COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE : Calendar No. Petition for Relief under Penal Code §1203.4 & §1203.4a Information and Instructions Plaintiff(s) : JUDICIAL SUBPOENA General Information: -against: After successful completion of probation, you may petition the court to dismiss the charges under Penal Code §1203.4. If it is in the interest of justice, the judge may allow : you to file the petition before probation ends. • Disclosure – Granting of this petition does NOT relieve you of the obligation to disclose the : conviction in response to any direct question contained in any questionnaire or application for public office, for licensure by any state or local agency, or for contracting with the California State Defendant(s) : . . . . . . . . Lottery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...... • DMV – Granting of this petition does NOT affect DMV actions or future consequences for crimes involving operation of a motor vehicle. • Firearms – Granting of this petition does NOT permit you to own, possess, or have in your custody THE STATE OF NEW YORK THE PEOPLE OFor control any concealable firearm. • Sealing – Granting of this petition does NOT seal your record. The case, including the conviction will remain public record. TO • Sex Registration – Granting of petiti on does NOT relieve you from any obligation to register under Penal Code §290. This information is for general use and not intended as full and comprehensive instruction governing the GREETINGS: relating to relief granted under Penal Code §1203.4. For further information you may refer laws and rules to Penal Code §1203.4 and 1203.4a or you may wish to seek legal assistance. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court Instructions: located at County of NOTE: Clerks cannot advise or render assistance in the completion of this petition. in room , on the day of , 20 , at o'clock in the noon, and at any recessed orIf your case has been destroyed pursuant toin this action on the part of the adjourned date, to testify and give evidence as a witness Government Code §68153, you must provide the court with either a copy of the probation order or the criminal history record from the California Department of Justice (RAP sheet). 1. Your failure tothe Petition for Relief underisPenal Code as a contempt of court (Incomplete forms liable to Complete comply with this subpoena punishable §1203.4 & 1203.4a. and will make you the party on whose behalf this subpoenareturned for correction.) will not be filed and will be was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. 2. A copy of the petition must be mailed or delivered to the District Attorney or City Attorney who prosecuted your case. Witness, Honorable , one of the Justices of the Court 3. in County, day of , the If mailed, the person mailing must complete20 Proof of Service, see page 2 of the petition. If delivered, the prosecutor may acknowledge its receipt by stamping the original petition to be delivered to the court. 4. (Attorney must sign prosecutor name below) Return the original petition and the completed P roof of S ervice (if above and typewas notified by mail) to the Criminal Operations Division of the Justice Center that has jurisdiction over the case. 5. A reimbursement cost of $120.00 for a petition pursuant to Penal Code 1203.4 or $60.00 for a petition pursuant to Penal Code 1203.4a is be submitted with each petition OR Judicial Council Form MC-210 – Defendant’s Financial Statement may be submitted if the petitioner chooses to have the court determine his/her ability to pay the reimbursement cost pursuant to the standards set forth in Penal Code 987.8(g)(2). The completed form should be submitted Office and P.O. Address with the original petition. Attorney(s) for Telephone No.: PETITION FOR RELIEF UNDER PENAL CODE §1203.4 & §1203.4a INFORMATION AND INSTRUCTIONS No.: Facsimile Form #1278 (New August 14 , 2003) Optional Form E-Mail Address: Mobile Tel. No.: Penal Code §1203.4, 1203.4a American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, Address, Telephone No.) : FOR COURT USE ONLY Calendar No. : ATTORNEY FOR (Name) : Plaintiff(s) SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE -againstJUSTICE CENTER: : £ Central - 700 Civic Center Dr. West, Santa Ana, CA 92701 £ Harbor-Newport Beach - 4601 Jamboree Rd., Newport Beach, CA 92660-2595 : £ Harbor-Laguna Niguel - 30143 Crown Valley Pkwy., Laguna Niguel, CA 92677 £ Harbor- Laguna Hills - 23141 Moulton Parkway 2nd Floor, Laguna Hills, CA 92563-1206 £ North - 1275 N. Berkeley Ave., P. O. Box 5000, Fullerton, CA 92838-0500 : £ West - 8141 13th Street, Westminster, CA 92683 JUDICIAL SUBPOENA PEOPLE OF THE STATE OF CALIFORNIA Defendant(s) : . . . . . . VS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... Defendant:__________________________________________ Case Number: Driver’s License Number: Date of Birth: I am the c Defendant c Attorney for the defendant c Probation Officer for the defendant in the above-entitled action. THE PEOPLE OF THE STATE OF NEW YORK CODE §1203.4, §1203.4a PETITION FOR RELIEF UNDER PENAL TO 1. 2. On the date of _________________, the defendant was convicted of the misdemeanor/felony offense of violation of section(s) (list all): GREETINGS: ____________________________________________________________________________________________ 3. Petitioner declares: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before c The defendant has fulfilled the conditions of probation for the entire period of probation or has been discharged , the Honorable prior to termination of the period ofat the probation; that theCourt defendant is not serving a sentence for any offense, on located at charged with the commission of any offense. (Penal Code §1203.4) County of probation for any offense, or in room , defendant was of placed on probation; that o'clock than one year has elapsed since the date of day not , 20 , at noon, and at any recessed c The on the more in the pronouncement of judgment; that the defendant has complied part of sentence of the court; that the defendant or adjourned date, to testify and give evidence as a witness in this action on thewith the the is not serving a sentence for any offense nor under charge of c ommission of any crime, and has since pronouncement of judgment lived an honest and upright life, and conformed to and obeyed the laws of the land. (Penal Code §1203.4a) Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to 4. whose behalf defendant understand that a maximum of this of $50 does damages sustained as a the party onPetitioner and this subpoena was issued for the granting penalty petition and all NOT relieve the defendant of the obligation to disclose result of your failure to comply. the conviction in response to any direct question contained in any questionnaire or application for public office, for licensure by any state or local agency, or for contracting with the California State Lottery, does NOT affect DMV actions or further consequences for crimes involving the operation of a motor vehicle, does NOT Witness, the defendant to own, possess or have in their custody or one of the Justices of the firearm. The granting of , control any concealable permit Honorable Court in this petition does NOT seal your record. The20 County, day of , case, including the conviction will remain public record. The granting of the petition does NOT relieve the defendant of any obligation to register under Penal Code 290. 5. Petitioner and defendant request the conviction be set aside, that a plea of not guilty be entered, and that the Court (Attorney §1203.4, §1203.4a. dismiss this action pursuant to the provisions of Penal Code must sign above and type name below) 6. Petitioner and defendant have the right to have the Court determine the defendant’s ability to pay the reimbursement costs by personally submitting the Defendant’s Financial Statement pursuant to the standards set Attorney(s) for forth in Penal Code 987.8(g)(2). If reimbursement costs are submitted with this petition, defendant waives the right to the judicial determination of ability to pay. 7. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date:____________________ Office and P.O. Address __________________________________ (Type or print name) Form # 1073 (Rev. August 14, 2003) Optional Form ____________________________________________ Telephone No.: (Signature of Petitioner) Facsimile No.: PETITION FOR RELIEF UNDER PENAL CODE §1203.4, §1203.4a E-Mail Address: Mobile Tel. No.: Penal Code §1203.4, 1203.4a American LegalNet, Inc. www.USCourtForms.com Page 1 of 2 COURT COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : Index No. ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, Address, Telephone No) : Calendar No. : Plaintiff(s) ATTORNEY FOR (Name) Bar No. -against- FOR COURT USE ONLY JUDICIAL SUBPOENA : SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE JUSTICE CENTER: : G Central - 700 Civic Center Dr. West, Santa Ana, CA 92701 G Harbor-Newport Beach - 4601 Jamboree Rd., Newport Beach, CA 92660 G Harbor-Laguna Niguel - 30143 Crow n Valley Pkwy., Laguna Niguel, CA 92677 : G Harbor-Laguna Hills - 23141 Moulton Parkway 2nd floor, Laguna Hills, CA 92653-1206 G North - 1275 N. Berkeley Ave., P. O. Box 5000, Fullerton, CA 92838-0500 Defendant(s) G West - 8141 13th Street, Westminster, CA 92683 : ...................................................... PEOPLE OF THE STATE OF CALIFORNIA VS. Defendant:__________________________________________ THE PEOPLE OF THE STATE OF NEW YORK PROOF OF SERVICE c PERSONAL SERVICE c SERVICE BY MAIL TO Case Number: This is a proof of service of a Petition for Relief Under Penal Code §1203.4 or Penal Code §1203.4a DIRECTIONS: A copy of this petition must be served upon the District Attorney or City Attorney who prosecuted your GREETINGS: Mail the front and back of each page of this document to the District Attorney or City Attorney who prosecuted the case. case. When the petition has been served, the original may then be filed with the court. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before 1. , the Honorable Person serving. I am over the age of 18 and not a party to this action. at the Court Name: located at County of Address: in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the Telephone: 2. I served a copy of the Petition for Relief Under Penal Code §1203.4/1203.4a as follows (check either a or b below): Your failurec comply with this subpoena is punishable as a contempt ofRelief under Penal Code §1203.4/1203.4a to to Personal Service: I personally delivered the Petition for court and will make you liable to a. the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a the person at the address listed below: result of your failure to comply. (1) Name of person served: (2) Address where served: Witness, Honorable (3) Date served: Court in County,Time served: day of (4) b. , one of the Justices of the , 20 c Service by Mail: I deposited the Petition for Relief under Penal Code §1203.4/12034a in the United States mail, in a sealed envelope with postage fully prepaid. The envelope was addressed as follows: (1) Name of person served: (Attorney must sign above and type name below) (2) Address: (3) Date of Mailing: (4) Place of Mailing (city and state): Attorney(s) for I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date:____________________ __________________________________ (Type or print name) Office and P.O. Address ____________________________________________ (Signature of Declarant) Telephone No.: Facsimile No.: PROOF OF SERVICE - PETITION FOR RELIEFAddress: PENAL CODE §1203.4, §1203.4a E-Mail UNDER Form # 1073 Mobile Tel. No.: (Rev. August 14, 2003) Optional Form Penal Code §1203.4, 1203.4a Page 2 of 2 American LegalNet, Inc. www.USCourtForms.com