Fill and Sign the Request Written Template Form

CITATION NUMBER: CASE NUMBER:––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––– –– ––– –– ––– –– ––– –– ––– –– ––– –– ––– –– ––– –– ––––– TR- 205 NAME OF COURT: FOR COURT USE ONLY STREETADDRESS : MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: PEOPLE OF THE STATE OF CALIFORNIA v s . DEFENDAN T: REQUEST FOR TRIAL BY WRITTEN DECLARATION (Vehicle Code, § 40902) TO BE FILLED OUT BY COURT CLERK A. DUE DATE (for receipt of this form and any unpaid bail (specify): B. Bail amount required: $ C. Bail amount already deposited by defendant: $ D. Date mailed or delivered by clerk E. Mail or deliver completed form, evidence, and mail to the Clerk of the (specify): Court at mailing address): REQUEST FOR TRIAL 1. I have reviewed the instructions to Defendant (Trial by Written Declaration) (form TR-200). 2. I request to have a trial by written declaration. 3. The facts contained in the Declaration of Facts on the reverse are personally known to me and are true an correcd. 4. I know that I have the right not to be compelled to be a witness against myself. I understand and agree that by making any statement, I am giving up and waiving that right and privilege. 5. EVIDENCE The following evidence supports my case and includes everything I want the court to consider in deciding my case: a . photograph , (specify total number): e . diagra m b . medical record f . car repair receipt C . registration documents g . insurance documents d . inspection certificate h . other (specify): (Declaration continued on reverse) Form Adopted by the REQUEST FOR TRIAL BY WRITTEN DECLARATION (Trial by Written Declaration-Traffic) Vehicle Code, § 40902 Judicial Council of CaliforniaTR-205 [New January 1, 1 999] electronic form ã 2000 WWW.LawCA.co m Law Publishers ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– PEOPLE v. DEFENDANT (Name): CASE NUMBER: 6. DECLARATION OF FACTS (Type or print only. State what happened and explain all the items of evidence you checked in item 5 on the reverse and tell how they support your case. You may add additional pages.) (Name ): (Current mailing address): STATEMENT OF FACTS (begin here): 7. Number of pages attached I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Dat e: (TYPE OR PRINT NAME) (SIGNATUR E) TR-205 [New January 1, 1 999] REQUEST FOR TRIAL BY WRITTEN DECLARATION (Trial by Written Declaration-Traffic) Page twoelectronic form ã 2000 WWW.LawCA.co m Law Publishers