On January 12, 2023 a
Request,Application
was filed
involving a dispute between
Jordon, Jeffrey Daniels,
and
People Of State Of California,
for 43:Unlim Other Petition (Not Spec)
in the District Court of Mendocino County.
Preview
STATE OF CALIFORNIA DEPARTMENT OF JUSTICE
80F 4009C (Rev
09/2016) PAGE1of 2
BUREAU OF FIREARMS
REQUEST FOR HEARING
FOR RELIEF FROM FIREARMS PROHIBITION
2 Upon or after discharge from a mental health any
facility. person subject to
FILED L
S, firearms prohibitions
subdivision (f)(1).
may
pursuant
request
to
a
Welfare
hearing
and
from
Institutions
the superior
Code
court
section
of his
8103.
or her
JAN 12 2023
1% county of residence to determine whether his or her right(s)to own. DOSSGSWOFMENOOCINOCOUNTY
control. receive. or purchase firearms will be restored by court order. The c OF CALIFORNIA
shall set a hearing date within 30 days of receipt of this request.
_
x \K
\ t'
I
d
N\W'
I,
TO:
Countyot eSidence
COUNTY SUPERIOR COURT. CVOCID35
NgEfi
[tiff C'f
,\_ T @hereby request a hearing for restoration of my right(s) to own or possess firearms.
N I
hereby request a confidential private hearing for restoration of my right(s) to own or possess firearms.
Pursuant to Welfare and Institutions Code section 8103, subdivision (f)(5), you have the right to request a
confidential private hearing that is not open to the public. This hearing will only be attended by persons
hearing in public. Tflrrr C- (
relevant to your case unless the court finds that the public interest would be better served by conducting the
\\LPACV\
\RQ
'.
" -
AKTQY M
_
Last Name First Name Middle Name
C'é' W'Cl
Date of Birth CA Identification or Driver License Number Social Security Number
138 \E( Kx.§\<\ $T \I\\<\C\\,\ /\ A
C
AV
Address City State Zip Code
Mfr/wins Mental Heal
AM
FaCIlity
{5"}al3
Discharge Date
to wont/Mm Address
Chirw City
0k
State
"'57?
Zip Code
Ideclare under penalty ofp unde the la 5 of the State of California that the foregoing is true and correct.
"A i\\l\l\r ~12:
Signature of Requester ate
Please forward completed form to the Superior Court of your County of Residence.
(1) Mental Hea/tii Facility, and (1) Requester
Distribution: (1) Superior Court, (1) DOJ,
Patient Identification
fig St. Helena. CA
.
REQUEST FOR HEARING
Adventistre:llth3
L e "'3
FOR RELIEF FROM JORDON JEFFREYA": DANIELS
"'1 A .
Y
.
FIREARMS PROHIBITION Eiébéi
2"! Nqa/g 700509248
MRN: 05134368 BHM PA
DOS: 12/31/2022 23:00
* .
BH
LegeIZDocumeEts
- MH 5170!) 5/15/19
Document Filed Date
January 12, 2023
Case Filing Date
January 12, 2023
Category
43:Unlim Other Petition (Not Spec)
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STATE OF CALIFORNIA DEPARTMENT OF JUSTICE 80F 4009C (Rev 09/2016) PAGE1of 2 BUREAU OF FIREARMS REQUEST FOR HEARING FOR RELIEF FROM FIREARMS PROHIBITION 2 Upon or after discharge from a mental health any facility. person subject to FILED L S, firearms prohibitions subdivision (f)(1). may pursuant request to a Welfare hearing and from Institutions the superior Code court section of his 8103. or her JAN 12 2023 1% county of residence to determine whether his or her right(s)to own. DOSSGSWOFMENOOCINOCOUNTY control. receive. or purchase firearms will be restored by court order. The c OF CALIFORNIA shall set a hearing date within 30 days of receipt of this request. _ x \K \ t' I d N\W' I, TO: Countyot eSidence COUNTY SUPERIOR COURT. CVOCID35 NgEfi [tiff C'f ,\_ T @hereby request a hearing for restoration of my right(s) to own or possess firearms. N I hereby request a confidential private hearing for restoration of my right(s) to own or possess firearms. Pursuant to Welfare and Institutions Code section 8103, subdivision (f)(5), you have the right to request a confidential private hearing that is not open to the public. This hearing will only be attended by persons hearing in public. Tflrrr C- ( relevant to your case unless the court finds that the public interest would be better served by conducting the \\LPACV\ \RQ '. " - AKTQY M _ Last Name First Name Middle Name C'é' W'Cl Date of Birth CA Identification or Driver License Number Social Security Number 138 \E( Kx.§\<\ $T \I\\<\C\\,\ /\ A C AV Address City State Zip Code Mfr/wins Mental Heal AM FaCIlity {5"}al3 Discharge Date to wont/Mm Address Chirw City 0k State "'57? Zip Code Ideclare under penalty ofp unde the la 5 of the State of California that the foregoing is true and correct. "A i\\l\l\r ~12: Signature of Requester ate Please forward completed form to the Superior Court of your County of Residence. (1) Mental Hea/tii Facility, and (1) Requester Distribution: (1) Superior Court, (1) DOJ, Patient Identification fig St. Helena. CA . REQUEST FOR HEARING Adventistre:llth3 L e "'3 FOR RELIEF FROM JORDON JEFFREYA": DANIELS "'1 A . Y . FIREARMS PROHIBITION Eiébéi 2"! Nqa/g 700509248 MRN: 05134368 BHM PA DOS: 12/31/2022 23:00 * . BH LegeIZDocumeEts - MH 5170!) 5/15/19