SUPCR 1126 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY TELEPHONE NO: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: FAX NO. (Optional) SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CRUZ The People of the State of California vs. Defendant: REQUEST FOR HEARING ON PROTECTIVE ORDER MODIFICATION AND 5 DAY WRITTEN NOTICE TO OFFICE OF THE DISTRICT ATTORNEY My name is: _______________________________________ I am the: Defendant (Restrained Person) Protected Person CASE NUMBER: FAMILY/CIVIL CASE NUMBER: Other: ________________ REQUEST FOR HEARING: I am asking for a hearing because the: Civil Restraining Order is different from the Criminal Protective Order. (Attach a copy of the civil order if possible). The Family/Civil case number is____________________________________________. Protected Person wants to have a "no contact" order in both the Criminal and Civil Cases. Protected Person wants the Criminal Protective Order to be modified to allow for peaceful contact and to delete the stay away orders. Restrained Person (defendant) and Protected Person want to live together. There is a custody/visitation order and the Criminal Protective Order needs to be changed to allow for peaceful contact between the Restrained Person (defendant) and the Protected Person regarding Courtordered visitation. Other:___________________________________________________________________________ FURTHER HEARING: There is a further hearing scheduled in the Family/Civil case on: (date) _________________ at time: __________ in Department: _________. Date: _______________________ ____________________________________ Signature of Requesting Party This matter will be set for hearing on (date)_______________at (time) ___________ in Department ________ ALEX CALVO, CHIEF EXECUTIVE OFFICER Date: ____________________ Clerk, by_______________________, Deputy REQUEST FOR HEARING ON PROTECTIVE ORDER MODIFICATION AND 5 DAY WRITTEN NOTICE TO OFFICE OF THE DISTRICT ATTORNEY Form Adopted for Optional Use Superior Court of Santa Cruz County SUPCR 1126 [New 1/1/2016] Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com