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FOR COURT USE ONLY
ATTORNEY OR PARTY WITHOUT ATTORNEY (NAME AND ADDRESS):
TELEPHONE NO.:
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA BARBARA
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
:
BRANCH NAME
Matter of
CASE NUMBER:
PETITION FOR RESTRICTED LICENSE – VC §13202.5
I, the undersigned, declare that I am under the age of twenty-one, and have been convicted in the above-entitled case for
an offense which requires that my privilege to drive by suspended for one year. My driving privilege is not currently suspended
for any other reason. I have not previously been convicted of any other offense requiring a suspension under Vehicle Code
§13202.5. I have a critical need to drive to and from school, work, or other place as described below, and public or other
mode of transportation is not adequate.
I live at ______________________________________________, __________________________, _______, ___________
Street Address
City
State
Zip
My driver's license number is _________________________. The school I attend is _______________________________,
which is _________ miles from home. I am in my ___________________ year, and I am currently carrying _________ units.
(first, second, etc.)
I work at ________________________________________, which is _________ miles from home, _________ hours a week.
My supervisor is ____________________________________________________ Phone: ___________________________
I also need to drive to ____________________________________________________________ because (explain in detail):
Public or other transportation is inadequate because (explain in detail):
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed at _________________________________________________, California, on ____________________________
_____________________________________________________
Signature
DO NOT WRITE BELOW THIS LINE – FOR COURT USE ONLY
ORDER
The petition for a restricted driver's license is granted as follows:
To and from work
To and from school
To and from treatment program
During the course of work
Other: ___________________________________________________________________________________________
An abstract with the restriction information has been transmitted to the Department of Motor Vehicles in Sacramento.
The petition for a restricted license is denied because:
No critical need has been shown
Insufficient evidence; Defendant may resubmit
Other: ___________________________________________________________________________________________
Dated:
Judge of the Superior Court
WARNING: THIS IS NOT A LICENSE TO DRIVE. This order allowing you to drive on a restricted basis is NOT VALID unless
you are also in possession of a currently valid driver's license issued by DMV.
SC-9007 [Revised Aug. 2, 2011]
CVC §13202.5
PETITION FOR RESTRICTED LICENSE (Juvenile)
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