OFFICE OF ADMINISTRATIVE HEARINGS STATE OF CALIFORNIA GENERAL JURISDICTION DIVISION Filing Instructions: File Electronically at TeacherDismissalMotions@dgs.ca.gov or by Fax to (916) 376-6324 For more information visit www.dgs.ca.gov/oah/home.aspx Teacher Dismissal Motion Cover Sheet CASE TITLE: Current Dates on Calendar (if any): PHC: Hearing: FILING PARTY/ ATTORNEY/ REPRESENTATIVE (Name and Address) OAH CASE NO. RESPONDING PARTY/ ATTORNEY/ REPRESENTATIVE (Name and Address) Telephone: Fax No: Email: Preferred Method of Service: [ ] Email [ ] Fax [ ] U.S. Mail Telephone: Fax No: Email: Preferred Method of Service: [ ] Email [ ] Fax [ ] U.S. Mail SECTION I: CASE TYPE Other Than Solely Egregious Misconduct Solely Egregious Misconduct (Must provide the timeline info below) Statutory Timelines: Discovery to be completed by: Hearing to be held by: SECTION II: MOTION TYPE Amend Pleadings Dismissal of Accusation Continuance Limit Evidence at Hearing Other Discovery (Complete SECTION III) In addition to the Motion, attached are: Declaration of good faith attempt at informal resolution Copy of current Pleadings and Proposed Amendment (Motion to Amend only) Notice of Motion SECTION III: DISCOVERY MOTION Good Faith Effort Conference was held on: Included is/are: Joint Stipulation Declaration re: Failure to File Joint Stipulation Memorandum of Points and Authorities Declaration in Support of Motion Proposed Order Proof of Service Printed Name of Person Filing Motion Signature of Person Filing Motion Date 2349 GATEWAY OAKS DR., SUITE 200 SACRAMENTO, CA 95833 Phone 916-263-0550 FAX 916-376-6349 sacfilings@dgs.ca.gov 1515 CLAY STREET, SUITE 206 OAKLAND, CA 94612 Phone 510-622-2722 FAX 916-376-6323 oakfilings@dgs.ca.gov 320 WEST FOURTH STREET, SUITE 630 LOS ANGELES, CA 90013 Phone 213-576-7200 FAX 916-376-6324 lateacherdismissal@dgs.ca.gov 1350 FRONT STREET, ROOM 3005 SAN DIEGO, CA 92101 Phone 619-525-4475 FAX 916-376-6325 sanfilings@dgs.ca.gov DGS-OAH 92 American LegalNet, Inc. www.FormsWorkFlow.com