Santa Barbara — SC-8028

Source: https://www.santabarbara.courts.ca.gov/system/files/forms-and-filings/sc8028.pdf

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SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA BARBARA FOR COURT USE ONLY

Santa Barbara Division Santa Maria Division Lompoc Division
118 East Figueroa St. 312 East Cook St. Bldg. E 115 Civic Center Plaza
Santa Barbara, CA 93101 Santa Maria, CA 93454 Lompoc, CA 93436
(805) 568-3959 (805) 614-6590 (805) 737-7789

PLAINTIFF: People of the State of California

DEFENDANT:

CITATION NUMBER:

ABILITY TO PAY DETERMINATION

INSTRUCTIONS: THIS FORM MAY ONLY BE SUBMITTED ONCE TO THE COURT.

Full Name Last: First: Middle: Suffix:

Current Address Street: City: State: Zip:

Additional Information: Telephone Number: Driver’s License #:

I am pleading guilty I am requesting Traffic School (if eligible); I have a financial hardship and I cannot pay

the full amount for the offenses on my citation. I am requesting a judicial determination regarding my ability to pay. Attached is my financial affidavit. I understand certain fines are mandated by the legislature and may be ineligible for reduction. I am requesting a reduction in the monthly installment payment amount to $_____________ per month. I am requesting a reduction in the fine that has already been imposed on this case. I declare under penalty of perjury that the foregoing is true and correct.

Dated: DEFENDANT

IT IS SO ORDERED:

Fine of $ imposed, due within 30 days of the date of mailing of this notice, or Due by
Monthly payments of $ to be paid to the court by the of every month.
Traffic School is authorized (additional $66.00 traffic violator school fee will be imposed.)
Defendant to appear in court on at a.m. / p.m. in Dept .
Denied. The court has determined the defendant has the ability to pay. Payments may be arranged through

the Traffic Department. Other:

SIGN

Dated: JUDICIAL OFFICER OF THE SUPERIOR COURT

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CLERK’S CERTIFICATE OF MAILING

I certify that I am not a party to this action and that a true copy of the foregoing was mailed first class, postage prepaid, in a sealed envelope addressed as shown, and that the mailing of the foregoing and execution of this certificate occurred at Santa Barbara Santa Maria Lompoc, California on (date): ________________,

Angela Braun, Executive Officer By SIGN , Deputy

SC-8028 [Revised Dec. 2016] ABILITY TO PAY DETERMINATION

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