Santa Cruz — SUPTMV-061

Source: https://www.santacruz.courts.ca.gov/system/files/forms-and-filings/post-web-suptmv-061-petition-relief-collections.pdf

SUPTMV 061

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY NAME: ADDRESS: CITY, STATE, ZIP:

TELEPHONE NO: FAX NO. (Optional): E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA COUNTY OF SANTA CRUZ 701 Ocean Street, Room 120 Santa Cruz, CA 95060 Santa Cruz Branch PEOPLE OF THE STATE OF CALIFORNIA CASE NUMBER: vs. DEFENDANT: PETITION FOR RELIEF FROM COLLECTIONS/MODIFY FINE AMOUNT FAILURE TO APPEAR

1. I did not appear in court, or I did not pay a fine ordered by the Court because of one or more of the following reasons (You must provide documentation to support your selection): a. I was hospitalized or incapacitated b. I was incarcerated (in jail or state prison) c. I experienced a death or hospitalization of a dependent or direct family member d. I was participating in a residential drug or alcohol treatment program e. I was on active military duty f. Other (including financial circumstances): Individuals selecting f due to financial circumstances must also submit form TR 320/CR-320

2. Plea to Underlying Charges: Even if the Court grants this petition, you must still address the underlying

charge(s) of your case(s). If you do not wish to appear in court, then you may enter a plea to the underlying

charge below. Enter a Plea: I, , waive formal arraignment and advisement of my rights; and enter a plea of GUILTY OR NO CONTEST to the infraction(s) in the above referenced case(s).

3. Request for Court Appearance: If you do not want to enter a plea above and want to schedule a court appearance to address the underlying charge(s), then check the box and the court will send you a notice to appear for court at the address you have listed on this form. I understand that I am required to provide proof of any statement related to good cause. I understand that my request may be denied if I do not provide this documentation. I declare under penalty of perjury that the forgoing statement is true and correct to the best of my knowledge Executed at (City and State): Date: Defendant’s Signature

Form Adopted for OPTIONAL USE PETITION FOR RELIEF FROM Page 1 of 1 Superior Court of Santa Cruz County Rule of Court 4.106 and 4.335SUPTMV 061 09/12/22 COLLECTIONS/MODIFY FINE Penal Code 1214.1 AMOUNT FAILURE TO APPEAR