Mendocino — MCR-103

Source: https://www.mendocino.courts.ca.gov/system/files/forms-and-filings/mcr-103.pdf

SUPERIOR COURT OF CALIFORNIA, COUNTY OF MENDOCINO FOR COURT USE ONLY

Ukiah Courthouse Ten Mile Branch Court
100 North State St 700 South Franklin St.
Ukiah, CA 95482 Ft. Bragg, CA 95437

PLAINTIFF: PEOPLE OF THE STATE OF CALIFORNIA vs.

DEFENDANT

& ADDRESS:

Charge(s):

REQUEST TO CALENDAR CASE CASE NUMBER:

In Custody CRIMINAL

I, Defendant Attorney for Defendant Deputy District Attorney
Probation Officer Court Clerk request that this matter be placed on calendar as follows:

Date: Location: Time: Reason: Violation of Probation (Arraignment) Modification: New Surrender Date (attach declaration)** Modification of Probation (attach declaration)** Modification: Re-referral 1 st offender DUI Program (attach declaration)** Termination of Probation (attach declaration and Modification: Re-referral Multiple Offender DUI proper motion)** Program (attach declaration)** Modification of Sentence (attach declaration)** Modification: Ignition Interlock (attach declaration)** Modification: Extend Time to Pay (attach Withdraw Plea/Dismiss – 1203.4 PC (attach proper declaration)** motion)** Modification: Fine to Community Service Recall Bench Warrant (attach declaration)** hours (attach declaration)** Modification: Extension on Community Warrant Arraignment (attach declaration)** Service hours (attach declaration and progress report)** Advance Hearing Other: Proof of Mailing Attached Proof of Service Attached

** DECLARATIONS ON THE FORM PROVIDED MUST BE ATTACHED TO ANY REQUESTS AS NOTED ABOVE. REQUEST WILL NOT BE FILED OR SUBMITTED TO THE COURT WITHOUT THE DECLARATION ATTACHED.**

Defendants/Parties are advised to check the posted calendar on the court date as departments are subject to change. I declare, under the penalty of perjury under California State law, that the information is true and correct.

Dated: Signature of Requesting Party Telephone Number If defendant has an outstanding warrant, he/she has been informed that the warrant remains active, and he/she is subject to arrest. IT IS HEREBY ORDERED In Custody Request to Calendar is: Granted Denied

Date: By: , Judicial Officer

Note: Case may not be placed on calendar for consideration of Sheriff’s decision on denying Work Release, Work Furlough, Home Monitoring, or Sheriff’s Parole.

CC: Jail (via FAX)

MCR-103 (rev 0325)