JV-755 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): FAX NO. (Optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: CASE NAME: CASE NUMBER: DEFERRED ENTRY OF JUDGMENT-- DISMISSAL AND SEALING OF JUVENILE RECORDS 1. Name of subject child: Date of birth: 2. a. Date of hearing: b. Judicial officer (name): Dept.: Room: 3. The court has read and considered the report of the probation officer and any other evidence presented or information provided. THE COURT MAKES THE FOLLOWING FINDINGS AND ORDERS: 4. The child has complied satisfactorily with the conditions imposed. 5. The petition filed on (date): is dismissed. 6. The child's juvenile records related to the arrest on (date): regarding an alleged violation of (specify offense): in the custody of this court and of the courts, agencies, and officials listed below are ordered sealed: District Attorney (specify county): Child's Attorney (name): Probation Dept. (specify county): California Dept. of Justice Other (specify): Attachment 7. All Deferred Entry of Judgment records are to be destroyed according to Welfare and Institutions Code section 793(c), and the arrest is deemed never to have occurred except that the prosecuting attorney and the probation officer of any county can access these records for the limited purpose of determining eligibility for deferred entry of judgment. Date: JUDICIAL OFFICER Page 1 of 1 Form Approved for Optional Use Judicial Council of California JV-755 [Rev. January 1, 2012] DEFERRED ENTRY OF JUDGMENT-- DISMISSAL AND SEALING OF JUVENILE RECORDS Welfare and Institutions Code, §§ 781(d), 793 www.courts.ca.gov American LegalNet, Inc. www.FormsWorkFlow.com