Placer — AB 2147 Petition (Fire Camp)

Source: https://www.placer.courts.ca.gov/sites/default/files/pl-cr016_ab-2147-petition-fire-camp_eff-jan-1-2021-final.pdf

SUPERIOR COURT OF THE STATE OF CALIFORNIA, COUNTY OF PLACER

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY

TELEPHONE NO.: FAX NO.: E-MAIL ADDRESS: ATTORNEY FOR (Name): PEOPLE OF THE STATE OF CALIFORNIA vs. DEFENDANT:

PETITION FOR EXPUNGEMENT: CASE NUMBER:
California Conservation Camp Program Expungement (Fire Camp)
Penal Code, § 1203.4b DATE:

TIME:

DEPARTMENT:

CONVICTION INFORMATION:

On (date) ___________, the defendant in the above-entitled criminal action, was convicted of the following offenses:

Code Section Type of Offense (felony, misdemeanor,)

I, THE UNDERSIGNED DECLARE:

I, the Defendant in the above-entitled criminal action, declare that I have successfully participated in the California Conservation Camp program as an incarcerated individual hand crew member, or successfully participated as a member of a county incarcerated individual hand crew, and hereby request:

That I be permitted to withdraw my plea of guilty or plea of nolo contendere, and enter a plea of not guilty, or,

That the court set aside my verdict of guilty, if convicted after a plea of not guilty, and

That the court dismiss this accusation or information against me, and that I shall be released from all penalties and disabilities resulting from this conviction.

CDCR Number: ________________________________________________________________________________

Fire Camp Name/Location: ________________________________________________________________________

Dates of Participation: ___________________________________________________________________________

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Dated: _________________________________ Signed: ___________________________________________

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Form Adopted for Optional Use www.placer.courts.ca.gov Superior Court of California, County of Placer Penal Code §1203.4b Form No. PL-CR016 Effective 01-01-2021