Free MC-265 PETITION FOR WRIT OF HABEAS CORPUS -- LPS Act (Mental Health) - California


File Size: 27.2 kB
Pages: 1
Date: June 24, 2009
File Format: PDF
State: California
Category: Court Forms - State
Author: West Group
Word Count: 464 Words, 3,044 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.courtinfo.ca.gov/forms/documents/mc265.pdf

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Preview MC-265 PETITION FOR WRIT OF HABEAS CORPUS -- LPS Act (Mental Health)
COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. :
ATTORNEY OR PETITIONER WITHOUT ATTORNEY (Name and Address):

Index No.
FOR COURT USE ONLY

TELEPHONE NO.:

: Plaintiff(s)
PETITIONER'S BIRTH DATE: -against-

Calendar No.

: : :

JUDICIAL SUBPOENA

SUPERIOR COURT OF CALIFORNIA, COUNTY OF

IN THE MATTER OF (NAME):

Petitioner

:

CASE NUMBER:

Defendant(s) : . . . . . . .PETITION .FOR .WRIT. OF.HABEAS CORPUS .--.LPS .Act . . . . . ....... ... ... .. .............. . ... ..
1. Petitioner is being unlawfully restrained of liberty at (specify name of treatment facility): by (specify name of agency and treating psychiatrist):

THE PEOPLE OF THE STATE OF NEW YORK
2. Petitioner was admitted to the treatment facility on (date): W & I § 5250 (14-day certification) W TO & I § 5150 (72-hour hold) W & I § 5270.15 (30-day cert.) W & I § 5300 (180-day post-certification) W & I § 5350 (conservatorship) Other (specify): 3. Check at least one box: GREETINGS: Petitioner is illegally confined for the following reason: a. and is currently being held pursuant to W & I § 5260 (2d 14-day certification) W & I § 5352.1 (temporary conservatorship)

WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the

b.

Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoenarights issued for a cause (Welfare and Institutions Code sections 5325, 5325.1, a Petitioner has been denied the following was without good maximum penalty of $50 and all damages sustained as result of5326): failure to comply. and your Witness, Honorable Court in County, , one of the Justices of the day of , 20

(Attorney must sign above and type name below)

4. Petitioner requests that this court (check all that apply): Attorney(s) for Issue a Writ of Habeas Corpus to the director of the facility named in item 1, commanding that the petitioner be brought a. before this court at a specified time and place. Order the facility to release petitioner from restraint. b. c. Order that all rights to which petitioner is entitled as a patient be observed. Office and P.O. Address d. Grant such other relief as this court deems appropriate. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date:

..............................................
(TYPE OR PRINT NAME)

Telephone No.: Facsimile No.: (SIGNATURE OF PETITIONER OR PERSON REQUESTING WRIT ON PETITIONER'S BEHALF) E-Mail Address: Mobile Tel. No.:
American LegalNet, Inc. www.USCourtForms.com

Form Approved by the Judicial Council of California MC-265 [New January 1, 1994]

PETITION FOR WRIT OF HABEAS CORPUS -- LPS Act (Mental Health)