ATTACHMENT PB-4054 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar Number and Address): FOR COURT USE ONLY TELEPHONE NUMBER: EMAIL ADDRESS (Optional): ATTORNEY FOR (Name): FAX NUMBER (Optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA COURT ADDRESS: CITY AND ZIP CODE: DIVISION: 191 North First Street San José, California 95113 Probate Division In the Matter of the Application of: WRIT OF HABEAS CORPUS (RE: QUARANTINE DETENTION) CASE NUMBER: 1. TO THE SANTA CLARA COUNTY PUBLIC HEALTH DEPARTMENT: YOU ARE ORDERED TO APPEAR to show cause at the hearing noted below why the Petitioner should not be released from quarantined confinement. Superior Court of California, County of Santa Clara 191 North First Street, San José, CA 95113 Date: Time: Dept. Department Phone Number: (408) 882- 2. TO THE CLERK OF THIS COURT: You are directed to serve this writ with the attached order to all interested parties by fax or email. If the Petitioner does not have fax or email capabilities and is selfrepresented, then you may give notice of the court date by phone as indicated in the petition. (Attach the original fax confirmation or printed email to this writ as proof of service for the file.) [SEAL] Date: Clerk, by , Deputy PB-4054 NEW 07/01/11 WRIT OF HABEAS CORPUS (RE: QUARANTINE DETENTION) Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com