AFFIDAVIT RE IGNITION INTERLOCK Form Adopted for Mandatory Use - Local Rules of the Superior Court of California Page 1 of 1 TUO-CR-250 (Revised ) TUO-CR-250 I, the above-named defendant, declare that at this time, I do not own nor have any motor vehicles registered in my name and will not operate any motor vehicle. I understand and declare that while I am subject to the provisions of maintaining an ignition interlock device, I will not own nor operate any motor vehicle that is not so equipped, unless required to operate a motor vehicle in the course and scope of my employment and that vehicle is owned by the employer, that the employer has been notified by me that my driving privilege has been restricted pursuant to Vehicle Code Section 23575 and that I must have proof of that notification in my possession or with the vehicle. Should I hereafter own or have registered in my name any motor vehicle, I will forthwith report any change in ownership of a vehicle to this Court and have it equipped with an ignition interlock device as required by the order of this Court. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: Signature of Defendant SUPERIOR COURT OF CALIFORNIA COUNTY OF TUOLUMNE 60 N. Washington Street Sonora, CA 95370 Phone: (209) 533-5563 The People of the State of California, Plaintiff, vs. Defendant. Case Number: AFFIDAVIT RE IGNITION INTERLOCK Space below for use of Court Clerk only American LegalNet, Inc. www.FormsWorkFlow.com