San Benito — SB-MC-3

Source: https://www.sanbenito.courts.ca.gov/system/files/forms-and-filings/sb-mc-3.pdf

SUPERIOR COURT OF CALIFORNIA County of San Benito 450 Fourth Street, Hollister, CA 95023 Criminal History Request

Date of Request:

Name : *

Alias:

DOB: * CDL:

CASE#: * CII:

California Penal Code § 11142. Any person authorized by law to receive a record or information obtained from a record who knowingly furnishes the record or information to a person who is not authorized by law to receive the record or information is guilty of a misdemeanor.

Requested by: Title:

Reason:

FOR COURT: FAX COMPLETED FORM TO:

DURING BUSINESS HOURS ATTN: RECORDS MON-THU 8AM – 5PM 831-636-1416

For Sheriff’s Office Use Only

Request Completed By: Date Completed: Comments:

*field with an asterisk must be completed, if DOB not know, give an estimate

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CRIMINAL HISTORY REQUEST

Form adopted for Mandatory Use Local Court Form SB-MC-3 [May 2024]