Name, address and telephone number of attorney or party without attorney: FOR COURT USE ONLY Telephone No.: Fax No.: SUPERIOR COURT OF CALIFORNIA, COUNTY OF SUTTER STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: 1175 Civic Center Boulevard 1175 Civic Center Boulevard Yuba City, CA 95993 PEOPLE OF THE STATE OF CALIFORNIA vs. DEFENDANT: REQUEST FOR PERMISSION TO ATTEND TRAFFIC SCHOOL SPEEDING MORE THAN 25 MILES OVER THE SPEED LIMIT I received a citation in Sutter County on: CASE NUMBER: for violating section(s): I wish to enter a plea of guilty or no contest (to all violations) and hereby request permission to attend traffic school. I have read and understand my statement of rights and have attached the signed original. I am eligible to attend traffic school and understand that I must pay the fine and $52 state administrative fee forthwith. I understand that if granted, I must complete traffic school within 90 days. If I fail to complete traffic school within 90 days my case will be closed and a conviction will be reported to the Department of Motor Vehicles. I understand the $52 administrative fee is not refundable. I am requesting traffic school because: I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: (TYPE OR PRINT NAME) (SIGNATURE OF DEFENDANT) FOR COURT USE ONLY Prior DMV Record: Yes No No CA DMV record available ORDER Request for permission to attend traffic school is: Matter is set for hearing on: HEARING DATE: HEARING TIME: Granted Denied LOCATION: 1175 Civic Center Blvd. Yuba City, CA 95993 Courtroom: TBD Date: Judge of the Superior Court Local Form Approved for Optional Use Sutter County Superior Court Effective: September 5, 2014 Revised: January 19, 2016 REQUEST FOR PERMISSION TO ATTEND TRAFFIC SCHOOL SPEEDING MORE THAN 25 MILES OVER THE SPEED LIMIT TR-03 Page 1 of 1 California Rules of Court, Rule 4.104 American LegalNet, Inc. www.FormsWorkFlow.com