Merced — MSC-JV-004

Source: https://www.merced.courts.ca.gov/system/files/forms-and-filings/msc-jv-004-petitions-terminate-sex-offender-registration-juv-ada-comp_0.pdf

MSC-JV-004 Declaration submitted by: FOR COURT USE ONLY Name: Office/Agency/Court: Street Address: City, State: Telephone Number: SUPERIOR COURT OF CALIFORNIA, COUNTY OF MERCED JUVENILE DIVISION Department: Juvenile Delinquency Street Address: 2840 W. Sandy Mush City & Zip Code: Merced, CA 95340 Name of Minor: Date of Birth:

PETITION TO TERMINATE SEX OFFENDER REGISTRATION— CASE NUMBER: JUVENILE (PEN. CODE § 290.5)

• Petitioner must continue to register as a sex offender until a court terminates the registration requirement. • A copy of this petition and proof of current registration must be served on the proper law enforcement agencies and district attorney offices. The petition may be denied if service is not complete.

1. Petitioner’s Information

   a. Name: Last First Middle Date of Birth: (MM/DD/YYYY)

   b. Attorney assisting with the petition (if any): Attorney Name: Firm: State Bar No.: c. Contact information (IMPORTANT: You may be contacted about this matter at the address, phone, or e- Check if attorney’s contact information Street Phone: City State Zip E-Mail (if available): I agree to e-mail communications

   d. If there is a hearing, petition requests an interpreter in (language):

2. Registration Status and Information

   a. Petitioner is currently registered as a sex offender in California in the County of:

   b. Identify the court in which petitioner was convicted of an offense requiring sex offender registration

   in California (e.g., specific California superior court, federal district court, military court, other state

   court):

   c. Indicate the case number(s):

   d. This petition is being filed on or after petitioner’s next birthday after July 1, 2021, following the

   expiration of petitioner’s mandated minimum registration period.

   e. Proof of current registration is attached.

For Optional Use PETITION TO TERMINATE SEX OFFENDER Page 1 of 2 MSC-JV-004 [Eff. Aug. 25, 2021] REGISTRATION—JUVENILE (PEN. CODE § 290.5)

MSC-JV-004 CASE NAME CASE NUMBER

3. Termination Request Petitioner requests termination of the requirement to register as a sex offender in California.

4. Pending Charges To my knowledge, there are no pending charges against petitioner that could extend the time to complete the registration requirements of petitioner’s tier or change petitioner’s tier status.

5. Custody Status Petitioner is not in custody (in jail or prison).

6. Supervision Status Petitioner is not on parole, probation, postconviction supervised release, or any other form of supervised release.

7. Tier Designation and Eligibility a. Tier 1 (Juvenile) (1) Petitioner has registered for at least 5 years. b. Tier 2 (Juvenile) (1) Petitioner has registered for at least 10 years.

8. Previous Petition a. Petitioner (check one) has has not previously filed a Penal Code section 290.5 petition in California for termination of a sex offender registration requirement that was denied by the court. b. The previous petition was denied in (case number): __________________, in the Superior Court of California, County of ___________________, on (date): ______________________________. c. The Court set _____ (years) _____ (months) as the time period after which petitioner may request termination again.

9. Registration Period Petitioner believes that they have met the requirements to register for the time period required by petitioner’s tier designation as determined by the Department of Justice.

I declare that the information provided is true and correct, except as to matters that are stated on my information and belief, and as to those matters, I believe them to be true.

Date:

SIGN

Printed name of petitioner or attorney Signature of petitioner or attorney

For Optional Use PETITION TO TERMINATE SEX OFFENDER Page 2 of 2 MSC-JV-004 [Eff. Aug. 25, 2021] REGISTRATION—JUVENILE (PEN. CODE § 290.5)