ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY TELEPHONE NO.: EMAIL ADDRESS (Optional): ATTORNEY FOR (Name): FAX NO. (Optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, COUNTY COURTHOUSE, 220 W. BROADWAY, SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910 PLAINTIFF THE PEOPLE OF THE STATE OF CALIFORNIA DEFENDANT REQUEST FOR MILITARY DIVERSION; ADVISAL AND WAIVER OF RIGHTS Defendant: Initial each statement below. 1. 2. 3. CASE NUMBER I am the defendant in the above-captioned case, which charges the following misdemeanor violation(s) for which I am requesting Military Diversion (Pen. Code § 1001.80): I have been advised of, understand, and waive my right to a speedy trial in this case. I understand that, to be granted Military Diversion, I am required to provide an assessment or other evidence confirming I am a current or former member of the military and may be suffering from sexual trauma, traumatic brain injury, post-traumatic stress disorder, substance abuse, or mental health problem, as a result of my military service. I understand I am also required to provide a recommended treatment plan for my sexual trauma, traumatic brain injury, post-traumatic stress disorder, substance abuse, or mental health problem. I understand that the Military Diversion program, if granted, will be no longer than two years and will include a court-ordered treatment program. I understand that, if accepted into the Military Diversion program, failure to comply with the terms of the diversion program may result in reinstatement of criminal proceedings. I understand that if I am arrested or charged with a new criminal offense while participating in the Military Diversion program, criminal proceedings in this case may be reinstated and I may be found no longer eligible for Military Diversion. I understand that if I perform satisfactorily during the period of Military Diversion, the court will dismiss the criminal charges. I understand that, upon successful completion of the Military Diversion program, the arrest upon which the diversion was based shall be deemed to have never occurred, except as stated in statement 8, below. I have been advised and understand that, regardless of my successful completion of diversion, the arrest upon which the diversion was based may be disclosed by the Department of Justice in response to a peace officer application request, and that I am still obligated to disclose the arrest in response to a direct question contained in a questionnaire or application for a position as a peace officer, as defined in Pen. Code § 830. 4. 5. 6. 7. 8. I declare under penalty of perjury under the laws of the State of California that I have read and understand each of the forgoing eight statements, and by initialing each statement I agree to their contents. Date: Type or print name Signature of Defendant SDSC CRM-284 (New 6/15) Mandatory Form REQUEST FOR MILITARY DIVERSION; ADVISAL AND WAIVER OF RIGHTS Pen. Code § 1001.80 American LegalNet, Inc. www.FormsWorkFlow.com