California > Local County > Orange > Criminal
Petition For Certificate Of Rehabilitation And Pardon L-408.1 - California
| Petition For Certificate Of Rehabilitation And Pardon Form. This is a California form and can be used in Criminal Orange Local County . |
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ATTORNEY OR PARTY WITHOUT ATTORNEY (Name & Address): FOR COURT USE ONLY Telephone No.: E-Mail Address (Optional): ATTORNEY FOR (Name): Fax No. (Optional): Bar No: SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE CENTRAL JUSTICE CENTER 700 CIVIC CENTER DRIVE WEST POST OFFICE BOX 22024 SANTA ANA, CA 92702-2024 In the Matter of the Application of ________________________________________________________________ Type Petitioner's full name First Middle Last and Suffix, if applicable Date of Birth: CII Number: Criminal Case Number(s): PETITION FOR CERTIFICATE OF REHABILITATION AND PARDON (Penal Code § 4852.01 et seq.) To the Superior Court of California, County of Orange: The above-named petitioner represents and shows that: CONVICTION HISTORY CASE NUMBER: M- [All qualifying convictions must be listed. If you have more than three (3) qualifying convictions, attach additional sheets following the same format.] Most Recent Qualifying Conviction (A) Offense On or about on case number: Month Day, Year , petitioner was convicted of the crime of in the County of , California. Indicate Crime and Code Section (B) Type of Sentence or Disposition Petitioner's sentence for this offense was: [Check the appropriate box] Commitment to state prison or other state institution at Name of institution or city where located ; Sentenced to state prison, but execution of sentence was suspended and petitioner was placed on probation. Imposition of sentence was suspended and petitioner was placed on probation. Page 1 of 5 PETITION FOR CERTIFICATE OF REHABILIATION AND PARDON Optional Use Form: L-408.1 [Rev. July 15, 2011] Penal Code, §§ 4852.01 and 4852.06 American LegalNet, Inc. www.FormsWorkFlow.com Name: Case Number: M- (C) Date of Release Thereafter, on or about [Check the appropriate box(es)] Date released from custody , petitioner was; Discharged from state prison or other state institution after completing his/her sentence on Released on parole on (date). (date). Released from custody on probation (after serving a jail sentence as a condition of probation) on __________________(date). Released on probation (if no jail sentence was imposed) on __________________(date). (D) Pen. Code § 1203.4 History (For Probationers Only) a) After termination of probation on ______________, a petition for relief under Penal Code section 1203.4 was granted on __________________(date). b) Has petitioner been incarcerated in any prison, jail, detention facility, or other penal institution or agency after his/her Penal Code section 1203.4 petition was granted? Yes_____ No_____ c) If yes, when and where? _______________________________. d) Is petitioner currently on probation for the commission of any other felony? Yes_____ No_____ e) Petitioner presents the following evidence that he/she has resided in California for the past five years (supporting documentation may be attached as exhibits to the petition): . . . Second Most Recent Qualifying Conviction (A) Offense On or about on case number: Month Day, Year , petitioner was convicted of the crime of in the County of , California. Indicate Crime and Code Section (B) Type of Sentence or Disposition Petitioner's sentence for this offense was: [Check the appropriate box] Commitment to state prison or other state institution at Name of institution or city where located ; Sentenced to state prison, but execution of sentence was suspended and petitioner was placed on probation. Imposition of sentence was suspended and petitioner was placed on probation. Page 2 of 5 PETITION FOR CERTIFICATE OF REHABILIATION AND PARDON Optional Use Form: L-408.1 [Rev. July 15, 2011] Penal Code, §§ 4852.01 and 4852.06 American LegalNet, Inc. www.FormsWorkFlow.com Name: Case Number: M- (C) Date of Release Thereafter, on or about [Check the appropriate box(es)] Date released from custody , petitioner was; Discharged from state prison or other state institution after completing his/her sentence on Released on parole on (date). (date). Released from custody on probation (after serving a jail sentence as a condition of probation) on __________________(date). Released on probation (if no jail sentence was imposed) on __________________(date). (D) Pen. Code § 1203.4 History (For Probationers Only) a) After termination of probation on ______________, a petition for relief under Penal Code section 1203.4 was granted on __________________(date). b) Has petitioner been incarcerated in any prison, jail, detention facility, or other penal institution or agency after his/her Penal Code section 1203.4 petition was granted? Yes_____ No_____ c) If yes, when and where? ______________________________ d) Is petitioner currently on probation for the commission of any other felony? Yes_____ No_____ e) Petitioner presents the following evidence that he/she has resided in California for the past five years (supporting documentation may be attached as exhibits to the petition): . . . Third Most Recent Qualifying Conviction (A) Offense On or about on case number: Month Day, Year , petitioner was convicted of the crime of in the County of , California. Indicate Crime and Code Section (B) Type of Sentence or Disposition Petitioner's sentence for this offense was: [Check the appropriate box] Commitment to state prison or other state institution at Name of institution or city where located ; Sentenced to state prison, but execution of sentence was suspended and petitioner was placed on probation. Imposition of sentence was suspended and petitioner was placed on probation. Page 3 of 5 PETITION FOR CERTIFICATE OF REHABILIATION AND PARDON Optional Use Form: L-408.1 [Rev. July 15, 2011] Penal Code, §§ 4852.01 and 4852.06 American LegalNet, Inc. www.FormsWorkFlow.com Name: Case Number: M- (C) Date of Release Thereafter, on or about [Check the appropriate box(es)] Date released from custody , petitioner was; Discharged from state prison or other state institution after completing his/her sentence on Released on parole on (date). (date). Released from custody on probation (after serving a jail sentence as a condition of probation) on __________________(date). Released on probation (if no jail sentence was imposed) on __________________(date). (D) Pen. Code § 1203.4 History (For Probationers Only) a) After termination of probation on ______________, a petition for relief under Penal Code section 1203.4 was granted on __________________(date). b) Has petitioner been incarcerated in any prison, jail, detention facility, or other pena
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