Madera — Certificate of Rehabilitation (MAD-CRM-010-A)

Source: https://www.madera.courts.ca.gov/system/files/forms-and-filings/mad-crm-010-certificate-rehabilitation-pursuant-penal-code-ss485213-rev-04-15-2020.pdf

MAD-CRM-010-A IN THE SUPERIOR COURT OF THE STATE OF CALIFORNIA IN AND FOR THE COUNTY OF MADERA

FOR COURT USE ONLY

In the Matter of the Application of

Type Applicant’s Full Name – First, Middle, Last, and Suffix

Date of Birth:

CII Number:

Criminal Case Number: List all applicable Criminal Numbers

CERTIFICATE OF REHABILITATION Pursuant to Penal Code §4852.13

The petition of , presently residing Type Applicant’s Full Name – First, Middle, Last and Suffix

at , heretofore filed, praying for Type Applicant’s Street Address, City, State and Zip Code

a Certificate of Rehabilitation pursuant to the provisions of Chapter 3.5, Title 6 and Part 3 of the Penal Code of the State of California, came on regularly for hearing on this day Day of the Month of and proof having been made to the Month, Year satisfaction of the Court that notice of the time of hearing has been regularly given as required by law; and from satisfactory proof taken at said hearing the Court finds that all allegations of said petition are true, and that the required period of rehabilitation has elapsed since petitioner’s date of discharge from custody due to completion of the term to which the petitioner was sentenced or upon the release on parole or probation on , that where appropriate, petitioner has obtained relief pursuant to Month, Day, Year Penal Code Section 1203.4, and that petitioner has demonstrated by the course of conduct his/her rehabilitation and fitness to exercise all the civil and political rights of citizenship (except as provided in Penal Code Section 485.15); and that Petitioner has been , time convicted of a felony; Total Number of Felony Convictions

WHEREFORE, It Is Ordered, Adjudged, and Decreed, and this court does hereby order, adjudge, and

decree the petitioner has been rehabilitated and is fit to exercise all the civil and political rights of citizenship (except as provided in Penal Code Section 4852.15), and by virtue thereof, this court recommends that the Governor of the State of California grant a full pardon to said petitioner.

Done in open court this day of
Day of the Month Month, Year

Judge of said Superior Court – TYPED or PRINTED Judge of said Superior Curt - SIGNATURE

Form Adopted for Optional Use Madera Superior Court Local Form CERTIFICATE OF REHABILITATION Page １ of 1 MAD-CRM-010-A [Rev. 04/15/2020] Pursuant to Penal Code §4852.13