Defendant Name: Street Address: City: State: Zip Code: Telephone: Superior Court of California County of Riverside People of the State of California, Plaintiff PETITION TO VACATE CIVIL ASSESSMENT FOR FAILURE TO PAY (PC §1214.1); DECLARATION IN SUPPORT OF PETITION; AND COURT ORDER ON PETITION v. , Case Number: Defendant IMPORTANT: Written proof of any of the following must be attached and cover the entire time period in question. Attach copies only – Originals will not be returned to you. Hospitalized Incarcerated Overseas Military Duty Other I had a good reason for not paying my fine when due because: (state your reason and attach further pages if necessary) I declare under penalty of perjury under the laws of the State of California that (1) the foregoing statement is true and correct and (2) any documents attached to this form are true and correct copies of the originals. Signature of Defendant: Signed on Date ORDER RE CIVIL ASSESSMENT (COURT USE ONLY) Petition to Vacate FTP Civil Assessment added (date) [ ] Granted [ ] Denied [ is: ] Ordered to Appear on (date) Date: Signature Judicial Officer The amount due on this case is now $ payment in full or arrange monthly payments. . Please contact the clerk’s office at once to make a RIOTS38P American LegalNet, Inc. www.FormsWorkflow.com CIVIL ASSESSMENT FOR FAILURE TO PAY FINE FREQUENTLY ASKED QUESTIONS What is a Civil Assessment? A Civil Assessment of $300.00 is imposed against anyone charged with a traffic, misdemeanor, or felony offense that after notice and without good cause, fails to pay all or any portion of a fine ordered by the court. The civil assessment is in addition to any other fines imposed on the case. This can include the failure to make a payment on a fine by the due date, or the failure to complete community service ordered in lieu of a fine. How is the Civil Assessment imposed? If you fail to make a payment on your fine on the date it is due, the clerk’s office will send a warning notice to you by first-class mail to the address shown on the notice to appear (your ticket), or to the last known address, if you have provided the court with a different address. If so mailed, there is a presumption that the notice has been received. There is no requirement that the court prove that you actually received the notice, only that it was mailed. What if I have moved? The Court is under no obligation to try to find your current address. You have an obligation to notify the court while the case is still open of any change of address. Can there be more than one civil assessment added to my case? Yes. It is possible to have a civil assessment added for each failure to pay. A separate warning notice is required to be sent for each assessment. When does the assessment become effective? The assessment cannot go into effect until at least 10 calendar days after the court mails the warning notice to you. Can I have the civil assessment set aside? If you appear within the time frame shown in the warning notice and show good cause for not appearing or paying when you were ordered to, the court may vacate the assessment. What is Good Cause? Good Cause is a sufficient reason that is beyond your control, (e.g. medical emergency, military duty, etc.), which prevented you from making a payment on or before the due date and a demonstration that you attempted to resolve the matter as soon as possible after that date. Good Cause is determined on a case-by-case basis. How can I have the civil assessment vacated (removed)? You may submit a request that the court remove or vacate the civil assessment by completing and submitting your request on the court approved form (see the front of this form). The judge will review the petition and either grant or deny your request. You are not entitled to a court hearing and the issue will not be addressed in court, unless the court orders a court hearing. What are the consequences of a civil assessment for a failure to pay a fine? The civil assessment is imposed after the 10 day warning notice is mailed, and at or about the same time, a notice is sent to the California Department of Motor Vehicles (DMV) requesting that a hold be placed on your privilege to drive, until the matter is cleared with the court. In response, the DMV may send you a notice advising that your privilege to drive will be suspended if the matter is not taken care of. In some cases, the DMV will not suspend your driving privilege but will not allow you to get a license, or renew a license, until it is cleared with the court. Once a failure to pay civil assessment is imposed the only way to have the DMV hold lifted is to pay the entire amount of the fine, including the added civil assessment. The court will not provide any restricted license. Revised 5-16-08 American LegalNet, Inc. www.FormsWorkflow.com