Declaration Of Petitioner And Request For Records Check {SB-13-00050-360}

DECLARATION OF PETITIONER AND REQUEST FOR RECORDS CHECK (PETITIONER OVER AGE 18 ONLY) 13-10050-360, REV: 04-2014 I, , declare under penalty of perjury that I am not under the jurisdiction of the Department of Corrections nor am I required to register as a sex offender pursuant to Section 290 of the Penal Code. Dated: Petitioner TO: CLETS operator for District. REQUEST FOR CRIMINAL RECORDS CHECK Pursuant to CCP 1279.5, please conduct a criminal records check for the following individual: CLETS CJIS Applicant Name: Date of Birth: SSN: Male Female Please forward results to the Civil Calendar Department at the above district. ATTORNEY OR PARTY WITHOUT (Name, State Bar Number, and address): Telephone No.: Fax No. (Optional): ATTORNEY FOR ( Name ) : Ba r No.: COUR T US E ONL Y SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN BERNARDINO STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME IN RE THE NAME CHANGE OF: DECLARATION OF PETITIONER AND REQUEST FOR RECORDS CHECK (PETITIONER OVER AGE 18 ONLY) CASE NUMBER : American LegalNet, Inc. www.FormsWorkFlow.com