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FOR COURT USE ONLY
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA BARBARA
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
People of the State of California
PLAINTIFF:
DEFENDANT:
CASE NUMBER:
PETITION FOR RESTRICTED LICENSE
(CVC §13201.5 and 13202.5)
I, the undersigned, declare that I was under the age of twenty-one at the time of violation in the above-entitled case for an
offense which requires that my privilege to drive be suspended for one year. My driving privilege is not currently suspended for
any other reason at this time.
I, the undersigned, declare that my privilege to drive is suspended for a violation in the above-entitled case only.
I have a critical need to drive 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 ___________________________
____________________________________________________
Defendant's 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: _________________________________________________________________________________________
Enclosed is a restriction card, which you should attach to your driver’s license. 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:
Judicial Officer 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-8006 [Rev. April 18, 2003]
CVC §13201.5, 13202.5
PETITION FOR RESTRICTED LICENSE
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