Form 1 (Revised 2/10/77) IN THE SUPERIOR COURT OF THE STATE OF CALIFORNIA IN AND FOR THE COUNTY OF KERN In the Matter of the Application of No (Print your name legibly) For a Certificate of Rehabilitation and Pardon PETITION FOR CERTIFICATE OF REHABILITATION AND PARDON To the Honorable Superior Court of the State of California, in and for the County of KERN The petition of (Fill in your name) hereby respectfully represents and shows that: I. (Complete this paragraph only with respect to your most recent felony conviction) On or about felony of (State crime and code section if you know it) , 20 , I was convicted of the , in the County of this offense was (check appropriate box): tion at a suspended sentence to state prison or other state institution. , State of California. My sentence for commitment to state prison or other state instituprobation with 2000 (C) American LegalNet, Inc. KC Clerk RE 4 (200 4-1-77 Rev.) Thereafter, on or about (check appropriate box): pleting my sentence; , 20 (Date of release from actual custody) , I was discharged from state prison or other state institution after comreleased on parole, from which I was finally discharged on , 20 - released from custody on probation , and obtained relief under Penal Code , 20 or after serving a jail sentence as part of my probation, successfully completed my probation on , 20 section 1203.4 on Note 1 (Complete this section with respect to your second most recent felony conviction, if any) On or about felony of (State crime and code section if you know it) , 20 , I was convicted of the , in the County of offense was (check appropriate box): at , State of California. My sentence for this commitment to state prison or other state institution probation with a suspended sentence to state prison or other state institution. Thereafter, on or about (check appropriate box): pleting my sentence; , 20 (Date of release from actual custody) , I was discharged from state prison or other state institution after comreleased on parole, from which I was finally discharged on , 20 released from custody on probation or after serving a jail sentence as part of my probation, successfully completed my probation on , 20 section 1203.4 on Note 2 (Complete this section with respect to your third most recent felony conviction, if any) , and obtained relief under Penal Code , 20 On or about , 20 (State crime and code section if you know it) , I was convicted of the felony of County of offense was (check appropriate box): , in the , State of California. My sentence for this commitment to state prison or other state institution probation with a 2000 (C) American LegalNet, Inc. at suspended sentence to state prison or other state institution. KC Clerk RE 4 Pg. 2 Thereafter, on or about (check appropriate box): pleting my sentence; (Date of release from actual custody) , 20 , I was discharged from state prison or other state institution after comreleased on parole, from which I was finally discharged on , 20 released from custody on probation or after serving a jail sentence as part of my probation, successfully completed my probation on , 20 section 1203.4 on , and obtained relief under Penal Code , 20 (If you have suffered more than three felony convictions, attach additional sheet following the same format used in paragraph I.) II. I am now a resident of the State of California and I have continuously resided in the State of California from III. , 20 , to the present date. During the period of my rehabilitation, I have lived an honest and upright life, conducted myself with sobriety and industry, and exhibited good moral character; I have conformed to and obeyed all the laws of the land. WHEREFORE, Your petitioner prays that the Court make its order and decree declaring that the petitioner has been rehabilitated, and for a Certificate of Rehabilitation recommending that the Governor of the State of California grant petitioner a full pardon; and that for such purpose a time be appointed for the hearing of the foregoing petition, and that all other and necessary proper orders may be made in the premises. DATED , 20 (SIGN YOUR NAME HERE) (Petitioner) (Residence address) 2000 (C) American LegalNet, Inc. KC Clerk RE 4 Pg. 3 INSTRUCTIONS (a) (b) Prepare this Petition, sign your name, and file it with the County Clerk. In every case, you must have resided continuously for three y ears in the State prior to filing the petition. If you were discharged or released on parole after May 13, 1943, or if you were released on felony probation, at least three years must have elapsed before you can file for a Certificate of Rehabilitation. In addition to such three-year period there must be added thereto thirty days for each year of the term prescribed by statute as the maximum possible penalty of imprisonment for each offense for which you were sentenced If you were sen- tenced to concurrent terms the greatest possible maximum for any such offenses shall con- stitute the maximum for the purpose of computing the period of rehabilitation. However, if you received any sentence with a maximum possible penalty of more than fifty years, or if the sum of the maximum possible penalties on consecutive terms is more than fifty years, the law allows you to calculate the additional period of residence as if the maximum possible penalty were only fifty years. (c) If you were released on parole or probation, or if you were discharged from custody prior to May 13, 1943, you may file a Petition for a Certificate of Rehabilitation and Pardon if you have resided in this State continuously for three years prior to the filing of such Petition. However, your parole or probation must have terminated. If you were required to serve jail time as part of your felony probation, the three year period does not begin to run until your actual release from custody. (d) If you were released on felony probation and successfully completed that probation, you must obtain relief under Penal Code section 1203.4 before applying for a Certificate of Re- habilitation. (e) You are entitled to be represented by an attorney of your own selection, or if you have none, by the public defender. If there is no public defender in the county, by a state parole officer, or by anyone assigned to you by the court. (f) (g) (h) (i) It is unlawful for anyone, including attorneys, to accept any fee, money or anything of value for their services in representing you in this proceeding. You are not required to pay fi