Party (Name and Address): Telephone No.: NAME OF COURT: SUPERIOR COURT OF CALIFORNIA, COUNTY OF SHASTA TRAFFIC/INFRACTIONS Mailing Address 1500 Court Street, Room 219 Street Address 1500 Court Street, Room 219 Redding, CA 96001 DEFENDANT'S NAME: PETITION TO VACATE OR REDUCE CIVIL ASSESSMENT; and ORDER THEREON (Penal Code §1214.1) I am requesting the Court Case Number: vacate / reduce the civil assessment for the following reason(s): IMPORTANT: Attach supporting documentation with your request. Your request may be denied if written proof is not received. DEATH IN THE FAMILY RESIDENTIAL TREATMENT CAREGIVER OF DEPENDENT MILITARY DUTY COURT ERROR INCARCERATED INCAPACITATION OTHER: ____________________________________________ HOSPITALIZATION OF YOURSELF, FAMILY MEMBER OR DEPENDANT Explanation of above (required): ______________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ I certify under penalty of perjury under the laws of the State of California that the information I have provided is true and correct. Date: ____________________ Signature: _____________________________________________ ORDER (COURT USE ONLY) The Court having read and considered the Petition, hereby makes the following order: Defendant's Petition to vacate/reduce civil assessment is: GRANTED DENIED GRANTED IN PART. Civil Assessment is reduced to $__________. Date: ____________________ Signature: _____________________________________________ Judicial Officer Court Clerk, Deputy _____________________________________________________________________________________ Form Approved for Optional Use Shasta County Superior Court LF-TRF-102 [new May 1, 2017] PETITION TO VACATE OR REDUCE CIVIL ASSESSMENT; and ORDER THEREON PC § 1214.1; CRC 4.106 Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com