PETITION FOR GANG INJUNCTION REMOVAL – LOS ANGELES CITY For support in filling out this form, connections for school, work or other resources, or for any additional questions about how to get off a gang injunction, contact the Youth Justice Coalition, 323-235-4243; PO Box 73688, L.A., CA 90037; 323-235-4243; [email protected]. ELIGIBILITY Los Angeles City now has a process for people to petition to be removed from gang injunctions. You are eligible to submit this written “petition” if you are named on a gang injunction – known as the “enforcement list” -- and if one or more of the following statements applies to you: (1) You are submitting the form within 90 days of being served with the injunction; (2) You were served with the injunction before April 15, 2007 when the process was established; and/or (3) You can show “good cause” why you should be removed, for example the completion of school, job training, a gang intervention program and/or other accomplishments. If you feel this applies to you, then fill out the form below and submit it to the locations on the back of this form. YOUR INFORMATION Today’s Date: _____/______/_____ With what injunction were you served: ____________________ Neighborhood Date (or approximate date) You Were Served with the injunction: _____/______/_____ Full name: ______________________________________________________________________ Last First Middle Date of Birth: ______/______/_____ Social Security Number: _____________________________ If you don’t have a social security number, attach a copy of your ID to this petition. Home Address: _________________________________________________________________ Street Apartment/Unit # Zip Code Home Phone: ____(________)____________________________________________________ Area Code Job Address and Phone: ______________________________________________________________________________ Company Name Address Zip Code Job Phone and Contact: _____(_______)___________________________________________ Area Code Supervisor/Contact Person Check the reasons you are submitting this petition (check everything that applies to you: ____ I was never a member of the gang named in the injunction. ____ I am no longer a member or an active member of the gang named in the injunction. ____ I was never a member of any gang. _____ I am no longer a member or an active member of a gang. For support in filling out this form, connections for school, work or other resources, or for any additional questions about how to get off a gang injunction, contact the Youth Justice Coalition, 323-235-4243; PO Box 73688, L.A., CA 90037; 323-235-4243; [email protected]. PERSONAL STATEMENT Write a statement here about why you are submitting this petition. Include any facts supporting your claim that you are not or never were a gang member. If you were a gang member in the past, include why you left the gang life. Include your current activities and accomplishments (including school, work, community service, awards, completion of Probation or Parole, etc.) ____________________________________________________________________/_____/____ Your Name Signature Date For support in filling out this form, connections for school, work or other resources, or for any additional questions about how to get off a gang injunction, contact the Youth Justice Coalition, 323-235-4243; PO Box 73688, L.A., CA 90037; 323-235-4243; [email protected]. PEOPLE WHO CAN SUPPORT YOUR PETITION The following people can speak to the fact that I am not a gang member. In addition to family and community members, include names of teachers, school administrators, community-based programs, employers or members/leaders of faith-based organizations (churches, mosques, temples, synagogues). ___________________________________________________________(_____)_____________ Name Address Phone How do you know this person: _____________________________________________________ ___________________________________________________________(_____)_____________ Name Address Phone How do you know this person: _____________________________________________________ ___________________________________________________________(_____)_____________ Name Address Phone How do you know this person: _____________________________________________________ ___________________________________________________________(_____)_____________ Name Address Phone How do you know this person: _____________________________________________________ ___________________________________________________________(_____)_____________ Name Address Phone How do you know this person: _____________________________________________________ Have each witness give you a letter or written statement supporting your claim that you are not in a gang or are no longer an active gang member, and attach those statements/letters to your petition. Make another copy of this page to include additional witnesses. HOW TO SUBMIT YOUR PETITION Once you have filled out this form, make four copies for your records and submit the original to the Los Angeles City Attorney’s Office, Suite 800, City Hall East, Los Angeles, CA 90012, 213-978-8340. We also recommend that you submit a copy to the office of your City Council member and ask them for additional support and to the YJC so we can push for your case to be taken seriously. FOR HELP FILLING OUT THIS FORM OR SUPPORT IN FOLLOWING UP WITH THE CITY ATTORNEY, contact the Youth Justice Coalition, 323-235-4243, 253 West Martin Luther King Blvd., Los Angeles, CA 90037.
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