L-404 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, Address.): FOR COURT USE ONLY (DO NOT LIST ADDRESS IF YOU ARE THE VICTIM) Telephone No.: Facsimile No.: ATTORNEY FOR (Name) : Bar No.: E-Mail address (optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE JUSTICE CENTER: Central - 700 Civic Center Dr. West, Santa Ana, CA 92701 Harbor-Newport Beach - 4601 Jamboree Rd., Newport Beach, CA 92660 Harbor-Laguna Niguel - 30143 Crown Valley Pkwy., Laguna Niguel, CA 92677 North - 1275 N. Berkeley Ave., P. O. Box 5000, Fullerton, CA 92838-0500 West - 8141 13th Street, Westminster, CA 92683 People of the State of California vs. Defendant: PETITION FOR MODIFICATION OF PROTECTIVE ORDER IN CRIMINAL PROCEEDING- DOMESTIC VIOLENCE CASE AND REQUEST FOR HEARING Case Number: 1. I, ____________________________________________________, the Petitioner, declare the following: (Print Your Name) a. (1) I am the defendant named on the protective order in the above-entitled case. In support of this request, I am providing a copy of a current progress report from the courtordered program (circle all that apply): Domestic Violence / Batterer's Treatment / Child Abuser / Drug and Alcohol. (2) (3) I have completed the court-ordered programs. Another Protective Order, Restraining Order or Child Custody Order is in effect and was issued by: ____________________________________________________________. (Name of Court, Case Number, Case Name and Case type) b. (1) I am the protected person named on the protective order in the above-entitled case. I have proof of _________ sessions of the Choices Personal Empowerment Other program (specify program) ___________________________________ attached. (2) I am freely and voluntarily asking the court to modify the Protective Order terms ordered on the above-named defendant whose address is: ___________________________________________________________________________. (3) c. I have discussed my decision to request a modification with the Victim Specialist. I am the parent or guardian of the protected person(s) named on the protective order in the above-entitled case. (1) I am freely and voluntarily asking the court to modify the Protective Order terms ordered on the above-named defendant whose address is: ______________________________________________________________________________. PETITION FOR MODIFICATION OF PROTECTIVE ORDER IN CRIMINAL PROCEEDING DOMESTIC VIOLENCE CASE AND REQUEST FOR HEARING L-404 (Revised July 1, 2006) Optional Form Page 1 of 2 American LegalNet, Inc. www.USCourtForms.com CASE NAME: CASE NUMBER: 2. I request a hearing for consideration of modifying the following terms listed on the protective order (check all that apply): a. b. Remove Remove Add: Add: Must have no personal, telephonic, or written contact with the protected person. Must have no contact with the protected persons through a third party, except an attorney of record. c. d. Remove Remove Add: Add: Must not come within ____________ yards of protected person. Other:___________________________________________________________. 3. In support of this request, I am providing the court with the following information (attach separate page if necessary):____________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ ____________________________________________________________________________________. I declare under the penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: 4 (Type or print name) 4 (Signature of Petitioner) NOTICE: After this form is properly filed, this case will be scheduled for a hearing. You will be notified by the court of a hearing date. A copy of this petition and a Notice of Hearing may be forwarded to all parties for review. Each party will have the right to attend the hearing and oppose the petition. PETITION FOR MODIFICATION OF PROTECTIVE ORDER IN CRIMINAL PROCEEDING DOMESTIC VIOLENCE CASE AND REQUEST FOR HEARING L-404 (Revised July 1, 2006) Optional Form Page 2 of 2 American LegalNet, Inc. www.USCourtForms.com