TR-210 NAME OF COURT: STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: FOR COURT USE ONLY PEOPLE OF THE STATE OF CALIFORNIA vs. DEFENDANT: NOTICE AND INSTRUCTIONS TO ARRESTING OFFICER VEHICLE CODE INFRACTION (Trial by Written Declaration--Vehicle Code, § 40902) CITATION NUMBER: The defendant has elected a trial by written declaration. CASE NUMBER: 1. a. b. A copy of the citation is attached. OR (1) Agency: (2) Officer name & I.D. number: (3) Citation number: (4) Citation date: 2. Return date: 3. INSTRUCTIONS TO ARRESTING OFFICER: Complete, date, and sign an officer's declaration, attach it to this notice, and file it with the court by the return date (see item 2 above). 4. File with or mail to the Clerk of the (specify): Court at (mailing address): 5. For information, call the court clerk's office at (telephone no.): 6. Number of pages attached: _____ Date: Clerk, by , Deputy CLERK'S CERTIFICATE OF MAILING 1. I am not a party to this action. 2. I served the Notice and Instructions to Arresting Officer by enclosing a copy in an envelope addressed to (specify agency name and address): and caused the envelope to be deposited with the United States Postal Service with first-class postage fully prepaid at (city): , California on (date): 3. I certify that the foregoing is true and correct. Date: Clerk, by , Deputy Form Adopted by the Judicial Council of California TR-210 [New January 1, 1999] NOTICE AND INSTRUCTIONS TO ARRESTING OFFICER (Trial by Written Declaration--Traffic) Vehicle Code, § 40902 American LegalNet, Inc. www.FormsWorkflow.com