ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): TELEPHONE NO.: Clerk stamps below when form is filed FAX NO. (Optional): E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CRUZ 701 Ocean Street, Room 110  1 Second Street, Room 300 Santa Cruz, CA 95060 Watsonville, CA 95076 PLAINTIFF: DEFENDANT: NOTICE OF MOTION AND MOTION FOR ORDER  TO MODIFY ORDER  TO TERMINATE ORDER  TO SET ASIDE AND GRANT A NEW HEARING  Civil Harassment  Workplace Violence  Elder/Dependent Adult Abuse CASE NUMBER:  TO RENEW  Civil Harassment  Workplace Violence TO: (Name) ___________________________________________ Notice is given that a hearing on the relief requested in this motion will be held as follow: Date of Hearing: _____________ Time: ______________________ Dept.: ___________________ The current restraining orders stay in effect until the hearing date. The other party must be served per Code of Civil Procedure section 1005(b) 1. I am the Plaintiff (Protected Party) Defendant (Restrained Party): 2. Currently the following type of restraining order was issued by the Santa Cruz Superior Court in this case: Civil Harassment Workplace Violence Elder Abuse or Dependent Adult Abuse 3. This current order will expire on: __________, a copy of the order is attached. Santa Cruz Superior Court Adopted for Optional use Rev. January 2011 Notice of Motion to Modify, Terminate, Renew or Set Aside Page 1 of 1 Civil Harassment, Workplace Violence or Elder Abuse Restraining Order SUP CV 1068 CCP §527.6, §527.8, WIC §15657.03 American LegalNet, Inc. www.FormsWorkFlow.com 4. I am requesting that the court: Modify the current order Terminate the current order Renew the current order for __________ years. If you are requesting to renew an Elder or Dependent Adult Abuse Protection Restraining Order use from EA-100 Request for Orders to Stop Elder or Dependent Adult Abuse. For a Civil Harassment Renewal request: Complete and attach CH-100. For a Workplace Violence request: Complete and attach WV-100.  Set Aside and Grant a New Hearing based on the following ground (s): CCP 473: Mistake, inadvertence, surprise or excusable neglect. This set aside request is filed within a reasonable time, and in no event later than 6 months from the date the judgment, dismissal, order or proceeding was taken. CCP 473.5: Lack of Notice: The Service of the summons has not resulted in actual notice in time for me to defend the action. This set aside request is filed within a reasonable time, and no later than the earlier of 180 days after service of written notice, or 2 years after entry of judgment. Other (write in code section): _________________________________________________ Note: With a set aside request you must attach a proposed Response/Answer (this is the same Response/Answer form that would have been originally used in this case). 5. I am making this request based for the following reasons (you must provide a statement with facts supporting your request):  See Attached Declaration: 6. I will bring a proposed order with me to court. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: ________________________ _______________________________ ___________________________________ Print your name Sign your name Santa Cruz Superior Court Adopted for Optional Use Rev. January 2011 Notice of Motion to Modify, Terminate, Renew or Set Aside Civil Harassment, Workplace Violence or Elder Abuse Restraining Order Page 2 of 2 SUP CV 1068 American LegalNet, Inc. www.FormsWorkFlow.com