El Dorado — Certificate of Rehabilitation

Source: https://www.eldorado.courts.ca.gov/system/files/certificate-rehabilitation.pdf

IN THE SUPERIOR COURT OF THE STATE OF CALIFORNIA

IN AND FOR THE COUNTY OF Applicant's County of Residence

In the Matter of the Application of

Court use only

Type Applicant’s Full Name - First Middle Last and Suffix, if applicable

Certificate Number

Date of Birth Month Day, Year CII Number

Criminal Case Number(s) List applicable Criminal Case Number(s) CERTIFICATE OF REHABILITATION Pursuant to Penal Code Section 4852.13

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

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 of 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 par-

ole or probation on , that, where appropriate, petitioner has Month Day, Year

obtained relief pursuant to 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 4852.15); and that petitioner has been Total Number of Felony Convictions

time(s) convicted of a felony;

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 Court - SIGNATURE

FORM 3 (Revised 12/12/18) This form was prepared by the Investigations Division of the Board of Parole Hearings pursuant to Penal Code Section 4852.18.