Claims for workers' compensation benefits can be complicated, so it's important to understand how the process works. In this blog post, we'll provide an overview of Form L 1279, which is used to file a claim for supplemental wages. We'll also explain what information is required on the form and discuss the steps involved in processing a claim. If you have any questions about using Form L 1279, please don't hesitate to contact us. We're here to help!
| Question | Answer |
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| Form Name | Form L 1279 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | licensure, DNA, Fullerton, 13th |
SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE |
FOR COURT USE ONLY |
JUSTICE CENTER: |
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Central - 700 Civic Center Dr. West, Santa Ana, CA 92701 |
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North - 1275 N. Berkeley Ave., P. O. Box 5000, Fullerton, CA |
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West - 8141 13th Street, Westminster, CA 92683 |
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PEOPLE OF THE STATE OF CALIFORNIA VS. |
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Defendant:__________________________________________ |
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Case Number: |
ORDER FOR RELIEF UNDER PENAL CODE §1203.4, §1203.4A, §1203.41 |
Driver’s License: |
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Date of Birth: |
If this order is granted under the provisions of Penal Code section 1203.4 or 1203.4a or 1203.41:
∙The defendant is relieved from all penalties and disabilities resulting from the offense except as provided in Vehicle Code section 13555.
∙Dismissal of an accusation or information pursuant to this section does not permit a person to own, possess, or have in his or her custody or control any firearm or prevent his or her conviction under Chapter 2 (commencing with Section 29800) of Division 9 of Title 4 of Part 6.
∙As required by Penal Code section 299(f), this relief does NOT release the defendant from the separate administrative duty to provide specimens, samples or print impressions under the DNA and Forensic Identification Database and Databank Act of 1998 if the defendant was found guilty by a trier of fact, not guilty by reason of insanity, or pled no contest to a qualifying offense as defined in Penal Code section 296(a).
If this order is granted the provisions of Penal Code section 1203.4 or 1203.4a or 1203.41 additionally apply:
∙Dismissal of the conviction does NOT relieve the defendant of the obligation to disclose the conviction in response to any direct question contained in any questionnaire or application for public office, for licensure by any state or local agency, or for contracting with the California State Lottery.
∙Dismissal of the conviction does NOT permit a person prohibited from holding public office as a result of that conviction to hold public office.
∙Dismissal of the conviction does NOT relieve the defendant from any obligation to register under
Penal Code section 290.
GRANTED: It appears to the court from the records on file in this matter, and from the petition, that the defendant is eligible for the relief requested. It is hereby ordered that the plea, verdict, or finding of guilt in the
The court has reviewed the Defendant’s Financial Statement and determines defendant can pay reimbursement of costs in the amount of $120 $60 other amount ___________, which must be paid on or before:
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The court has reviewed the Defendant’s Financial Statement and determines defendant cannot pay reimbursement of costs.
DENIED
OTHER:
Date: _____________
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Judge/Commissioner of the Superior Court |
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Form # |
ORDER FOR RELIEF UNDER PENAL CODE §1203.4, §1203.4A, §1203.41 |
Penal Code, §§1203.4, |
Revised February 4, 2014 |
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Optional Form |
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1203.4a, 1203.41 |