Superior Court of California, County of El Dorado Request to Vacate or Reduce Civil Assessment (PC 1214.1) Information and Instruction Sheet What is Civil Assessment? A Civil Assessment fee of $300 is imposed against anyone who does not appear (FTA) in court and/or pay a court-ordered fine by the due date (FTP). The Civil Assessment is addition to any fine and fees associated to your case. You must pay the Civil Assessment even if you are not found guilty of the traffic citation. Can the Civil Assessment be Reviewed? You may ask the Court to remove or reduce the Civil Assessment for good cause. Circumstances that indicate good cause may include, but are not limited to, one of the following reasons: Hospitalization Incarceration Housed in residential treatment Death or hospitalization of your dependent or immediate family member Incapacitation Military duty Court error Caregiver responsibility for a sick or disabled dependent or immediate family member What Do I Do? 1. Fill out the "Request to Vacate or Reduce Civil Assessment" form and bring or mail to the court. West Slope South Lake Tahoe branch 2850 Fairlane Court, Bldg. C, Suite 120 1354 Johnson Blvd. Placerville CA 95667 South Lake Tahoe, CA 96150 530-621-7470 530-573-3044 2. Attach supporting documentation with your request. Your request may be denied if written proof is not received. Examples of supporting documentation include: · Records of admission and discharge from the hospital (the court does not need to know your medical condition) · Court orders to remand into custody/or records of release from custody · Appropriate military orders for active service · Death certificate 3. No posting of fees required at time of request. 4. Once your application has been approved or denied, you will be notified by mail. REQUEST TO VACATE OR REDUCE CIVIL ASSESSMENT (PC 1214.1) Local Form M-40 Mandatory Use only Revised 03/21/17 American LegalNet, Inc. www.FormsWorkFlow.com PARTY'S NAME AND ADDRESS: FOR COURT USE ONLY TELEPHONE NO. SUPERIOR COURT OF CALIFORNIA, COUNTY OF EL DORADO West Slope: 2850 Fairlane Court, Bldg. C., Placerville CA 95667 South Lake Tahoe: 1354 Johnson Blvd., South Lake Tahoe CA 96150 DEFENDANT'S NAME: CASE NUMBER: REQUEST TO VACATE OR REDUCE CIVIL ASSESSMENT (PC 1214.1) I am requesting the Court for the following reason(s). vacate / reduce the civil assessment and recall my case from collections IMPORTANT: Attach supporting documentation with your request. Your request may be denied if written proof is not received. DEATH IN THE FAMILY MILITARY DUTY INCARCERATED RESIDENTIAL TREATMENT COURT ERROR INCAPACITATION CAREGIVER OF DEPENDENT OTHER:_________________________ HOSPITALIZATION OF YOURSELF, FAMILY MEMBER OR DEPENDENT Explanation:__________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ I certify under penalty of perjury under the laws of the State of California that the information I've provided is true and correct. Date: Signature: _____________________________________________________________________________________ ORDER (COURT USE ONLY) The Court having read and considered the Petition, hereby makes the following order: Defendant's Petition to vacate/reduce civil assessment is: GRANTED DENIED GRANTED IN PART. Civil assessment reduced to $_______ Date: Signature: Judicial Officer REQUEST TO VACATE OR REDUCE CIVIL ASSESSMENT (PC 1214.1) Local Form M-40 Mandatory Use only Revised 03/21/17 American LegalNet, Inc. www.FormsWorkFlow.com