CR-300 SUPERVISING AGENCY (Name and address): FOR COURT USE ONLY FAX NO. (Optional): TELEPHONE NO.: E-MAIL ADDRESS (Optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: CITY AND ZIP CODE: BRANCH NAME: IN THE MATTER OF (name of supervised person): Date of birth: CDCR NUMBER, IF ANY: PETITION FOR REVOCATION OF COMMUNITY SUPERVISION COURT/CASE NUMBER: INSTRUCTIONS • Before filing this form, petitioner should consult local rules and court staff to schedule the hearing in item 1. • Petitioner must provide notice of the date, time, and place for the hearing in item 1 to the supervised person, the supervised person’s counsel, if any, the prosecutor, and any victims. (Cal. Rules of Court, rule 4.540(e).) • Petitioner must attach a written report that contains the declaration and information required under rule 4.541. • Upon filing the petition, petitioner must provide copies of the petition and written report to the prosecutor and the supervised person’s counsel or, if unrepresented, the supervised person. (Cal. Rules of Court, rule 4.540(c)(4).) 1. HEARING INFORMATION: A hearing on this petition for revocation has been scheduled as follows: Date: Time: Location (if different than court address above): If an interpreter is needed, please specify the language: not in custody in custody (specify location): 2. CUSTODY STATUS: (Select one): Booking number (if any): 3. CONVICTION INFORMATION: The supervised person was originally convicted of the following offenses: on (specify date): in case numbers (specify): in county of (specify): and sentenced to (specify sentence): 4. SUPERVISION INFORMATION: The supervised person was released on community supervision on (specify date): Name of current supervising agent or officer: Supervision is scheduled to expire on (specify date): 5. SPECIFIC TERMS AND CONDITIONS: Petitioner alleges that the supervised person has violated the following terms and conditions of community supervision (if more space is needed, please use Attachment to Judicial Council Form (MC-025)): 6. SUMMARY: The supervising agency established probable cause for the alleged violation on (specify date): The circumstances of the alleged violation are (if more space is needed, please use Attachment to Judicial Council Form (MC-025)): I declare under penalty of perjury and to the best of my information and belief that the foregoing is true and correct. By Date: SIGNATURE OF PETITIONER NAME AND TITLE OF PETITIONER COURT’S PROBABLE CAUSE FINDING AND ORDERS The court (select one): finds probable cause to support a revocation and preliminarily revokes supervision. does not find probable cause to support a revocation, vacates any hearing dates, and returns the supervised person to community supervision on the same terms and conditions. The supervising agency must notify the prosecutor, supervised person, and supervised person’s counsel (if any) of the dismissal. FOR COURT USE ONLY Date: JUDICIAL OFFICER Form Adopted for Mandatory Use Judicial Council of California CR-300 [New October 28, 2011] PETITION FOR REVOCATION OF COMMUNITY SUPERVISION Page 1 of 1 www.courts.ca.gov (Pen. Code, § 3455) American LegalNet, Inc. www.FormsWorkFlow.com