Fillable Conviction Review Request Form (County of Los Angeles / Internal Services Department)

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Conviction Review Request Form (County of Los Angeles / Internal Services Department)

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The Conviction Review Request Form (County of Los Angeles / Internal Services Department) form is 3 pages long and contains:

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©2019 Los Angeles County District Attorney’s Office
Conviction Review Request Form
Mail to: Los Angeles County District Attorney’s Office
Conviction Review Unit
211 West Temple Street, Room 1255
Los Angeles, CA 90012
Email to: CRU@da.lacounty.gov
Claim No. ____________________________
(To be supplied by the DA’s Office)
1. Convicted person’s name:
2. Convicted person’s date of birth (MM/DD/YYYY):
3. Is the convicted person incarcerated?
Yes No
4. If presently incarcerated, please provide the following information:
a. CDC Number:
b. Prison where incarcerated:
c. Cell location:
d. P.O. Box:
e. City, State, Zip:
5. Name and location of the court where the person was convicted and sentenced:
6. Los Angeles County Superior Court Case Number:
7. Provide the Penal Code section of the crime(s) the person was convicted of:
8. Date convicted:
9. Date sentenced:
1
10.
Sentence received:
11.
Expected release date:
12.
How was the person convicted?
a. Jury Trial
b. Court Trial
c. Guilty Plea
d. No Contest Plea
13. Is the conviction currently being challenged on appeal?
Yes No
14. Is there a habeas corpus petition currently pending before a court?
Yes No
15. Has a habeas corpus petition ever been filed regarding the conviction?
Yes No
16. Did the person who was convicted ever give a statement to law enforcement
when arrested?
Yes No
17. If there was a trial, did the person who was convicted testify in the trial?
Yes No
18. What new evidence, if any, exists that was not known at the time of trial? If
you need extra space, you may attach additional pages to this request.
19.
Please state the reason(s) the conviction should be reviewed. If you need
extra space, you may attach additional pages to this request.
2
©2019 Los Angeles County District Attorney’s Office
20. You may attach copies of exhibits or documents to this questionnaire to assist
the Conviction Review Unit’s examination of your request. Please retain all
original documentary evidence for your records.
21. If this request is being submitted by someone other than the person convicted,
please state your relationship to the person convicted:
22. If this request is being submitted by someone other than the person convicted,
have you obtained the written consent of the person convicted to file this
request?
Yes No
23. Please provide the information below so that we may contact you.
Complainant’s Full Name:
Address (Number, Street, City, State and Zip Code):
Email:
Date:
_________________________
Signature of Claimant
_________________________
Type/Handwrite Name
Once the questionnaire is received by the Los Angeles County District Attorney’s Office,
you will be contacted and informed about the status of your request.
3
©2019 Los Angeles County District Attorney’s Office
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Conviction Review Request Form (County of Los Angeles Internal Services Department)

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Completed 30 April 2021

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