Choose a location ATTORNEY OR PARTY WITHOUT ATTORNEY (NAME AND ADDRESS): TELEPHONE NO.: FOR COURT USE ONLY ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA BARBARA STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: Matter of PETITION FOR RESTRICTED LICENSE ­ VC §13202.5 CASE NUMBER: I, the undersigned, declare that I am under the age of twenty-one, and have been convicted in the above-entitled case for an offense which requires that my privilege to drive by suspended for one year. My driving privilege is not currently suspended for any other reason. I have not previously been convicted of any other offense requiring a suspension under Vehicle Code §13202.5. I have a critical need to drive to and from school, work, or other place as described below, and public or other mode of transportation is not adequate. I live at ______________________________________________, __________________________, _______, ___________ Street Address City State Zip My driver's license number is _________________________. The school I attend is _______________________________, which is _________ miles from home. I am in my ___________________ year, and I am currently carrying _________ units. (first, second, etc.) I work at ________________________________________, which is _________ miles from home, _________ hours a week. My supervisor is ____________________________________________________ Phone: ___________________________ I also need to drive to ____________________________________________________________ because (explain in detail): Public or other transportation is inadequate because (explain in detail): I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed at _________________________________________________, California, on ____________________________ _____________________________________________________ Signature DO NOT WRITE BELOW THIS LINE ­ FOR COURT USE ONLY ORDER The petition for a restricted driver's license is granted as follows: To and from work To and from school To and from treatment program During the course of work Other: ___________________________________________________________________________________________ An abstract with the restriction information has been transmitted to the Department of Motor Vehicles in Sacramento. The petition for a restricted license is denied because: No critical need has been shown Insufficient evidence; Defendant may resubmit Other: ___________________________________________________________________________________________ Dated: Judge of the Superior Court WARNING: THIS IS NOT A LICENSE TO DRIVE. This order allowing you to drive on a restricted basis is NOT VALID unless you are also in possession of a currently valid driver's license issued by DMV. SC-9007 [Revised Aug. 2, 2011] PETITION FOR RESTRICTED LICENSE (Juvenile) American LegalNet, Inc. www.FormsWorkFlow.com CVC §13202.5