ID-140 SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: FOR COURT USE ONLY NAME OF DEFENDANT: STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: HOME TELEPHONE NO.: WORK TELEPHONE NO.: DRIVER'S LICENSE NO.: IGNITION INTERLOCK REMOVAL AND MODIFICATION TO PROBATION ORDER (Ignition Interlock Device) CASE NUMBER: 1. Order to change vehicles. The above-named defendant has approval of the court to change the ignition interlock device ) to another vehicle. (system serial number: a. Remove from vehicle: Model Make Year Color License Plate No. and/or VIN b. Reinstall in vehicle: Make Model Year Color License Plate No. and/or VIN 2. Order for additional installation. The above-named defendant must install an ignition interlock device on the vehicle designated below by (date): Model Year Color License Plate No. and/or VIN Make 3. 4. Order to remove device. Additional orders: Date: I acknowledge receipt of this order. (TYPE OR PRINT NAME) (SIGNATURE OF DEFENDANT) Date: JUDICIAL OFFICER OF THE SUPERIOR COURT Page 1 of 1 Form Approved for Optional Use Judicial Council of California ID-140 [Rev. July 1, 2008] IGNITION INTERLOCK REMOVAL AND MODIFICATION TO PROBATION ORDER (Ignition Interlock Device) Vehicle Code, §§ 23575, 23576 www.courtinfo.ca.gov American LegalNet, Inc. www.FormsWorkflow.com