PETITION FOR MODIFICATION OF PROTECTIVE ORDER IN CRIMINAL PROCEEDING DOMESTIC VIOLENCE CASE AND REQUEST FOR HEARING L-404 (Revised July 1, 2006) Optional Form L-404 1. I, ____________________________________________________, the Petitioner, declare the following: (Print Your Name) a. I am the defendant named on the protective order in the above-entitled case.

(1) In support of this request, I am providing a copy of a current progress report from the court- ordered program (circle all that apply): Domestic Violence / Batterer’s Treatment / Child Abuser / Drug and Alcohol.

(2) I have completed the court-ordered programs.

(3) Another Protective Order, Restraining Order or Child Custody Order is in effect and was issued by: ____________________________________________________________. (Name of Court, Case Number, Case Name and Case type) b. I am the protected person named on the protective order in the above-entitled case.

(1) I have proof of _________ sessions of the Choices Personal Empowerment Other program (specify program) ___________________________________ attached.

(2) I am freely and voluntarily asking the court to modify the Protective Order terms ordered on the above-named defendant whose address is: ___________________________________________________________________________.

(3) I have discussed my decision to request a modification with the Victim Specialist. c. I am the parent or guardian of the protected person(

s) named on the protective order in the above-entitled case.

(1) I am freely and voluntarily asking the court to modify the Protective Order terms ordered on the above-named defendant whose address is: ______________________________________________________________________________. ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, Address.): (DO NOT LIST ADDRESS IF YOU ARE THE VICTIM) Telephone No.: Facsimile No.: ATTORNEY FOR (Name) : Bar No.: E-Mail address (optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE JUSTICE CENTER: Central - 700 Civic Center Dr.

West, Santa Ana, CA Harbor-Newport Beach - 4601 Jamboree Rd., Newport Beach, CA Harbor-Laguna Niguel - 30143 Crown Valley Pkwy., Laguna Niguel, CA North - 1275 N. Berkeley Ave., P. O. Box 5000, Fullerton, CA 92838-0500 West - 8141 th Street, Westminster, CA People of the State of California vs.

Defendant: FOR COURT USE ONLY PETITION FOR MODIFICATION OF PROTECTIVE ORDER IN CRIMINAL PROCEEDING- DOMESTIC VIOLENCE CASE AND REQUEST FOR HEARING Case Number: PETITION FOR MODIFICATION OF PROTECTIVE ORDER IN CRIMINAL PROCEEDING DOMESTIC VIOLENCE CASE AND REQUEST FOR HEARING L-404 (Revised July 1, 2006) Optional Form CASE NAME: CASE NUMBER: 2. I request a hearing for consideration of modifying the following terms listed on the protective order (check all that apply): a. Remove Add: Must have no personal, telephonic, or written contact with the protected person. b.

Remove Add: Must have no contact with the protected persons through a third party, except an attorney of record. c. Remove Add: Must not come within ____________ yards of protected person. d. Remove Add: Other:___________________________________________________________. 3.

In support of this request, I am providing the court with the following information (attach separate page if necessary):____________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ ____________________________________________________________________________________.

I declare under the penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: 4 (Type or print name) 4 (Signature of Petitioner) NOTICE: After this form is properly filed, this case will be scheduled for a hearing. You will be notified by the court of a hearing date. A copy of this petition and a Notice of Hearing may be forwarded to all parties for review. Each party will have the right to attend the hearing and oppose the petition.