FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA STREET ADDRESS: FILED MAILING ADDRESS: CITY AND ZIP CODE: DATED:_______________ David H. Yamasaki Chief Executive Officer/Clerk Superior Court of California County of Santa Clara BRANCH NAME: PEOPLE OF THE STATE OF CALIFORNIA vs. By:____________________ Deputy Clerk DEFENDANT: REQUEST FOR HEARING ON PROTECTIVE ORDER MODIFICATION AND 5 DAY WRITTEN NOTICE TO OFFICE OF THE DISTRICT ATTORNEY CRIMINAL CASE NUMBER: FAMILY/ CIVIL CASE NUMBER: My name is: I am the: Defendant (Restrained Person) Protected Person 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 Court-ordered 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 # , located at: 190 W. Hedding Street, San Jose, CA 95110 270 Grant Avenue, Palo Alto, CA 94306 301 Diana Avenue, Morgan Hill, CA 95037 DAVID H. YAMASAKI, CHIEF EXECUTIVE OFFICER Date: Clerk, by , Deputy A map is available on the Court’s website at: www.sccsuperiorcourt.org/criminal/ DISTRIBUTION: CR-6003 REV 4/06/09 White: File Green: Defendant Canary: Victim Pink: Adult Probation Department Goldenrod: District Attorney REQUEST FOR HEARING ON PROTECTIVE ORDER MODIFICATION AND 5 DAY WRITTEN NOTICE TO OFFICE OF THE DISTRICT ATTORNEY Page 1 of 1 American LegalNet, Inc. www.FormsWorkflow.com