0].Item14[0].Pages_ft[0] (0.32 conf)
w_v_page_attorney_sign_dt was WV-120[0].Page4[0].AttorneySign[0].AttorneySignature_dt[0] (0.36 conf)
w_v_page_attorney_sign_name was WV-120[0].Page4[0].AttorneySign[0].AttorneyName2[0] (0.32 conf)
w_v_page_declaration_respondent_signature_dt was WV-120[0].Page4[0].Declaration[0].RespondentSignature_dt[0] (0.33 conf)
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We've done our best to group similar variables togther to avoid overwhelming the user.

Suggested Screen 0:

w_v_page_p_info_ft
w_v_page_p_case_number__1
w_v_page_item_name_ft
w_v_page_item_student_name
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v_page_list_street_ft
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w_v_page_list_state
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page_line_stay_away_following__1
v_page_list_stay_away_following__1
w_v_page_list_stay_away__1
w_v_page_list_stay_away__2
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w_v_page_p_case_number__2
w_v_page_list_check_box__3
w_v_page_list_li_additional_cb
w_v_page_list_li_b_additional_cb
w_v_page_list_li_guns_cg
w_page_list_b_orders_following
w_v_page_list_li_b_excuse_overflow_cb__1
w_v_page_list_li_b_excuse_overflow_cb__2
w_v_page_list_li_c_guns_surrender_cb
w_v_page_list_li_c_guns_receipt_cb__1
w_v_page_list_li_c_guns_receipt_cb__2
w_v_page_list_check_box__4
w_v_page_list_li_orders_cb
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w_v_page_list_li_c_orders_following_cb
w_c_multi_line_orders_following
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w_v_page_item_disagree_overflow_cb
v_page_item_multi_line_disagree
w_v_page_p_case_number__4
w_v_page_list_fee_cb
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w_v_page_list_costs_cb
w_v_page_list_li_costs_pay_cb
w_page_list_amount_requests_costs__1
w_page_list_amount_requests_costs__2
w_page_list_amount_requests_costs__3
w_page_list_amount_requests_costs__4
w_page_list_amount_requests_costs__5
w_page_list_amount_requests_costs__6
w_page_list_amount_requests_costs__7
w_page_list_amount_requests_costs__8
w_page_list_amount_requests_costs__9
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w_page_list_amount_requests_costs__11
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w_v_page_list_li_costs_f_cb
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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Response to Petition for Workplace Violence Restraining Orders

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