DEFENDANT'S NAME AND ADDRESS: FOR COURT USE ONLY TELEPHONE NO: NAME OF COURT: SUPERIOR COURT, STATE OF CALIFORNIA COUNTY OF STANISLAUS STREET ADDRESS: 2260 FLOYD AVE. MAILING ADDRESS: 2260 FLOYD AVE. CITY AND ZIP CODE: MODESTO, CA 95355 BRANCH NAME: TRAFFIC DIVISION PEOPLE OF THE STATE OF CALIFORNIA vs. DEFENDANT: CASE NUMBER: CITATION NUMBER: MOTION AND DECLARATION 1. I request the court to make an order to (specify): 2. My request is based on this motion and declaration, the records on file with the court, and any evidence that may be presented at the hearing. 3. I am the defendant in this action. 4. The facts supporting this motion are as follows (specify): Item 4 continued on attached page. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: _____________________________________ TYPE OR PRINT NAME ______________________________________________ SIGNATURE DATE TIME AM LOCATION 2260 FLOYD AVE, MODESTO, CA 95355 DEPARTMENT 20 SPANISH INTERPRETER NEEDED YES OR NO DATE: _________________________ BY: _____________________________________________ DEPUTY CLERK MOTION AND DECLARATION American LegalNet, Inc. www.FormsWorkFlow.com TRF-1 (REV 4/12)