Santa Clara — PB-4053*

Source: https://santaclara.courts.ca.gov/system/files/forms/pb-4053_rem.pdf

ATTACHMENT PB-4053 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar Number and Address): FOR COURT USE ONLY

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ATTORNEY FOR (Name):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA COURT ADDRESS: 191 North First Street CITY AND ZIP CODE: San José, California 95113 DIVISION: Probate Division

In the Matter of the Application of:

CASE NUMBER:

ORDER FOR WRIT OF HABEAS CORPUS (RE: QUARANTINE DETENTION)

The application of the Petitioner for a Writ of Habeas Corpus has been considered by the court.

The Court finds:

The Santa Clara County Public Health Department has sufficient grounds to legally confine
Petitioner pursuant to California Health & Safety Code Sections 120130 and 120175. This Petition
is DENIED.

The clerk of this court is directed to issue a Writ of Habeas Corpus returnable before said Superior
Court in Department , located at 191 North First Street, San José, CA, on the date and
time indicated on the attached writ. Petitioner is required to appear by phone and/or have an
attorney appear for them at the hearing.

Other Orders:

WHETHER A HEARING IS GRANTED OR NOT, YOU ARE REQUIRED TO CONTINUE
TO OBEY THE QUARANTINE ORDER UNDER CALIFORNIA HEALTH & SAFETY
CODE SECTION 120220 PENDING FURTHER ORDER OF THE COURT.
FAILURE TO COMPLY IS A MISDEMEANOR PUNISHABLE BY IMPRISONMENT,
FINE OR BOTH FOR EACH DAY YOU FAIL TO COMPLY
(CALIFORNIA HEALTH & SAFETY CODE SECTIONS 120275 AND 120295).

Date: Judicial Officer

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PB-4053 NEW 07/01/11 ORDER FOR WRIT OF HABEAS CORPUS Page 1 of 1 (RE: QUARANTINE DETENTION)