PB-4054 NEW 07/01/11
WRIT OF HABEAS CORPUS
(RE: QUARANTINE DETENTION)
Page 1 of 1
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar Number and Address):
TELEPHONE NUMBER: FAX NUMBER (Optional):
EMAIL ADDRESS (Optional):
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA
COURT ADDRESS:
CITY AND ZIP CODE:
DIVISION:
191 North First Street
San José, California 95113
Probate Division
In the Matter of the Application of:
FOR COURT USE ONLY
WRIT OF HABEAS CORPUS
(RE: QUARANTINE DETENTION)
CASE NUMBER:
1. TO THE SANTA CLARA COUNTY PUBLIC HEALTH DEPARTMENT:
YOU ARE ORDERED TO APPEAR to show cause at the hearing noted below why the Petitioner should
not be released from quarantined confinement.
Superior Court of California, County of Santa Clara
191 North First Street, San José, CA 95113
Date: Time: Dept.
Department Phone Number: (408) 882-
2. TO THE CLERK OF THIS COURT: You are directed to serve this writ with the attached order to all
interested parties by fax or email. If the Petitioner does not have fax or email capabilities and is self-
represented, then you may give notice of the court date by phone as indicated in the petition. (Attach the
original fax confirmation or printed email to this writ as proof of service for the file.)
[SEAL]
Date: Clerk, by
, Deputy
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