PEOPLE OF THE STATE OF CALIFORNIA v. DEFENDANT Case Number: ADDITIONAL CONVICTIONS (in same court case): 1. CONVICTION INFORMATION On (date): _________________, Petitioner/Applicant, the defendant in the above-entitled criminal action, was convicted of the following Health and Safety Code section 11357 11358 11359 11360. The offense has been reclassified under Proposition 64. Petitioner/Applicant further declares that when the conduct occurred, resulting in the conviction, he/she was: 18 to 20 years of age; 21 years old or older. Date of birth:_______________________ Petitioner/Applicant further declares 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: _________________________________________________________________________________ 2. REQUEST FOR RESENTENCING/DISMISSAL Petitioner/Applicant is currently serving the sentence for the crime noted above, and requests the sentence be recalled and relief be granted in accordance with Health and Safety Code §11361.8(f), as follows: Petitioner be resentenced to a misdemeanor. Petitioner be resentenced to an infraction. The conviction for the crime be set aside and the charge be dismissed because it is now legally invalid. other: _____________________________________________________________________________ 3. REQUEST FOR REDESIGNATION/DISMISSAL/SEALING Petitioner/Applicant has completed the sentence for the same crime noted above, and requests the sentence be recalled and relief be granted in accordance with Health and Safety Code §11361.8(f) as follows: The offense be redesignated or dismissed as required by law. If the court grants dismissal of the conviction, the court's record of conviction be sealed. other: ___________________________________________________________________ _____________________________________________________________________________________ Form Approved for Optional Use Shasta County Superior Court LF-CRM-112[new Dec. 21, 2016] PETITION/APPLICATIONSUPPLEMENTAL PAGE Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com