[NAME, ADDRESS & PHONE # OF PARTY MAKING THE REQUEST] PLAINTIFF: FOR COURT USE ONLY PEOPLE OF THE STATE OF CALIFORNIA Vs DEFENDANT: HEARING DATE: REQUEST TO ATTEND TRAFFIC SCHOOL AND ORDER CASE NUMBER: The defendant in this case is seeking the Court’s permission to attend traffic school, prior to disposition of his/her case, as to count(s) ____________, namely section(s) _____________________________ of the Vehicle Code. Traffic School must be court ordered as the defendant is accused of going ________ mph in a ________ mph zone, ________ miles over the posted speed limit, which is out of the authority of a court clerk to grant traffic school (California Rule of Court 4.104(b)(2)(G)). Defendant is making this request through the mail by submitting the fine payment and $49 traffic school administrative fee. Defendant is making this request in person Date: [SIGNATURE OF DEFENDANT] [TO BE COMPLETED BY JUDGE] Defendant’s request is denied. Defendant’s request is granted. Defendant is to attend traffic school as to count(s) __________. If not already submitted, Defendant must pay a nonrefundable $49 administrative fee within 10 days, in addition to the fine amount. A certificate of completion of traffic school is to be filed with the clerk of the court within 60 days of today’s date. ____________ ____________ DATED: JUDGE OF THE SUPERIOR COURT REVISED 6/24/09 REQUEST FOR TRAFFIC SCHOOL AND ORDER TRF027 American LegalNet, Inc. www.FormsWorkFlow.com 1 PROOF OF SERVICE BY MAIL H. SWIFT, Clerk of the Amador Superior Court, State of California, and not a party to the within entitled action, served the attached. REQUEST TO ATTEND TRAFFIC SCHOOL AND ORDER on the parties in said action, by placing a true copy thereof enclosed in a sealed envelope with postage thereon addressed as shown, for collection and mailing pursuant to the ordinary business practice of the office which is that mail is collected and deposited with the United States Postal Service on the same day in the ordinary course of business. ____________________________________________ DEFENDANT [NAME] ____________________________________________ [MAILING ADDRESS: STREET OR PO BOX] ____________________________________________ [CITY, STATE, AND ZIP CODE] ____________________________________________ [TELEPHONE NUMBER] [TO BE COMPLETED BY CLERK] I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. . Executed at Jackson, California on H. SWIFT, CLERK By ________________________________ Deputy Clerk REVISED 6/24/09 REQUEST FOR TRAFFIC SCHOOL AND ORDER TRF027 American LegalNet, Inc. www.FormsWorkFlow.com 2