Fill and Sign the Order to Install Ignition Interlock Device California Form

SUPERIOR COURT O F CALFORNIA, COUN T Y OF 5 . Defen d an t mus t t a k e veh i cles t o th e i n stal l er for ca l ibration 60 day s othe r (sp e c i fy freq u ency): fol l owing the dat e of inst a llation. Date: Fo r m A p pr ov e d fo r O p tio n al Use ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– – – ––––– – ––––– ––––– ––––– ––––– ––––– FOR CO U R T U S E ONLY ID- 100 STR E ET A DDRE S S M A LING A DDRE S S : CITY AN D ZIP CODE B RANCH N A ME: N A ME O F D E FEND A NT: STR E ET ADDR E S S : MAILING A DDR E S S : CIT Y A N D Z IP CODe H OM E T E L E PH ON E NO.: WORK TE L E P HO N E NO.: DRI V ER ' S LICEN SE NO.: OR D E R TO INSTALL IGN I TION INTERLO C K DEVICE CA SE NUM B ER: Under V e hicle Code section 2357 5, the cour t orders : a functioni n g Ign i ti o n Interlock D e v i c e b e i n stal l e d o n th e follo w in g vehicles owned or operated b y d efe n dant: a . b . c . M a k e Mode l Y e a r Col o r Lic e nse Pl a t e No. a n d/ o r VIN 1 . T his o r d er d o es n ot r e ins ta te the defenda n t ' s d r ivi n g priv i lege. 2 . Instal l at i on must b e n o l a te r t h a n (sp e c i fy a d at e no la t er th an 30 d ays f r o m th e d a te o f co n v i c t io n) : 3 . Defen d ant must presen t this f o rm t o th e i nst a ller at t he time of install a ti o n. 4 . Defen d ant must ret u r n complete d Ignition Inter l ock Insta l lation Verif i c a ti on (for m ID-110 ) to the n o l at er tha n (s p ecify a dat e n o l a ter t h an 30 days fro m the d at e o f c o nvicti o n): cour t prob a ti o n d ept. 6 . Defen d ant must mak e p ayme n ts direc t l y t o the install e r and must adh e r e to th e pa y men t p lan f o r install a ti on o f t he i gniti o n d e v i c e . 7 . W i th o ut a court order , the devices may no t be removed prior t o (specif y a date no late r than t h r ee ye ar s from th e d a te o f co n v i c tio n ) : 8 . D e fe n dant's em p loye r re q uire s d ef e ndant to drive a v e hicle owne d by t he emp l oyer withi n th e cours e a nd sco p e of defenda n t ' s emp l oyme n t. D e fe n dant mus t provi de the employer wit h th e Notice t o Emp l oyers of Ign i ti o n Interlock R e strict i o n (form ID-150) no late r tha n (specify d a te): . Defenda n t m u st k e ep a co p y o f th e Notice to Em p loyer s o f Ign i ti o n Interlock Re s t rictio n in def e ndant ' s possessio n or keep th e ori g inal or a co p y in the em p loyer's vehicle. 9 . Def e ndant must mai n ta i n current i nsu r ance and registr a ti on on a ll v e hicles owne d . 1 0. O t h e r (specify ) : D at e : I acknowl e dge receip t o f th is order. (T Y P E OR PRINT NAM E OF DEF E NDA N T ) (D E FEND A NT'S SIGNATUR E ) JUDICIA L OFFICE R O F TH E S UP E RIOR COUR T P a ge 1 of 2 V e h i c le C o d e , § § 2 3 5 7 5, 2 3 5 7 6Ju d icia l C o u n c i l of C a lifor n ia ID- 1 0 0 [R e v. Ju l y 1 , 2 0 0 5 ] ORDER TO INSTALL IGNITION I N TERLOCK DEVICE (Ignition Inter l ock Device) el ectr onic form ã 2005 WWW.LawCA.co m L a w P u b l i s h e r s ––––– –––––SHOR T TITLE: C A S E NUM BE R: WHAT IS A VIOLATION O F THIS ORDER? 1 . F a ilure to have ig n it i on interloc k d e vice s i n stal l ed wit h in 30 day s o f th e dat e of thi s order. 2 . Failure t o return co m p lete d Ignition Interlock Ins t allation Verificatio n (form ID-110 ) t o th e c o ur t o r p r o bation dep a rtment (as i n dicated on th e reverse ) w i th in th e t i m e limit sp e cif i ed i n thi s order. 3 . F a ilure to comply thre e or more tim e s wit h any re q uirement for th e maintena n c e o r calibratio n of th e ig n it i o n interlock d evi c es. 4. Fai l ur e to com p l y with any c o urt order. 5 . Defaul t on a n y p a yme n t plan arrang ed w i th the inst a ller o r o r d e re d b y t h e co u r t, resultin g i n fail u r e to comp ly herew i th, a bsent a showi n g i n co u r t of goo d cause. 6 . I f defenda nt has a val i d d r iv e r 's l icense, driv i n g any ve h ic le wit h out a n i g nitio n interlock d evice e x ce pt as p r o v i de d bel o w a n d exc e pt fo r empl o y e r -ow n ed v e hicles r e quired t o be o perate d w it h i n the course and sc o pe of employment . A motor v e hicle owned b y a busi n ess entit y t hat is who l ly o r partly ow n e d or c ontroll ed b y defend a nt is no t a mot or vehicl e ow n e d by a n empl o y er subj e c t to t he e x e m p tio n. 7 . F a ilure to maintain curren t l i c e ns e a nd r e gistratio n o n a ny vehicl e ow n e d by d e fe n dant. 8 . F a ilure to notif y a n y perso n who rents, leases , o r lo a n s a mot o r vehicl e t o defendant of the r e stric t i on im p osed b y this o r der. 9 . Req u esti n g or solicitin g a ny perso n to b lo w into a n i g nit i on interloc k d evice o r t o start a m o tor vehicle eq u ippe d with t h e device f o r the purpose o f provi d ing defend a nt wit h a n o perabl e motor veh i c l e. 10 . T ampering with or circumv e nt i ng th e op e r a ti on o f an ign i ti on i nt e r l ock device. Und er Vehicl e Co d e sectio n 23 5 7 5 on l y , i t i s an a ffirm a tive defense t o Vio l at i on Nu m ber s 7 , 8 , and 9 i f defen d an t can show t h at he o r s h e l eased, re n ted , or b o rro we d a veh i c l e fo r em e r g ency us e whe n n o othe r f e asible alternative wa s a v a ilab l e, or for a b on a f i de busi n es s purp o s e wh e n a way from de f en d ant's r e gular place o f b u siness. WHA T WILL HAPPEN I F Y O U VIOLATE THI S ORDER? Und er Vehicl e C o de s e ctio n 23 5 75, i f a d ef e ndant fai ls to p r o v i d e proof o f inst a llat i on within t he o r d ered time limit, absent a sh o wing of g oo d cause, th e c o u r t m u st notify t he D e partment of Motor Vehicl e s . YOUR RIG H TS 1 . If y ou a r e req u ired to install ig n it i on int e r l oc k d e v i c e s pursua n t t o Veh i c le C o d e s e ctio n 2 3 575, a n d y o u h ave a medica l c o n d it i on t h at you bel i ev e p r e v e nts you fro m b r e at h ing wit h sufficient strength t o act i v a te the devices, you ha v e t he ri g ht t o pres en t a physicia n 's statemen t t o the cou rt d o c u me n ti ng the cond i ti on a nd to have t he co u r t det e r mi ne w h et h er the me d ical conditio n do e s mak e u s e o f the devices medical l y impossib l e. 2 . I f y o ur drivi n g p r i v i leg e ha s bee n r e voked or s u spende d p u rsu a nt t o Ve h icle Cod e secti on 2 3575, and i t is restore d before t h e e n d o f t he p e r i od ordered herei n fo r i nsta l lation of the ignitio n i n t e rl o c k devices, yo u may p e titio n th e cour t to revi e w wh e th er c ontinu e d restriction i s necessary. D e f e nd a nt : Ca ll th e i g n iti o n i n ter l ock d e vi ce i n s t a l l er w i t h i n 48 h o u rs o f t h is o r der a n d arra n ge for the in s t a llati on of t h e d evice(s). T h e c o urt w i l l p r ov i d e yo u w i t h a l i st of man u factur e rs certified b y the D e partme nt of Moto r Vehicles . Co nt act a c e r t ifi ed man u factur e r t o loc a t e a n installer. ID - 1 0 0 [R e v. Ju ly 1 , 2 0 0 5 ] ORDE R T O I NSTALL IGNITION INTERLOCK DEVICE (Ig n i t ion Int er lo c k D e v i ce) P a ge 2 o f 2el ectr onic form ã 2005 WWW.LawCA.co m L a w P u b l i s h e r s