S SUUPPEERRIIOORR CCOOUURRTT OOFF C CAALLIIFFOORRNNIIAA C COOUUNNTTYY OOFF L LOOSS AANNGGEELLEES S P PRROOBBAABBLLEE CCAAUUSSEE DDEETTEERRMMIINNAATTIIOONN ( (DDEECCLLAARRAATTIIOONN)) Location Booked: B ooking N o. : A rrest File No. : Arrestee/Suspect (Last, First, Middle): D OB: Arrestee222s/Suspect222s Residential Address: Location of Occurrence: Booking Charge(s): Misdemeanor Felony Supplemental Hold s/Warrants Charges: Date/Time of Arrest: 48 Hour Expiration Date and Time: Arresting A gency /Division : Arresting Officer(s): Employee No (s) .: Supervisor(s) Approving: Employee No.: Date/Time: Contact Phone No.: Facts establishing elements of offense(s)/violation(s). Information identifying/connecting arrestee/suspect by name with the violation(s) listed: See attached reports incorporated herein by reference. I declare under penalty of perjury that the foregoing is true and cor rect to the best of my knowledge and belief. Executed on (Date) (Signature) in the County of Los Angeles, California. (Time) (Print Name) (Employee No.) Telephonic Determination ONLY On , I was placed under oath and read the contents of the foregoing, including the contents of any attached reports or declaration, verbatim to the Honorable . The Judicial Officer advised me that there ( ) IS ( ) IS NOT probable cause to believe this arrestee has committed a crime. I declare under penalty of perjury that the foregoing is true and correct. Executed in Los Angeles County, California, on (Date) (Signature)(Employee No.) Probable Cause Determination On the basis of either reports reviewed and/or officer222s declaration I hereby determine that there ( ) IS ( ) IS NOT probable cause to believe this arrestee has committed a crime. (Judicial Officer222s Signature) (Date) (Block Stamp) (Time) American LegalNet, Inc. www.FormsWorkFlow.com