CR-301 SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: FOR COURT USE ONLY PEOPLE OF THE STATE OF CALIFORNIA vs. SUPERVISED PERSON: WARRANT REQUEST AND ORDER PAROLE CII No.: CDCR No.: PRCS FBI No.: CASE NUMBER: CONVICTION AND SUPERVISION INFORMATION: The supervised person was convicted of the following offenses: on (date): in case number(s): The supervised person was released on supervision on (date): Supervision is scheduled to expire on (date): and sentenced to: WARRANT REQUEST A warrant is being requested because (select one): The supervised person has absconded and his or her whereabouts are unknown. The supervised person has committed a new offense (specify offense): The supervised person has violated the following term(s) of supervision (specify): Other (specify): To be entered into the state (WPS) national (NCIC) warrant system(s). DECLARATION (State facts that establish probable cause for the warrant. If more space is needed, attach the Attached Declaration (form MC-031).) INFORMATION ABOUT THE SUPERVISED PERSON Name: Race: DOB: Gender: Tattoos: Last Known Address: Armed and dangerous. Alias: Height: Other: Weight: Hair: Eyes: Possible mental disorder. 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 AND TITLE ORDER SIGNATURE For court use only Based on the above declaration and information, the court finds probable cause to arrest and orders Bail Amount (specify): No Bail a warrant for the arrest of the supervised person national (NCIC) warrant system(s). described above to be entered into the state (WPS) The court also summarily revokes supervision and tolls the running of the supervision period. Request Denied. The court finds no probable cause to arrest. Date: Time: Location: JUDICIAL OFFICER Form Approved for Optional Use Judicial Council of California CR-301 [New July 1, 2013] Page 1 of 1 Penal Code, §§ 1203.2, 3000.08, and 3455 www.courts.ca.gov American LegalNet, Inc. www.FormsWorkFlow.com WARRANT REQUEST AND ORDER