Fill and Sign the California Officers Declaration Form

(Continued on reverse) OFFICER'S DECLARATION (Trial by Written Declaration —Vehicle Code, § 40902) TR-235 OFFICER'S DECLARATION (Trial by Written Declaration — Traffic) Form Adopted for Mandatory Use Judicial Council of California TR-235 [New January 1, 2000] Vehicle Code, § 40902 INSTRUCTIONS: The defendant in the case listed above has opted for trial\ by written declaration pursuant to Vehicle Code section 40902. The officer named above shall check all statements t\ hat apply, date, sign, and complete and return this form to the court named above by the return date. FOR COURT USE ONLY STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: PEOPLE OF THE STATE OF CALIFORNIA DEFENDANT: vs. NAME OF COURT: CITATION NUMBER/DATE ISSUED: CASE NUMBER: OFFICER'S DECLARATION: Except as expressly stated below, I have personal knowledge of the facts\ stated herein. The events occurred in the County of (specify): \ at about the date, time, and location stated in the citation. 1. 2. At the time of the citation I was a peace officer on-duty RETURN DATE: OFFICE [IF ANY]: AGENCY NAME: ARRESTING/CITING OFFICER NAME/ID NO.: a. b. The offense(s) were not committed in my presence. c. Any statement(s) made by the defendant were voluntary, recorded verbatim and is/are reasonably complete and accurate in substance. not verbatim d. Safety is an element of the violation alleged. In my opinion, the defend\ ant's operation of the vehicle was unsafe. e. Any equipment used by me to gather evidence in support of this violation\ was properly maintained, in good working order, and I have been trained in its use. f. Any traffic sign, signal, or device mentioned was official and properly \ located, maintained, in good working order, and clearly visible to a driver of a vehicle controlled, governed, or affect\ ed by such sign, signal, or device. g. Any diagram(s) submitted is/are not exact or to scale, but is/are reas\ onably complete, accurate, and fairly depict(s) the location, situation, and events described. h. Speed supported by the patrol vehicle's speedometer was a significant fa\ ctor. Pursuant to department policy, the patrol vehicle used in connection with this citation was officially calibrated \ on (date) : \ The result was (specify): The calibration was considered by me in determining defendant's speed. THE METHOD(S) USED TO DETERMINE THE SPEED OF THE INVOLVED VEHICLE WAS/\ WERE: a. b. c. d. e. f. Odometer Visual estimation Pacing Radar (see items 4, 5, 6, below)Laser Aircraft a. 3. Engineering and traffic survey (ETS) not required per Vehicle Code section 40802, subdivision (b). 4. ETS completed within five (5) years prior to date of alleged violation. b. ETS attached. ETS on file with the court. 5. ETS completed within five (5) and seven (7) years prior to date of alle\ ged violation. a. ETS attached. TELEPHONE: for the exclusive or main purpose of traffic enforcement not for the exclusive or main purpose of traffic enforcement, and I was was not wearing a uniform as required by the Vehicle Code section 40800. Any vehicle used by me co\ mplied with Vehicle Code section 40800. i. Defendant was identified by Driver's License g. Other (specify) : or other (specify) : PEOPLE v. DEFENDANT (Name): CASE NUMBER: c. d. e. f. Arresting/citing officer has successfully completed a radar operator cou\ rse of not less than 24 hours approved and certified by the Commission on Peace Officer Standards and Training (PO\ ST). Laser or other electronic device was used to measure speed. Arresting/citing officer successfully completed an additional training course of not less than two hours approved and certi\ fied by POST. The speed measuring device used to measure the speed of defendant (Seri\ al No: ) meets or exceeds the minimum operational standards of the National Highw\ ay Traffic Safety Administration (NHTSA) and was last calibrated on (date): by an ind\ ependent certified laser/radar repair and testing/calibration facility. Equipment accuracy check conducted on (date): at (time): and again on (date): \ at (time): 6. a. ETS completed within seven (7) and ten (10) years prior to the date of \ the alleged violation. A registered engineer has evaluated the section of the highway in quest\ ion and has determined that no significant changes in roadway or traffic conditions have occurred. b. All of the elements marked under item 5, above, which are applicable. 7. 5. FACTS AND CIRCUMSTANCES (Type or print only. State what happened) : Continued on attachment. 8. OTHER EVIDENCE AND STATEMENTS (Explain any other evidence and statements) : Continued on attachment. 9. DIAGRAM(S) (specify): Attached. OFFICER'S DECLARATION (Trial by Written Declaration — Traffic) TR-235 [New January 1, 2000] Page two I declare under penalty of perjury under the laws of the State of Califo\ rnia that the foregoing is true and correct. Date: (SIGNATURE OF OFFICER) (TYPE OR PRINT NAME) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . \ . . . . . . . . . 10. Number of pages attached: _____ ID Number: Agency NCIC Number: b. ETS on file with the court.