Ukiah
100 North State St
Ukiah, CA 95482 / Ten Mile
700 South Franklin St.
Fort Bragg, CA 95437
PLAINTIFF: People of the State of California
DEFENDANT:
ADDRESS:
Charge(s):
REQUEST TO CALENDAR CASE
In Custody CRIMINAL TRAFFIC / CASE NUMBER:
I , Defendant Attorney for Defendant Deputy District Attorney
Probation Officer Court Clerk request that this matter be placed on calendar as follows:
Calendar date: / Dept: / Time:Reason: / Violation of Probation (Arraignment)
Modification of Probation (attach declaration)**
Termination of Probation (declaration and
proper motion must be attached)
Modification of Sentence (attach declaration)**
Modification: Extend Time to Pay
(attach declaration)**
Modification: Fine to C/S* hours
(attach declaration)**
Modification: Extension on C/S* hours (declaration and progress report must be attached) / Modification: New Surrender Date (attach declaration)**
Modification: Re-referral 1st offender DUI Program
(attach declaration)**
Modification: Re-referral Multiple Offender DUI Program
(attach declaration)**
Modification: Ignition Interlock (attach declaration)**
Withdraw Plea/Dismiss – 1203.4 PC
(proper motion must be attached)
Recall Bench Warrant (attach declaration)**
Warrant Arraignment (attach declaration)**
Advance Hearing
Other:
Proof of Mailing Attached Proof of Service Attached
** DECLARATIONS ON THE FORM PROVIDED MUST BE ATTACHED TO ANY REQUESTS AS NOTED ABOVE. REQUEST WILL NOT BE FILED OR SUBMITTED TO THE COURT WITHOUT THE DECLARATION ATTACHED.
Defendants/Parties are advised to check the posted calendar on the court date as departments are subject to change.
I declare, under the penalty of perjury under California State law, that the information is true and correct.
Dated: .
Signature of Requesting Party Telephone Number
If defendant has an outstanding warrant, he/she has been informed that the warrant remains active
and he/she is subject to arrest.
IT IS HEREBY ORDERED In Custody Request to Calendar is: Granted Denied
Date: By: , Judicial Officer
Note: Case may not be placed on calendar for consideration of Sheriff’s decision on denying Work Release, Work Furlough, Home Monitoring, or Sheriff’s Parole.
CC: Via FAX to Jail
MCR-103-local (rev 0110) REQUEST TO CALENDAR CASE *C/S = Community Service