Name: Address: City: State: Zip Code: Telephone: Attorney for/Pro Per: SUPERIOR COURT OF CALIFORNIA, COUNTY OF SHASTA MAILING ADDRESS: 1500 Court Street, Room 219 STREET ADDRESS: 1500 Court Street, Room 219 CITY AND ZIP CODE: Redding, CA 96001 PEOPLE OF THE STATE OF CALIFORNIA v. DEFENDANT: FOR COURT USE ONLY PETITION/APPLICATION (Health and Safety Code § 11361.8) FOR RESENTENCING OR DISMISSAL (H&S § 11361.8(b)) REDESIGNATION OR DISMISSAL/SEALING (H&S § 11361.8(f) Case Number: Date/Time/Dept: INSTRUCTIONS TO DEFENDANT If petitioner/applicant is currently serving a sentence for a qualified crime, please fill out sections 1 and 2A. If the petitioner/applicant has completed the sentence for a qualified crime, please fill out sections 1 and 2B. Complete sections 3 and 4 as necessary. Upon the filing of the petition/application, the petitioner/applicant is required to have the District Attorney served with a copy of the petition/application. It may be served personally or by mail; a signed proof of service must be filed with the court. 1. CONVICTION INFORMATION On (date):__________________, petitioner/applicant, the defendant in the above-entitled criminal action, was convicted of the following Health and Safety § 11357 11358 11359 11360, which has been reclassified under Proposition 64. Petitioner/Applicant further states that when committing the conduct resulting in the conviction he/she was: 18 to 20 years of age; 21 years old or older. Date of birth______________________. Petitioner/Applicant further states that the nature of the substance which resulted in the conviction was: marijuana not in the form of concentrated cannabis; concentrated cannabis; marijuana plants; other: _____________________. Petitioner/Applicant further states that the quantity of the substance which resulted in the conviction was: not more than 28.5 grams of marijuana not in the form of concentrated cannabis; not more than 4 grams of marijuana in the form of concentrated cannabis; not more than 8 grams of marijuana in the form of concentrated cannabis; not more than 6 marijuana plants. 2. REQUEST (Select one box): A RESENTENCING/DISMISSAL: Petitioner/Applicant is currently serving the sentence for the crime noted above, and requests the sentence be recalled and that he/she be resentenced or the charge be dismissed as required by law. B REDESIGNATION/DISMISSAL/SEALING: Petitioner/Applicant has completed the sentence for the crime noted above and requests the sentence be recalled and the conviction be redesignated or dismissed. If dismissed, applicant requests the court's record of conviction be sealed. 3. WAIVER OF HEARING BY ORIGINAL SENTENCING JUDGE Petitioner/applicant waives the right to have this matter heard by the original sentencing judge. The Presiding Judge of the court may designate any judge to rule on this matter. 4. WAIVER OF APPEARANCE Petitioner/Applicant understands there is a right to personally attend any hearing held in this matter. Petitioner/Applicant gives up that right; the matter may be heard without his/her presence. Dated: ____________________ ____________________________________ Signature of petitioner/applicant PETITION/APPLICATION American LegalNet, Inc. www.FormsWorkFlow.com _____________________________________________________________________________________ Form Approved for Optional Use Shasta County Superior Court LF-CRM-111[new Dec. 21, 2016] H&S § 11361.8 Page 1 of 1