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DV-101

Description of Abuse

,Case N:umber:

This form is attached to DV ..IOO~, Request for Domestic Violence Restraining Order.

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Name of person asking for' pretectton:

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Name of person you want protection from: _M_a__ ,

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Describe the 2nd most recent abuse. a, Date of2n.d most recent abuse: '1,2-21 ~2013,
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,- b. Who was there?

M,art~F. Hern.~ndez and myse'lf

c. Describe how the. person ill abused you or your children: ,M_~rio F..Hernandez arri.ved Sit my home at appro,ximately 1'0:30 in the evening. He,was there to e,x'plain to me why he had without any' prior inai'cation 'chos,en to 5reak' 6ff o'ur relationsfdp- and move ba.cK in wltFlhis estranged wife:. H was a very emotional conversation betWeen tFie n,?th of us. I was crying and frying (0_. u~naerstand how we had reached 'mat pail,!.. He was a'iso very aistraught~ A.e had e·xprafne:dfie w'a-s very sorry bUf that. netiad to do Wflat was Ilest for rus yo:Un==gest son. 1=Ie exp·lamed'that Ii,e ' l'ove1tm e very mnclTbut1twas a difficoltdecl'$,lon he haD reacl1ecJaTrdhff'was sorry he had not kept-me inforrrled uftris pla,ns. He keptsaying over an-d over ttrattre a1d rroton'derstand what was IlsPP'erling to Ilrnraffd ttmtlt.e ilated-tri-rn:self for doirlg wlfattle~'was duirlg~ HewasgelUrlg .. aggitated' at fliln,ss'lf anti 'kept--saying-h~t1pfd-he w'as to"'have caused aU th'es'e'problems in ott:Niv·es:--He-apol·ogized-for the-tneident-that-1ofJk-p,H;:';tAQ-lIii :t-N-A\-H~~--------1

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H·e stated that he Yv~s-§eiflg to-leave 8AEI-we-walkeEt 9l,leF te the a:eeF~ l-t-1y§@ea~R9I"""'~-.ask~--him-eAe:-Ia$.Hh::ae for U;6~to.jt-H-Rk thFebt-sh-SRd· fe.;:·t:li~-R(Jt ~k?EWaR:JeH.ike-tRis<l At this 'tAJ~iGt:1--PQim-i-le-sr:1appedT-l=fegRabb@.d me~y tRe+1eckwi~~~t-haAd ~d-sbov-eG-me-i,'i-H'nto~" :,tbe-waJLwitb.-bis-left.ba!ld oll-my...shoulder~nd ,proceeded...to..cbok.e-rne ~I-str:u.ggtedwitb bim...to

l~m~ounm~eased~sgtipaod,I~,.
d, Describe any use or threatened use of gun'
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ldi~D~I~e~-a~p~o~"~ce~:,~re~p~o~ct_.~~~~~~

s or other weap-ons:

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e. Describe any injuries: shoulder ..

B,urI]p .on the back ~f, my h'ea,d ·an,d~oreness· to, m~ right

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f. Did the police or other law enforcement come? If yes, did they give you or the person in

'Th,eEmergency 'Protective Order protects 0 vO'U ,0 The person in ® Attach a copy of the Emergency Protective Order if you have one.

00· an Emergency Protective

0 No 0 Yes

Order? DYes

0

No

D I don't know

Judicial Council of' Califomiat www~courb.OO.90V Rev. January 1~2012f Optionai Fotlf:F. FatnUy Code! § 6200- et seq.

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(Domestic Violence Pre·ve.ntion)

Description of Abuse

DV·101,. Pa.ge 1 of2
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'Number:

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C:aS9

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Ptl6131121

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Describe how the person in ® abused you, Abuse means to intentionally or recklessly cause or attempt to cause bodily injury to you; Oli to place you or another person in reasonable fear of imminent serious bodily injury; or to molest, attack, hit, stalk, threaten, batter, harass, telephone, or contact you; or to disturb your peace; or to destroy your personal property. Abuse can be spoken, written, or physical. (For a complete definition, see Family Code
§§·6203, 6320).

Oescr.ibe Abuse

c. Describe how the person in (~) abused you or your children: _~~~Atta·ch~d.Decfaratio.n (O'V-1OOl I~.I!I :~~._RecentAb~se)

need morespace, Attach a sheet of'paper and ..vrite .NDV... 00~ Recent Abuse't for a title.. I d. Did the person. iu.@use or threaten to use a gun or any other weapon? 0 N-o DYes (lfyes describe)."
1

o Check here ifyou

et Describe any injuries: ~
f. f)idthe~olice co~ne?

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If yes, did they give you or the person In Auach a CQPY'lfyou have one. The order protects D 'you 01' D the person in
g. Has the person in

No p(Yes,

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.... .'. an Emergency Protective Order?

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0 Yes D! No 0 I dOJ1't know

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you (or your children) other tnnes?

.lfye~''Elch~ck: here and use Form DV-IOI, Description of Abuse or a sheet a/paper to describe any .prevlou; ;Su£e~

Other Persons to Be Protected
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The persons listed in item @ need ..n order for protection because (describe):

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Number of pages attached to this form, if any: _._ .......... ~~ ".-.'

I declare under penalty of perjury under the laws of the State of California that the information above is true and correct, Date; July ~~J 2012 Type or print-your name Date:
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Lawyer's name, if you have one .
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Lawyer's signature

This is not a Court Order.
(.Domestlc Via·lence Prevent-ion)

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Request for Domestlc Violence Restraining order
DASH San Fernando

DV... 100, Page 5 of 5

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De La Torre vs. Hernandez l'
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Form DV,~100,Item 25

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J am the Petitioner in this case.

Mario F~,Hernandez is the Respondent:

C'R.PH). RP and 1 are dating (or used to date). I am asking for a restrain.ing order against .RP to, protect m'er RP fllled his own restraining order AG,AI'SNT me on

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July 3,rd2012 but he does not need one I do.

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On 6.128/2012'1' at.approximately 5:30pm RP and

were discussinp our

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relatlonshio ion the phone" I was mentionlnq to RP that he had been actlnq differently. Towards the end of the conversation he, said, ~'Wellhere is somethlnq

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10 else you are not going
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to like, I am

leaving in 30 minutes to a retreat." I told RP I

couldn't be ln this type of relationship anymore. and that I wanted my IP'a.d and some

12: personal items back. I hung up and decided to head to hils house. As ,Iwas driv:ing' I
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received the foUolw~ngtexts from RP, "Just as I thouqht." "lt's my tPad~n"~t"sat St
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Josephs SUesi'ans y'o,uth renewal center." UEmerg'ency '#

confused as to what RP was referring'•. to. I drove to R,P'·s home t.o reqaln my.'"

17. ,be,lo,;ngi'ngs,RP's car wasn't there so I caned RP~ RP stated he was horne and I told
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him I was cornlnq over RP said ok ..When I rang the door bell, RP motioned me in.
We had an argument about what RP was doing. f told him I wanted mylPad and my

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other personal be~'on.gj'ng·slI told RP .1 'was goIng into his room to get them. RP said, UO.kay but
YO,U

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are not g",·oing to find them th.. ;are at: my morn's house." I walked into ey···

his room, opened RP's lugg'age; ;RP came into the room and slammed the, door on

24, my right shoulder, R,Pthen brought me down with tremendous force and olnned me
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on the bed, RP had a. strong gri;p to both arms and elbows, RP',s left knee, was

26 shoved to my ri'ght leg and RP forcefuUy assaulted me, I then managed to kick him
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DASH San Fernando
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De La Torre vs, Hernandez

F· orm 'DV' 100 Itern 25 ..· . - .", .'
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Case NOt:

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2· 3 grabbed me, turned me and brought me up my feet and shammed me into the

W·h·en I stood up I realized f had. cut my right foot on a sharp object. R.P then

4: hardwood floor. While RP was on top of me RP brought me down on knees and 5
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my

head slammed on the floor. I heard my neck and entire spinal cord crack and .1
blacked out. Once I regained consciousness RP was on top of me from behind and

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· had all his·w'ei·ght pushinq down on my back, I was stiU on the 'floor on my knees, with
my head pinned to the groundt I was finaUy' able to g,et my right hand under me and

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10; started grasping for a way to get RP off of me. I was able to get

a grasp of

Rpts left

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hand thumb and I pushed it back as hard as II could. I told hfm I would let 'go of hls thumb if he let go of
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When RP released me I stood up and RP jammed me into
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the, door frame, ~,left in a daze, shaken, afrald, and distraught. I had visible br1uising

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rig.ht upp ·.er thi'g"_' .r hand knees and bru·ising··.. and swelfing:.~' n; my left· a.nkle. o 16' 17
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to my left shoulder, my 'eft forearm,

I had rug burns Q1nmy left. elbow, bruising on' my

On 12/21/2011,R.,P

arrived at,my home approximately 10::30 pm to have a

conversation sbout our relatio:nship. RP was confused about certain declsicns he

was making that were affecting our lives. . RP was apologetic and sorry for putti:ng me
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throu.gh it. Once the conversatlon was over l walked .RP to the front door, gave him a hug and said, "letJs think this throuqh, " RP snapped and Igrab1be·d me .by the neck and began strangling me and slammed me up against the wall. I told RP to let me go, and then R.P·released and walked out of my home Ii:ke i'f nothing' had happened, I never filed a report: for either incident d'ue to a number of reasons, We are both
public flqures and thi.s would cause undue media pressures to ourselves and our
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famines, .. Secondly, RP ls currently under treatment for Dissociative Disorder
DA·SH San Fernando
Pag·e20f.3

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De La Torre vs. Hernandez

Case 'N,D,:,

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(multlple personality' dlsorder.) RP is under treatment. with -DR. ,Jeffrey J. Steffen. 1 believe his actions leading up to his assault and afterwards are 'a direct result of his
unstable mental. health due to the tremendous stressore in his Ufe~I believed on
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June

zs" that this matter should
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have continued to be handled by his therapist,
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I'm ask~ng~'d' , __'_-'__ ll _' th' ,e JU

',',,' ,_ge -I=' ,. a" res training lor

O]' d:', er
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,·t:',.- set ":I'f'· , d -, "-, ,pro:eclng myse, an, my c hildrran i.I,
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because I'm atraid for our safety, RP has put me through so much physlcal, emotional, and psychological abuse, 'I do, not know what RP' is capable of dolnq due
to hls unstable mental health condition.

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