LASC MH 002 Rev 1/1 For Mandatory Use TO: LOS ANGELES SUPERIOR COURT ATTORNEY OF PARTY WITHOUT ATTORNEY (Name, State Bar Number and Address) , Public Defender , Head Deputy TELEPHONE NUMBER: FAX NO. (Optional): ATTORNEY FOR: FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF LOS ANGELES STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: In the Matter of the Application of: DOB: PETITION FOR WRIT OF HABEAS CORPUS CASE NUMBER: ZW Petitioner is The Petitioner respectfully alleges as follows: is being illegally confined in the custody of in the County of Los Angeles, State of California on a commitment because he/she does not fall within the following Lanterman-Petris-Short (LPS) criteria: THE PETITIONER DEMANDS THE RIGHT TO A COURT REVIEW AS PROVIDED IN SECTION 5275 AND 5353 WELFARE AND INSTITUTIONS CODE No other application for a WRIT OF HABEAS CORPUS has been made on the above ground, by or on behalf of said person in regard to said restraint, except as follows: . WHEREFORE, your petitioner prays that a WRIT OF HABEAS CORPUS be issued directed to the , commanding him/her to have Said Person before this court at the specified time and place stated below. I certify (or declare) under penalty of perjury that the foregoing is true and correct and that this petition is executed in Los Angeles County on this day of , 20 . (PETITIONER SIGNATURE) The Clerk is directed to issue a Writ of Habeas Corpus returnable before said Superior Court in Department , fl, Courthouse, , Los Angeles, CA , on the day of , 20 at 8:30 a.m. DATE Judge of the Superior Court WRIT OF HABEAS CORPUS THE PEOPLE OF THE STATE OF CALIFORNIA, TO (AGENCY DETAINING SAID PERSON) We command you, to have the body of , a person in your custody, power or restraint, as it is said, together with the time and cause of such custody, power or restraint and all treatment records pertaining to said person, before the Honorable , Judge of the Superior Court, County of Los Angeles, State of California, at the courtroom of Department , located at Courthouse, fl, , Los Angeles, CA , on the day of , 20 , at 8:30 a.m. to do and receive what shall then and there be considered concerning the Said Person; and have you then and there with this Writ. Given under my hand with the Seal of Said Court, this day of , 20 . SHERRI R. CARTER, Executive Officer/Clerk of Court By: Deputy Clerk CERTIFICATE OF SERVICE I hereby certify that I received and served the above Writ on the day of , , by delivering said Writ to o n (Person) (Unit / Ward) (SIGNATURE) (PRINT NAME) (TITLE AND TELEPHONE NUMBER) (14 - day, 30 - day or T - Con) American LegalNet, Inc. www.FormsWorkFlow.com