Fill and Sign the Request for Trial by Written Declaration Vehicle Code Form

CIT A TIO N N UM BER :CASE N UM BER :          T R -2 05NAM E O F C O URT:FO R C O URT U SE O NLYS TR EETA D DRESS:M AIL IN G A D D RESS:C IT Y A N D Z IP C O DE:BR AN CH N AM E:P EO PLE O F T H E S TA TE O F C ALIF O RNIAv s.D EFE N DAN T:R EQ UEST F O R T R IA L B Y W RIT TE N D EC LA R ATIO N (Veh ic le C ode, § 4 0902)T O B E F IL LE D O UT B Y C O URT C LE R KA. DUE DATE (for receipt of this form and any unpaid bail (specify):B. Bail amount required: $C. B ail a m ount a lr e ady d eposit e d b y d efe ndant: $D. Date mailed or delivered by clerkE . M ail o r d eliv e r c o m ple te d f o rm , e vid ence , a nd m ail t o t h e C le rk o f t h e ( s p ecif y ):C ourt a t m ailin g a ddre ss):R EQ UEST F O R T R IA L1. I h ave r e vie w ed t h e in str u ctio ns t o D efe ndant ( T ria l b y W rit te n D ecla ra tio n) ( fo rm T R -2 00).2 . I r e quest t o h ave a t r ia l b y w rit te n d ecla ra tio n.3. T he f a cts c o nta in ed in t h e D ecla ra tio n o f F acts o n t h e r e ve rs e a re p ers o nally k n ow n t o m e a nd a re t r u e a n c o rre cd .4. I k n ow t h at I h ave t h e r ig ht n ot t o b e c o m pelle d t o b e a w it n ess a gain st m yse lf . I u nders ta nd a nd a gre e t h at b y m akin g a ny sta te m ent, I a m g iv in g u p a nd w aiv in g t h at r ig ht a nd p riv ile ge.5. E V ID EN CE T he f o llo w in g e vid ence s u pports m y c a se a nd in clu de s e ve ry th in g I w ant t h e c o urt t o c o nsid er in d ecid in g m y c a se :a.p hoto gra ph , ( s p ecif y t o ta l n um ber):e .d ia gra mb.m edic a l r e co rdf.c a r r e pair r e ce ip tC.re gis tr a tio n d ocu m entsg .in su ra nce d ocu m entsd .in sp ectio n c e rtif ic a teh .o th er ( s p ecif y ):(D ecla ra tio n c o ntin u ed o n r e ve rs e )Form A dopte d b y th eR EQ UEST F O R T R IA L B Y W RIT TE N D EC LA RATIO N (Tria l b y W rit te n D ecla ra tio n-T ra ffic )Vehic le C ode, § 4 0902Ju dic ia l C oun cil o f C alif o rn iaT R -2 05 [N ew J a nuary 1 , 1 9 99]electronic form 2000 WWW.LawCA.com Law Publishers PEO PLE v . D EFE N D AN T ( N am e):C ASE N UM BER :6 . D EC LA R ATIO N O F F A C TS ( T yp e o r p rin t o nly . S ta te w hat h appe ned a nd e xp la in a ll t h e it e m s o f e vid ence y o u c h ecke d in it e m 5 on t h e r e ve rs e a nd t e ll h ow t h ey s u pport y o ur c a se . Y ou m ay a dd a ddit io nal p ages.)( N am e):(C urre nt m ailin g a dd re ss):S TA TE M EN T O F F A C TS ( b egin h ere ):7. Number of pages attachedI d ecla re u nder p e nalt y o f p erju ry u nder t h e la w s o f t h e S ta te o f C alif o rn ia t h at t h e f o re goin g is t r u e a nd c o rre ct.D ate :(T Y PE O R P R IN T N AM E)(S IG NATU RE)TR -2 05 [N ew J a nuary 1 , 1 9 99]R EQ UEST F O R T R IA L B Y W RIT TE N D EC LA RATIO N (Tria l b y W rit te n D ecla ra tio n-T ra ffic )Page twoelectronic form 2000 WWW.LawCA.com Law Publishers