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SHC-CRIM-01 (Rev. 09/09/2020)
Please visit our Self-Help Portal at: https://selfhelp.occourts.org
LamoreauxJusticeCenter
Room C-190
341TheCityDrive
Orange,CA
Cen
tralJusticeCenter
RoomG‐100
700CivicCenterDrive
SantaAna,CA
NorthJusticeCenter
R
oom355
1275N.BerkeleyAvenue
Fullerton,CA
WestJusticeCenter
1
st
Floor
814113thStreet
Westminster,CA
SUPERIOR COURT OF CALIFORNIA
COUNTY
OF ORANGE
SELF-HELP CENTER
www.occourts.org/self-help
PETITION FOR DISMISSAL
UNDER PENAL CODE §§ 17(b); 17(d)(2); 1203.4;
1203.4a; 1203.41; 1203.42; 1203.43 and 1203.49
The Self-Help Center provides a free document review
service. To obtain an appointment to have your documents
reviewed, you must first fully complete the forms.
Pleaseuseblackink.
Self-Help Center Locations:
INSTRUCTIONS FOR FILLING OUT A PETITION FOR DISMISSAL (SHC-CRIM-01)
STEP 1: HAVE YOUR CASE INFORMATION AVAILABLE
Review your case file to gather the information listed below. If you do not have your case file, you can print a
free summary of your case at: https://ocjustice.occourts.org/Vision_PublicNS/. If you have any questions,
please contact the Self-Help Center at: 657-622-6623 or by email at SelfHelpCrimTraffic@occourts.org.
Information Needed:
1. Date of Conviction or Disposition
2. Type of Violation (Code and Section number) e.g., PC 487(a), VC 23152(a) or HS 11357
3. Type of Offense (felony, misdemeanor or infraction)
4. Whether your case is eligible for reduction from felony to misdemeanor or from misdemeanor to
infraction.
STEP 2: DETERMINE IF YOU ARE ELIGIBLE
Type of Offense Requirements
Felony or misdemeanor with probation
Fulfilled all conditions of probation or discharged from
probation before period ended
Not currently serving a sentence for any offense, on probation
or charged with commission of any crime
Can file any time after termination of probation
Misdemeanor or infraction, not granted
probation
Not granted probation and complied with sentence of the court
Not serving sentence for any offense or charged with
commission of any crime
Has lived an honest and upright life since judgment and
obeyed laws of the land or should be granted relief in the
interests of justice
Can file after one year since the date of judgment
Misdemeanor under PC 647(b)
Completed probation for conviction of solicitation or
prostitution
Can show by clear and convincing evidence that conviction
was because you were a victim of human trafficking
Felony county jail sentence under PC
1170(h)(5)
Not under supervision
Not serving sentence, on probation or charged with
commission of any offense
> 1 year since felony county jail sentence with mandatory
supervision by county probation officer (split sentence)
> 2 years since felony county jail sentence without mandatory
supervision (straight sentence in custody)
Felony prison sentence that would’ve been
eligible for felony county jail sentence after
2011
Not under supervision
Not serving sentence, on probation or charged with
commission of any offense
> 2 years since felony prison sentence completed
Deferred entry of judgment
Performed satisfactorily during period of deferred entry of
judgment
Criminal charges were dismissed
CR-180
DATE OF BIRTH:
FOR COURT USE ONLY
CASE NUMBER:
PETITION FOR DISMISSAL
(Pen. Code, §§ 17(b), 17(d)(2), 1203.4, 1203.4a, 1203.41, 1203.42, 1203.43, 1203.49)
FOR COURT USE ONLY
DATE:
TIME:
DEPARTMENT:
ATTORNEY OR PARTY WITHOUT ATTORNEY:
STATE: ZIP CODE:CITY:
STREET ADDRESS:
FIRM NAME:
NAME:
STATE BAR NUMBER:
TELEPHONE NO.: FAX NO.:
E-MAIL ADDRESS:
ATTORNEY FOR (name):
(date):
On , the petitioner (the defendant in the above-entitled criminal action) was convicted of a violation of the
following offenses or was granted deferred entry of judgment for the following offenses:
Code Section
Type of offense (felony,
misdemeanor, or infraction):
Eligible for reduction to
misdemeanor under Penal
Code,
§
17(b) (yes or no)
Eligible for reduction to
infraction under Penal
Code,
§ 17(d)(2) (yes or no)
If additional space is needed for listing offenses, use Attachment to Judicial Council Form (form MC-025).
1.
a.
b.
c.
2.
Felony or misdemeanor with probation granted (Pen. Code, § 1203.4)
has fulfilled the conditions of probation for the entire period thereof.
has been discharged from probation prior to the termination of the period thereof.
should be granted relief in the interests of justice. (Please note: You may explain why granting a dismissal would
be in the interests of justice. You can provide that information by writing in the space below, or by attaching a letter
or other relevant documents. If you need more space for your writing, you can use the Attached Declaration (form
MC-031) and attach it to this petition.)
Form Approved for Optional Use
Judicial Council of California
CR-180 [Rev. January 1, 2019]
PETITION FOR DISMISSAL
Penal Code, §§ 17(b), 17(d)(2), 1203.4, 1203.4a,
1203.41, 1203.42, 1203.43, and 1203.49
www.courts.ca.gov
Probation was granted on the terms and conditions stated in the docket of the above-entitled court; the petitioner is not
serving a sentence for any offense, on probation for any offense, or under charge of commission of any crime, and the
petitioner (check all that apply)
Page 1 of 3
Write your full name as shown in your case file,
your current address and contact information.
Write your Case Number
PEOPLE OF THE STATE OF CALIFORNIA
v.
DEFENDANT:
Write your name as shown in your case
Write your
date of birth
Write date of conviction or date of deferred entry of judgment found in your case summary
E.g. PC
E.g. 484(a)
Misdemeanor
Y/N
Y/N
Read sections 2 through 7 and only check the boxes that apply to your situation. Likely, you will check one section and leave the rest
blank.
2
Check box #2 if you were convicted of a felony or misdemeanor and granted probation. Check a, b or c,
as applicable. If you did not complete probation successfully or were not discharged early from
probation, then check box "c." You
may write a declaration (form MC-031) explaining why a dismissal
would be in the interests of justice. Please see attached Sample Declaration. You may also include
letters of reference, certificates of completion or any other relevant documents that support your
request for a dismissal.
O
Review the "O" as possible
applicable sections.
STEP 3: FILL OUT FORMS CR-180 AND CR-181
Page 2 of 3
CR-180 [Rev. January 1, 2019]
PETITION FOR DISMISSAL
CASE NUMBER:
PEOPLE OF THE STATE OF CALIFORNIA v. DEFENDANT:
CR-180
4.
Misdemeanor conviction under Penal Code section 647(b) (Pen. Code, § 1203.49)
should be granted relief in the interests of justice. (Please note: You may explain why granting a dismissal would
be in the interests of justice. You can provide that information by writing in the space below or by attaching a letter
or other relevant documents. If you need more space for your writing, you can use the Attached Declaration (form
MC-031) and attach it to this petition.)
has lived an honest and upright life since pronouncement of judgment and conformed to and obeyed the laws of
the land; or
Probation was not granted; more than one year has elapsed since the date of pronouncement of judgment. Petitioner has
complied with the sentence of the court and is not serving a sentence for any offense or under charge of commission of any
crime; and the petitioner (check one):
a.
b.
3.
Misdemeanor or infraction with sentence other than probation (Pen. Code, § 1203.4a)
Petitioner has completed a term of probation for a conviction under Penal Code section 647(b) and should be granted relief
because the petitioner can establish by clear and convincing evidence that the conviction was the result of his or her status
as a victim of human trafficking.
(Please note: You may provide evidence that the conviction was the result of your status as a victim of human trafficking.
You can provide that information by writing in the space below or by attaching a letter or other relevant documents. If you
need more space for your writing, you can use the Attached Declaration (form MC-031) and attach it to this petition.)
Felony county jail sentence under Penal Code section 1170(h)(5) (Pen. Code, § 1203.41)
(Please note: You may explain why granting a dismissal would be in the interests of justice. You can provide that
information by writing in the space below or by attaching a letter or other relevant documents. If you need more
space for your writing, you can use the Attached Declaration (form MC-031) and attach it to this petition.)
Petitioner is not under supervision under Penal Code section 1170(h)(5)(B); is not serving a sentence for, on probation for, or
charged with the commission of any offense; and should be granted relief in the interests of justice, and (check one)
more than one year has elapsed since petitioner completed the felony county jail sentence with a period of
mandatory supervision imposed under Penal Code section 1170(h)(5)(B); or
more than two years have elapsed since petitioner completed the felony county jail sentence without a period of
mandatory supervision imposed under Penal Code section 1170(h)(5)(A).
a.
b.
5.
Write your full name as shown in your case file
Write your Case Number
O
Check box #3 only if you were convicted of a misdemeanor or infraction and not granted probation
and check a or b, as applicable.
Check box #4 only if you have clear and convincing evidence that your conviction for solicitation or
prostitution was the result of your status
as a victim of human trafficking.
O
O
Check box #5 only if you served a felony county jail sentence under PC 1170(h)(5).
If you were sentenced to county jail with mandatory supervision and more than a year has
elapsed since you completed your sentence, then check "a."
If you were sentence to county jail without mandatory supervision and more than two years
have elapsed since you completed your sentence, then check "b."
You may complete a declaration (form MC-031) where you explain why granting a dismissal
would be in the interests of justice. Please see attached Sample Declaration. You may also
include letters of reference, certificates of completion or any other relevant documents that
support your request for a dismissal.
Petitioner requests that he or she be permitted to withdraw the plea of guilty, or that the verdict or finding of guilt be set aside and a
plea of not guilty be entered and the court dismiss this action under the Penal Code section(s) noted above.
Petitioner requests that the eligible felony offenses listed above be reduced to misdemeanors under Penal Code section 17(b)
and eligible misdemeanor offenses be reduced to infractions under Penal Code section 17(d)(2).
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:
(ADDRESS OF PETITIONER)
(CITY) (STATE)
(ZIP CODE)
(SIGNATURE OF PETITIONER OR ATTORNEY)
8.
9.
7.
attached a copy of his or her state summary criminal history information.
court records are available showing the case resolution; or
petitioner declares under penalty of perjury that the charges were dismissed after he or she completed the
requirements for deferred entry of judgment. Petitioner (check one)
has
has not
a.
b.
(1)
(2)
(s) were dismissed under former Penal Code section 1000.3 on (date): . Furthermore (check one),
Page 3 of 3
CR-180 [Rev. January 1, 2019]
PETITION FOR DISMISSAL
CASE NUMBER:
PEOPLE OF THE STATE OF CALIFORNIA v. DEFENDANT:
CR-180
6.
Felony prison sentence that would have been eligible for a felony county jail sentence after 2011 under Penal Code
section 1170(h)(5) (Pen. Code, § 1203.42)
Petitioner is not under supervision and is not serving a sentence for, on probation for, or charged with the commission of any
offense; more than two years have elapsed since petitioner completed the felony prison sentence; and petitioner should be
granted relief in the interests of justice.
(Please note: You may explain why granting a dismissal would be in the interests of justice. You can provide that information
by writing in the space below or by attaching a letter or other relevant documents. If you need more space for your writing,
you can use the Attached Declaration (form MC-031) and attach it to this petition.)
O
O
Write your full name as shown in your case file
Write your Case Number
Sign
Write today's date
Write your complete address
Check box #6 only i
f you were sentenced to state prison, but you would have been eligible for a felony
county jail sentence after 2011.
You can explain why your petition should be granted in the interests of justice. Please see attached
Sample Declaration. You may also include letters of reference, certificates of completion or any other
relevant documents that support your request for a dismissal.
Check box #7 only if you successfully completed a deferred entry of judgment program and check a or b, as
applicable.
Deferred entry of judgment (Pen. Code, §
1203.43)
Petitioner performed satisfactorily during the period in which deferred entry of judgment was granted. The criminal charge
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The declaration is your chance to present your statement and evidence to convince the judge that you deserve a dismissal.
Here are some ideas that you can include in your declaration:
1. Explain the basic information about your conviction and sentence. Tell the judge why your conviction meets the requirements for dismissal.
2. Explain why granting your dismissal would be “in the interests of justice”— meaning why you deserve to have your conviction dismissed, and how
the dismissal will help you succeed in the future.
a. Here are some examples of things you may want to talk about (but only if they are true for your situation):
i. If there were circumstances that made your life especially difficult at time of your conviction;
ii. How you are turning your life around;
iii. Your work and/or school history (including any vocational training, GED or other classes, and other programs you’ve participated
in);
iv. Current opportunities for work, school, and other activities to enrich your life, and how dismissal will help you take advantage of
these opportunities;
v. Your family situation and needs, and how a dismissal will help you reconnect with, support, or otherwise benefit your family; and
vi. Any problems you have had completing probation, and what you are doing to address those problems.
You should be specific and honest, and include as many details as possible to give the judge a clear picture of what happened. But you should
not include irrelevant or unnecessary information that might distract the judge.
You may also include letters of reference, certificates of completion or any other relevant documents.
People of the State of California v.
SAMPLE ONLY: DO NOT FILE THIS PAGE
§ 1203.41
ALL CONVICTIONS OR PLEAS FOR DEFERRED ENTRY OF JUDGMENT in the above-entitled action.
only the following convictions or pleas for deferred entry of judgment in the above-entitled action
§ 1203.49
Form Approved for Optional Use
Judicial Council of California
CR-181 [Rev. January 1, 2019]
ORDER FOR DISMISSAL
Page 1 of 2
Penal Code, §§ 17(b), 17(d)(2), 1203.4, 1203.4a,
1203.41, 1203.42, 1203.43, and 1203.49
www.courts.ca.gov
CR-181
DATE OF BIRTH:
ORDER FOR DISMISSAL
(Pen. Code, §§ 17(b), 17(d)(2), 1203.4, 1203.4a, 1203.41, 1203.42, 1203.43, 1203.49)
FOR COURT USE ONLY
CASE NUMBER:
ATTORNEY OR PARTY WITHOUT ATTORNEY:
STATE: ZIP CODE:CITY:
STREET ADDRESS:
FIRM NAME:
NAME:
STATE BAR NUMBER:
TELEPHONE NO.: FAX NO.:
E-MAIL ADDRESS:
ATTORNEY FOR (name):
1. The court GRANTS the petition for reduction of a felony to a misdemeanor (maximum punishment of 364 days per Pen. Code,
§ 18.5) under Penal Code section 17(b) and/or for reduction of a misdemeanor to an infraction under Penal Code section
17(d)(2) and reduces
ALL FELONY CONVICTIONS in the above-entitled action.
only the following convictions in the above-entitled action (specify charges and date of conviction):
2. The court DENIES the petition for reduction of a felony to a misdemeanor under Penal Code section 17(b) and/or for reduction of a
misdemeanor to an infraction under Penal Code section 17(d)(2) for
ALL FELONY CONVICTIONS in the above-entitled action.
only the following convictions in the above-entitled action (specify charges and date of conviction):
3.
ALL MISDEMEANOR CONVICTIONS in the above-entitled action.
ALL MISDEMEANOR CONVICTIONS in the above-entitled action.
(specify charges and date
of conviction or plea for deferred entry of judgment):
The court GRANTS the petition for dismissal regarding the following convictions under Penal Code (check all that apply)
§ 1203.42
and it is ordered that the pleas of guilty or nolo contendere or verdicts or findings of guilt be set aside and vacated and a plea of
not guilty be entered and that the complaint or information be, and is hereby, dismissed for (check one)
§ 1203.43
§ 1203.4a§ 1203.4
a.
b.
c.
a.
b.
c.
a.
b.
Write your full name as shown in your case file,
your current address and contact information.
PEOPLE OF THE STATE OF CALIFORNIA
v.
DEFENDANT:
Write your name as shown in your case
Write your
date of birth
Write your Case Number
The court finds from the records on file in this case, and from the foregoing petition, that the petitioner (the defendant in the
above-entitled criminal action) is eligible for the following requested relief:**LEAVE THE REST OF THIS PAGE BLANK**
Next, on form CR-181, fill out the information in the top boxes of page 1 and page 2. Write your full name as
shown in your case file, your current address and contact information, Date of Birth and Case Number.
Do not fill out the information below the boxes, as the court will fill out the rest of the form to make orders.
FOR COURT USE ONLY
(JUDICIAL OFFICER)
If the order is granted under the provisions of Penal Code section 1203.4, 1203.4a, 1203.41, 1203.42, or 1203.49, the petitioner is
released from all penalties and disabilities resulting from the offense except as provided in Penal Code sections 29800 and 29900
(formerly sections 12021 and 12021.1) and Vehicle Code section 13555. In any subsequent prosecution of the petitioner for any
other offense, the prior conviction may be pleaded and proved and shall have the same effect as if probation had not been granted
or the accusation or information dismissed. The dismissal does not permit a person to own, possess, or have in his or her control a
firearm if prevented by Penal Code sections 29800 or 29900 (formerly sections 12021 and 12021.1). Dismissal of a conviction
does not permit a person prohibited from holding public office as a result of that conviction to hold public office.
9.
In addition, as required by Penal Code section 299(f), relief under Penal Code sections 17(b), 17(d)(2),
1203.4, 1203.4a, 1203.41, 1203.42, or 1203.49 does not release petitioner from the separate
administrative duty to provide specimens, samples, or print impressions under the DNA and Forensic
Identification Database and Data Bank Act (Pen. Code, § 295 et seq.) if petitioner was found guilty by
a trier of fact, not guilty by reason of insanity, or pled no contest to a qualifying offense as defined in
Penal Code section 296(a).
Date:
6.
8.
The basis for an order of dismissal granted under the provisions of Penal Code section 1203.43 is the
invalidity of defendant's prior plea due to misinformation in former Penal Code section 1000.4
regarding the actual consequences of making a plea and successful completion of a deferred entry of
judgment program.
10.
If this order is granted under the provisions of Penal Code section 1203.4, 1203.41, or 1203.42,
the petitioner is required to disclose the above conviction in response to any direct question contained in any questionnaire or
application for public office, or for licensure by any state or local agency, or for contracting with the California State Lottery
Commission; and
dismissal of the conviction does not automatically relieve petitioner from the requirement to register as a sex offender.
(See, e.g., Pen. Code, § 290.5.)
a.
b.
7.
5. In granting this order under the provisions of Penal Code section 1203.49, the court finds that the petitioner was a victim of human
trafficking when he or she committed the crime. The court orders (check one)
CASE NUMBER:
CR-181
Page 2 of 2 CR-181 [Rev. January 1, 2019]
ORDER FOR DISMISSAL
ALL CONVICTIONS OR PLEAS FOR DEFERRED ENTRY OF JUDGMENT in the above-entitled action.
1203.49 for (check one)
only the following convictions or pleas for deferred entry of judgment in the above-entitled action (specify charges and
date of conviction or plea for deferred entry of judgment):
4. The court DENIES the petition for dismissal under Penal Code (check all that apply)
§ 1203.4
§ 1203.4a
§ 1203.41
§ 1203.42 § 1203.43
§
If the order is granted under the provisions of Penal Code section 1203.49, the Department of Justice is hereby notified that
petitioner was a victim of human trafficking when he or she committed the crime, and of the relief ordered.
a.
b.
a.
b.
the relief described in section 1203.4.
the relief described in section 1203.4, with the following exceptions (specify):
PEOPLE OF THE STATE OF CALIFORNIA v. DEFENDANT:
Write your full name as sho
wn in your case file
Write your Case Number
**LEAVE THE REST OF THIS PAGE BLANK**
STEP 4: HAVE ANOTHER ADULT SERVE THE DISTRICT ATTORNEY’S OFFICE
Make at least two copies of your completed CR-180 and attachments. One of those copies needs to be served
by a person over the age of 18, other than you, to the District Attorney’s office. The adult that served the
District Attorney’s office must complete a Proof of Service (form CR-106).
STEP 5: FILE YOUR DOCUMENTS
You should have an original and a copy of the completed CR-180 (with attachments) and CR-181. Make a copy
of the completed Proof of Service (form CR-106), which was signed by the person who served the copies to
the DA’s office, and gather all the forms to file with the court.
To file in person, go to Criminal Clerk’s office at the Justice Center where your case was filed. Present the
original and the copies. The clerk will stamp both sets of documents. The original will remain with the court and
a conformed copy will be returned to you for your own records.
Or, you could file by mail, by sending your documents to the court, addressing the envelope to the Justice
Center as the recipient. To ensure that the conformed copies will be returned to you, include a self-addressed
stamped envelope in your package, so that the clerk can send your copies after filing your original documents.
Finally, there is a fee related to this filing, up to $150.00. If you are unable to pay costs and fees related to this
filing, please complete form CR-105 in its entirety and file it along with this packet.
STEP 6: WAIT FOR A RULING OR FOR A HEARING DATE TO BE SET
Once you file your documents, a judge will review your request. Depending on the facts of your case, a judge
can approve or deny your request without a hearing. The judge also has the ability to set a hearing. If a
hearing is scheduled, it is crucial that you appear on the day of the hearing or the court will likely deny your
petition. If your petition is granted, you need to verify that you have paid any fees imposed by the court or you
will not receive your certificate.
SHC-CRIM-01 Information Sheet
The information that you complete here
will appear on your forms.
Your Full Name: _______________________________________________________________________
Your Street Address: ____________________________________________________________________
City: _______________________________, State: _________ Zip Code: ___________
Your Phone Number: _______________________________
Your E-mail Address: ____________________________________________________________
Your Date of Birth (MM/DD/YYYY): ____________________
Your Court Case Number: ____________________________
Your Violation (Code/Section): _______________e.g. PC or HS ______________________e.g. 242 or 11350
Conviction Date (MM/DD/YYYY): ______________________
Today’s Date (MM/DD/YYYY): _________________________
CR-180
PEOPLE OF THE STATE OF CALIFORNIA
v.
DATE OF BIRTH:
DEFENDANT:
FOR COURT USE ONLY
CASE NUMBER:
PETITION FOR DISMISSAL
(Pen. Code, §§ 17(b), 17(d)(2), 1203.4, 1203.4a, 1203.41, 1203.42, 1203.43, 1203.49)
FOR COURT USE ONLY
DATE:
TIME:
DEPARTMENT:
ATTORNEY OR PARTY WITHOUT ATTORNEY:
STATE: ZIP CODE:CITY:
STREET ADDRESS:
FIRM NAME:
NAME:
STATE BAR NUMBER:
TELEPHONE NO.: FAX NO.:
E-MAIL ADDRESS:
ATTORNEY FOR (name):
(date):
On , the petitioner (the defendant in the above-entitled criminal action) was convicted of a violation of the
following offenses or was granted deferred entry of judgment for the following offenses:
Code Section
Type of offense (felony,
misdemeanor, or infraction):
Eligible for reduction to
misdemeanor under Penal
Code,
§
17(b) (yes or no)
Eligible for reduction to
infraction under Penal
Code,
§ 17(d)(2) (yes or no)
If additional space is needed for listing offenses, use Attachment to Judicial Council Form (form MC-025).
1.
a.
b.
c.
2.
Felony or misdemeanor with probation granted (Pen. Code, § 1203.4)
has fulfilled the conditions of probation for the entire period thereof.
has been discharged from probation prior to the termination of the period thereof.
should be granted relief in the interests of justice. (Please note: You may explain why granting a dismissal would
be in the interests of justice. You can provide that information by writing in the space below, or by attaching a letter
or other relevant documents. If you need more space for your writing, you can use the Attached Declaration (form
MC-031) and attach it to this petition.)
Form Approved for Optional Use
Judicial Council of California
CR-180 [Rev. January 1, 2019]
PETITION FOR DISMISSAL
Penal Code, §§ 17(b), 17(d)(2), 1203.4, 1203.4a,
1203.41, 1203.42, 1203.43, and 1203.49
www.courts.ca.gov
Probation was granted on the terms and conditions stated in the docket of the above-entitled court; the petitioner is not
serving a sentence for any offense, on probation for any offense, or under charge of commission of any crime, and the
petitioner (check all that apply)
Page 1 of 3
Self-Represented
Page 2 of 3
CR-180 [Rev. January 1, 2019]
PETITION FOR DISMISSAL
CASE NUMBER:
PEOPLE OF THE STATE OF CALIFORNIA v. DEFENDANT:
CR-180
4.
Misdemeanor conviction under Penal Code section 647(b) (Pen. Code, § 1203.49)
should be granted relief in the interests of justice. (Please note: You may explain why granting a dismissal would
be in the interests of justice. You can provide that information by writing in the space below or by attaching a letter
or other relevant documents. If you need more space for your writing, you can use the Attached Declaration (form
MC-031) and attach it to this petition.)
has lived an honest and upright life since pronouncement of judgment and conformed to and obeyed the laws of
the land; or
Probation was not granted; more than one year has elapsed since the date of pronouncement of judgment. Petitioner has
complied with the sentence of the court and is not serving a sentence for any offense or under charge of commission of any
crime; and the petitioner (check one):
a.
b.
3.
Misdemeanor or infraction with sentence other than probation (Pen. Code, § 1203.4a)
Petitioner has completed a term of probation for a conviction under Penal Code section 647(b) and should be granted relief
because the petitioner can establish by clear and convincing evidence that the conviction was the result of his or her status
as a victim of human trafficking.
(Please note: You may provide evidence that the conviction was the result of your status as a victim of human trafficking.
You can provide that information by writing in the space below or by attaching a letter or other relevant documents. If you
need more space for your writing, you can use the Attached Declaration (form MC-031) and attach it to this petition.)
Felony county jail sentence under Penal Code section 1170(h)(5) (Pen. Code, § 1203.41)
(Please note: You may explain why granting a dismissal would be in the interests of justice. You can provide that
information by writing in the space below or by attaching a letter or other relevant documents. If you need more
space for your writing, you can use the Attached Declaration (form MC-031) and attach it to this petition.)
Petitioner is not under supervision under Penal Code section 1170(h)(5)(B); is not serving a sentence for, on probation for, or
charged with the commission of any offense; and should be granted relief in the interests of justice, and (check one)
more than one year has elapsed since petitioner completed the felony county jail sentence with a period of
mandatory supervision imposed under Penal Code section 1170(h)(5)(B); or
more than two years have elapsed since petitioner completed the felony county jail sentence without a period of
mandatory supervision imposed under Penal Code section 1170(h)(5)(A).
a.
b.
5.
Petitioner requests that he or she be permitted to withdraw the plea of guilty, or that the verdict or finding of guilt be set aside and a
plea of not guilty be entered and the court dismiss this action under the Penal Code section(s) noted above.
Petitioner requests that the eligible felony offenses listed above be reduced to misdemeanors under Penal Code section 17(b)
and eligible misdemeanor offenses be reduced to infractions under Penal Code section 17(d)(2).
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:
(ADDRESS OF PETITIONER)
(CITY) (STATE)
(ZIP CODE)
(SIGNATURE OF PETITIONER OR ATTORNEY)
8.
9.
7.
attached a copy of his or her state summary criminal history information.
court records are available showing the case resolution; or
petitioner declares under penalty of perjury that the charges were dismissed after he or she completed the
requirements for deferred entry of judgment. Petitioner (check one)
has
has not
a.
b.
(1)
(2)
Deferred entry of judgment (Pen. Code, § 1203.43)
Petitioner performed satisfactorily during the period in which deferred entry of judgment was granted. The criminal charge
(s) were dismissed under former Penal Code section 1000.3 on (date): . Furthermore (check one),
Page 3 of 3
CR-180 [Rev. January 1, 2019]
PETITION FOR DISMISSAL
CASE NUMBER:
PEOPLE OF THE STATE OF CALIFORNIA v. DEFENDANT:
CR-180
6.
Felony prison sentence that would have been eligible for a felony county jail sentence after 2011 under Penal Code
section 1170(h)(5) (Pen. Code, § 1203.42)
Petitioner is not under supervision and is not serving a sentence for, on probation for, or charged with the commission of any
offense; more than two years have elapsed since petitioner completed the felony prison sentence; and petitioner should be
granted relief in the interests of justice.
(Please note: You may explain why granting a dismissal would be in the interests of justice. You can provide that information
by writing in the space below or by attaching a letter or other relevant documents. If you need more space for your writing,
you can use the Attached Declaration (form MC-031) and attach it to this petition.)
Form Approved for Optional Use
Judicial Council of California
MC-031 [Rev. July 1, 2005]
ATTACHED DECLARATION
PLAINTIFF/PETITIONER:
CASE NUMBER:
DEFENDANT/RESPONDENT:
MC-031
(This form must be attached to another form or court paper before it can be filed in court.)
DECLARATION
Date:
(SIGNATURE OF DECLARANT)
(TYPE OR PRINT NAME)
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Plaintiff
Other (Specify):
Defendant
Attorney for
Petitioner
Respondent
Page 1 of 1
People of the State of California
✔
§ 1203.41
ALL CONVICTIONS OR PLEAS FOR DEFERRED ENTRY OF JUDGMENT in the above-entitled action.
only the following convictions or pleas for deferred entry of judgment in the above-entitled action
§ 1203.49
Form Approved for Optional Use
Judicial Council of California
CR-181 [Rev. January 1, 2019]
ORDER FOR DISMISSAL
Page 1 of 2
Penal Code, §§ 17(b), 17(d)(2), 1203.4, 1203.4a,
1203.41, 1203.42, 1203.43, and 1203.49
www.courts.ca.gov
CR-181
PEOPLE OF THE STATE OF CALIFORNIA
v.
DATE OF BIRTH:
DEFENDANT:
ORDER FOR DISMISSAL
(Pen. Code, §§ 17(b), 17(d)(2), 1203.4, 1203.4a, 1203.41, 1203.42, 1203.43, 1203.49)
FOR COURT USE ONLY
CASE NUMBER:
ATTORNEY OR PARTY WITHOUT ATTORNEY:
STATE: ZIP CODE:CITY:
STREET ADDRESS:
FIRM NAME:
NAME:
STATE BAR NUMBER:
TELEPHONE NO.: FAX NO.:
E-MAIL ADDRESS:
ATTORNEY FOR (name):
1. The court GRANTS the petition for reduction of a felony to a misdemeanor (maximum punishment of 364 days per Pen. Code,
§ 18.5) under Penal Code section 17(b) and/or for reduction of a misdemeanor to an infraction under Penal Code section
17(d)(2) and reduces
The court finds from the records on file in this case, and from the foregoing petition, that the petitioner (the defendant in the above-
entitled criminal action) is eligible for the following requested relief:
ALL FELONY CONVICTIONS in the above-entitled action.
only the following convictions in the above-entitled action (specify charges and date of conviction):
2. The court DENIES the petition for reduction of a felony to a misdemeanor under Penal Code section 17(b) and/or for reduction of a
misdemeanor to an infraction under Penal Code section 17(d)(2) for
ALL FELONY CONVICTIONS in the above-entitled action.
only the following convictions in the above-entitled action (specify charges and date of conviction):
3.
ALL MISDEMEANOR CONVICTIONS in the above-entitled action.
ALL MISDEMEANOR CONVICTIONS in the above-entitled action.
(specify charges and date
of conviction or plea for deferred entry of judgment):
The court GRANTS the petition for dismissal regarding the following convictions under Penal Code (check all that apply)
§ 1203.42
and it is ordered that the pleas of guilty or nolo contendere or verdicts or findings of guilt be set aside and vacated and a plea of
not guilty be entered and that the complaint or information be, and is hereby, dismissed for (check one)
§ 1203.43
§ 1203.4a§ 1203.4
a.
b.
c.
a.
b.
c.
a.
b.
Self-Represented
FOR COURT USE ONLY
(JUDICIAL OFFICER)
If the order is granted under the provisions of Penal Code section 1203.4, 1203.4a, 1203.41, 1203.42, or 1203.49, the petitioner is
released from all penalties and disabilities resulting from the offense except as provided in Penal Code sections 29800 and 29900
(formerly sections 12021 and 12021.1) and Vehicle Code section 13555. In any subsequent prosecution of the petitioner for any
other offense, the prior conviction may be pleaded and proved and shall have the same effect as if probation had not been granted
or the accusation or information dismissed. The dismissal does not permit a person to own, possess, or have in his or her control a
firearm if prevented by Penal Code sections 29800 or 29900 (formerly sections 12021 and 12021.1). Dismissal of a conviction
does not permit a person prohibited from holding public office as a result of that conviction to hold public office.
9.
In addition, as required by Penal Code section 299(f), relief under Penal Code sections 17(b), 17(d)(2),
1203.4, 1203.4a, 1203.41, 1203.42, or 1203.49 does not release petitioner from the separate
administrative duty to provide specimens, samples, or print impressions under the DNA and Forensic
Identification Database and Data Bank Act (Pen. Code, § 295 et seq.) if petitioner was found guilty by
a trier of fact, not guilty by reason of insanity, or pled no contest to a qualifying offense as defined in
Penal Code section 296(a).
Date:
6.
8.
The basis for an order of dismissal granted under the provisions of Penal Code section 1203.43 is the
invalidity of defendant's prior plea due to misinformation in former Penal Code section 1000.4
regarding the actual consequences of making a plea and successful completion of a deferred entry of
judgment program.
10.
If this order is granted under the provisions of Penal Code section 1203.4, 1203.41, or 1203.42,
the petitioner is required to disclose the above conviction in response to any direct question contained in any questionnaire or
application for public office, or for licensure by any state or local agency, or for contracting with the California State Lottery
Commission; and
dismissal of the conviction does not automatically relieve petitioner from the requirement to register as a sex offender.
(See, e.g., Pen. Code, § 290.5.)
a.
b.
7.
5. In granting this order under the provisions of Penal Code section 1203.49, the court finds that the petitioner was a victim of human
trafficking when he or she committed the crime. The court orders (check one)
CASE NUMBER:
PEOPLE OF THE STATE OF CALIFORNIA v. DEFENDANT:
CR-181
Page 2 of 2 CR-181 [Rev. January 1, 2019]
ORDER FOR DISMISSAL
4.
The court DENIES the petition for dismissal under Penal Code (check all that apply)
ALL CONVICTIONS OR PLEAS FOR DEFERRED ENTRY OF JUDGMENT in the above-entitled action.
§ 1203.49 for (check one)
only the following convictions or pleas for deferred entry of judgment in the above-entitled action (specify charges and
date of conviction or plea for deferred entry of judgment):
§ 1203.41
§ 1203.42 § 1203.43
§ 1203.4
§ 1203.4a
If the order is granted under the provisions of Penal Code section 1203.49, the Department of Justice is hereby notified that
petitioner was a victim of human trafficking when he or she committed the crime, and of the relief ordered.
a.
b.
a.
b.
the relief described in section 1203.4.
the relief described in section 1203.4, with the following exceptions (specify):
Proof of Service —
Criminal Record Clearing
CR-106, Page 1 of 2
Judicial Council of California, www.courts.ca.gov
New January 1, 2020, Optional Form
CR-106
Proof of Service —
Criminal Record Clearing
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California, County of
Fill in criminal case number and case name:
Case Number:
Case Name:
People of the State of California
v.
Service by mail
(a)
(b)
4
Before using this form, read Information on How to File a Proof of Service
in Criminal Record Clearing Requests (form CR-106-INFO).
1
The person who serves (delivers) a document or form in this case and
who fills out this form must be at least 18 years old.
This form is only for providing proof that a document or form was served
(delivered) in a case requesting that a court review a criminal record for
dismissal, vacatur, resentencing, reduction, sealing, or other record clearing
remedy.
At the time I served the document or form listed below, I was at least 18
years old.
Instructions
My
Street
City State
Zip
2
I mailed or personally delivered the following document or form (fill in the name of the document you are
serving and complete or ):
3
5
I put one copy of the document or form in an envelope addressed to each agency (and person, if applicable)
listed below, sealed the envelope, and put first-class postage on the envelope.
The envelope or envelopes were addressed as follows:
(1)
Name of agency served (and person, if applicable):
Address on envelope:
Street
City
State Zip
(2)
Name of agency served (and person, if applicable):
Address on envelope:
Street City
State
Zip
4
Check here if you mailed copies of the document or form to more people or agencies. Attach a
separate page listing the names and addresses on each additional envelope you mailed. Write
“CR-106, Item 4” on the top of the page.
business address is:home
A completed form should be filed with the court. Keep a copy of this form
for your records.
(c)
I mailed the envelope or envelopes on
With the U.S. Postal Service.
At an office or business mail drop where I know the mail is picked up every day and deposited
(1)
(2)
by depositing the envelope or envelopes (check one):
(date): from (city): (state):
This form is for proof of service by mail or personal delivery. For proof of
electronic service, use Proof of Electronic Service (form POS-050/EFS-050
).
with the U.S. Postal Service.
Petition for Dismissal (CR-180)
Case Number:
5
New January 1, 2020
Proof of Service —
Criminal Record Clearing
CR-106, Page 2 of 2
Server signs here after serving
Date:
Type or print server’s name
I personally gave one copy of the document or form to each of the following:
(a)
Address where you gave the document or form to this person:
Name of person and agency served:
Date when you gave the document or form to this person:
Time when you gave the document or form to this person:
Street City
State Zip
(1)
(3)
(2)
(b)
Address where you gave the document or form to this person:
Name of person and agency served:
Date when you gave the document or form to this person:
Time when you gave the document or form to this person:
Street
City
State Zip
(1)
(3)
(2)
Check here if you gave copies of the document or form to more people. Attach a separate page
listing the names of each of these people, the address where you gave each of them the document
or form, and the date and time you gave them the document or form. Write “CR-106, Item 5” on
the top of the page.
I declare under penalty of perjury under California state law that the information above is true and correct.
6
Service by Personal Delivery
Defendant married.
Defendant's present employment:
If defendant is not now working, state the name and address of defendant's last employer and the last date defendant was
employed.
Spouse's present employment
If spouse is not now working, state the name and address of spouse's last employer and the last date spouse was employed.
Dependents
Name Address Relationship Age
DEFENDANT'S FINANCIAL STATEMENT ON ELIGIBILITY FOR
APPOINTMENT OF COUNSEL AND REIMBURSEMENT AND
RECORD ON APPEAL AT PUBLIC EXPENSE
Pen. Code, § 987. 8
www.courts.ca.gov
Form Approved for Optional Use
Judicial Council of California
CR-105 [Rev. September 1, 2018]
Page 1 of 2
7.
1. a.
b.
c.
d.
e.
f.
8.
6.
2.
3.
a.
b.
c.
d.
e.
f.
g.
b.
c.
CR-105
4.
5.
DEFENDANT:
PEOPLE OF THE STATE OF CALIFORNIA v.
FOR COURT USE ONLY
DEFENDANT'S FINANCIAL STATEMENT AND NOTICE TO DEFENDANT
(check all that apply)
ELIGIBILITY FOR APPOINTMENT OF COUNSEL
REIMBURSEMENT FOR COST OF COURT-APPOINTED COUNSEL
ELIGIBILITY FOR RECORD ON APPEAL AT PUBLIC EXPENSE
Defendant's name:
Other names used:
Telephone number:
Driver's license number:
Address:
Occupation:
Name of credit union:
Name of union:
Gross pay per month: $ week: $ day: $
Address:
Name of employer:
Take-home pay per month: $ week: $ day: $
Address:
Name:
Last date of employment:
is
is not
a.
b.
c.
d.
e.
f.
Spouse's name:
Other names used:
Telephone number:
Driver's license number:
Address:
a.
b.
c.
d.
e.
f.
g.
Occupation:
Name of credit union:
Name of union:
Gross pay per month: $
week: $ day: $
Address:
Name of employer:
Take-home pay per month: $ week: $ day: $
a.
b.
c.
Address:
Name:
Last date of employment:
Date of birth:
Date of birth:
a.
SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
CASE NUMBER:
OTHER MONTHLY INCOME
Defendant
9.
Spouse
EXPENSES
Monthly expenses being paid by defendant alone or by defendant and spouse
Installment payments other than those listed in item 10.
MonthIy Payment
Balance Owed
a.
b.
c.
d.
e.
Total:
$
ASSETS
What do you own? (State value):
Cash
House equity
Cars, other vehicles and boat equity (List
make, year, and license number of each)
Checking, savings, and credit union accounts
(List name and account number of each)
Other real estate equity
Income tax refunds due
Life insurance policies (ordinary life, face value)
Other personal property (jewelry, furniture, furs, stocks and bonds, etc.)
13.
ELIGIBILITY FOR APPOINTMENT OF COUNSEL AND NOTICE TO DEFENDANT: If an attorney is appointed to represent you,
the court will, at the conclusion of the criminal proceedings, after a hearing, make a determination of your ability to pay all or a
portion of the cost of the attorney. If the court determines that you are at that time able to pay, the court will order you to pay all or
part of such cost. Such an order will have the same force and effect as a judgment in a civil action and will be subject to execution.
Declaration of Defendant
I declare under penalty of perjury that the foregoing is true and correct, and that I understand the notice contained in item 13, under the
laws of the state of California.
SIGNATURE OF DEFENDANT
Name of Creditor
CR-105
e.
d.
a.
c.
b.
f.
h.
g.
e.
d.
a.
c.
b.
h.
g.
f.
Unemployment and disability
Social Security
Welfare, TANF
Veteran's benefits
Worker's compensation
Child support payments
Spousal support payments
All other income not elsewhere listed
Total:
$
$
$
$
$
$
$
$
$
e.
d.
a.
c.
b.
h.
g.
f.
Unemployment and disability
Social Security
Welfare, TANF
Veteran's benefits
Worker's compensation
Child support payments
Spousal support payments
All other income not elsewhere listed
CASE NUMBER:
PEOPLE OF THE STATE OF CALIFORNIA v.
DEFENDANT:
Total:
$
$
$
$
$
$
$
$
$
11.
10.
Rent or house payments
Clothing and laundry
Food
Support payments
Insurance payments
Other payments (union, taxes,
utilities)
Total (a-j):
j.
i.
f.
h.
g.
$
$
$
$
$
$
Car payments
Transportation payments
Medical and dental payments
Loan paymentse.
d.
a.
c.
b.
$
$
$
$
$
$
$
$
$
$
Total:
$
$
$
$
$
$
12.
Total:
$
$
$
$
$
$
$
$
$
Length of ownership
Date:
DEFENDANT'S FINANCIAL STATEMENT ON ELIGIBILITY FOR
APPOINTMENT OF COUNSEL AND REIMBURSEMENT AND
RECORD ON APPEAL AT PUBLIC EXPENSE
Page 2 of 2 CR-105 [Rev. September 1, 2018]
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SUPERIOR COURT OF CALIFORNIA COUNTY OF ORANGE SELF-HELP (The Superior Court of California - County of Orange)

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Completed 4 January 2021

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