Fillable DISORDERLY CONDUCT PETITION San Manuel Tribal Court San (San Manuel Band of Mission Indians)

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DISORDERLY CONDUCT PETITION San Manuel Tribal Court San (San Manuel Band of Mission Indians)

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The DISORDERLY CONDUCT PETITION San Manuel Tribal Court San (San Manuel Band of Mission Indians) form is 4 pages long and contains:

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U.S.A. forms for San Manuel Band of Mission Indians

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San Manuel Tribal Court
San Manuel Indian Reservation
3214 Victoria Avenue
Highland, CA 92346
Phone: (909) 907-6920
DISORDERLY CONDUCT PETITION
Page 1 of 4
(If more space is needed for any item, attach additional sheets as needed, with “Disorderly Conduct Petition” at top.)
1. Petitioner is (check one): San Manuel Tribal Member Tribe
If Petitioner is a San Manuel General Council member, he/she must attach proof that he/she is a Tribal Member
and is at least 18 years old, which can be obtained from Senior Executive Assistant to the Business Committee,
Michelle Olden.
2. a. Petitioner’s Address:
(If not provided above)
b. Petitioner’s Phone No.: c. Petitioner’s Fax No.:
3. a. Respondent’s Address:
b. Respondent’s Phone No.: c. Respondent’s Date of Birth:
Attorney Advocate Party Representing Self (check one)
Rev. 1/2021
Name:
For Court Use Only
Address:
Phone:
Email:
If Attorney or Advocate, name of party represented: Case Number:
Petitioner(s): Hearing Date:
Time:
Respondent(s):
Page 2 of 4
Rev.
01/2021 DISORDERLY CONDUCT PETITION
Petitioner(s)/Respondent(s): Case Number:
4. Identify whether the respondent is any of the following (check all that apply):
San Manuel Tribal Member Non-Member Indian
Non-Indian Resident of San Manuel Reservation
A Tribal Member whose minor child allegedly committed the incident of disorderly conduct
A Tribal Member whose guest (including a spouse or person residing with the member) allegedly committed
the incident of disorderly conduct
5. a. Date(s) alleged incident committed:
b. Date Petitioner learned of alleged incident:
6. Applicable paragraph(s) of section 8.2.2 of Disorderly Conduct Ordinance ((a) - (p)):
7. Location where alleged act(s) occurred (check all that apply):
Within the boundaries of the San Manuel Reservation At a San Manuel Tribal facility
Specify location:
8. If alleged act(s) occurred at a San Manuel Tribal event:
a. Describe event (date, time, location, name or type of event):
b. Was event sponsored, in whole or in part, by the Tribe?
c. WereTribalgovernmentofcialsorTribalMembersinvited?
9. Describe the alleged act(s) in detail:
See attached declaration(s), incident report(s) or other documents for further details.
10. Describe potential or actual severity of harm related to the alleged act(s):
Yes No
Yes No
Page 3 of 4
Rev.
01/2021 DISORDERLY CONDUCT PETITION
Petitioner(s)/Respondent(s): Case Number:
11. How many persons were affected by the alleged act(s)? (Provide names, if possible, and potential or actual harm
suffered by each)
12. Describe level of government resources required to address the alleged act(s):
13. Describe impact of alleged act(s) on residential life on Tribal lands and impact on government enterprises:
14. If Respondent is known to have committed prior act(s), in violation of the San Manuel Disorderly Conduct Ordinance
withinthepastveyears,providedetailsbelow:
15. IfPetitionerisseekingspecicsanctionsorremediesagainsttheRespondentfortheallegedact(s),orotherreliefor
orders, please describe:
Page 4 of 4DISORDERLY CONDUCT PETITION
Petitioner(s)/Respondent(s): Case Number:
16. Number of pages attached to this form, if any:
Note:ThisDisorderlyConductPetitionmustbeservedandaproofofserviceledwiththecourtwithin60daysofthedate
on which the Court Clerk issues the related Summons to Appear.
I declare under penalty of perjury under the laws of the San Manuel Band of Mission Indians that the foregoing is
true and correct.
Date:
Date:
________________________________
Attorney’s or Advocate’s Signature
(if applicable)
________________________________
Petitioner’s Signature
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DISORDERLY CONDUCT PETITION San Manuel Tribal Court San (San Manuel Band of Mission Indians)

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Completed 27 January 2021

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