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Here is the text we could read:

SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:

FOR COURT USE ONLY

CR-221

MAILING ADDRESS:

CITY:

BRANCH NAME:

NAME OF DEFENDANT:

STREET ADDRESS:

MAILING ADDRESS:

CITY:

TELEPHONE NO.:

EMAIL ADDRESS:

DRIVER'S LICENSE NO.:

STATE:

ZIP CODE:

STATE:

FAX NO.:

ZIP CODE:

ORDER TO INSTALL IGNITION INTERLOCK DEVICE

CASE NUMBER:

Under Vehicle Code section 23575, the court orders: a functioning, certified Ignition Interlock Device installed on the following vehicles
operated by defendant:

Make

Model

Year

Color

License Plate No. and/or VIN

Date:

Installation of an ignition interlock device on a vehicle does not allow defendant to drive without a valid driver's license.

Installation must be no later than (date):

3. Defendant must present this form to the installer at the time of installation.

4. Defendant must return completed Ignition Interlock Installation Verification (form CR-222) or the Department of Motor Vehicles

Verification of Installation—Ignition Interlock (DL 920) to the court no later than (date):

Defendant must take vehicles to the installer to recalibrate or monitor the device:

once every 60 days

other (specify frequency):

following the date of installation.

6. Without a court order, the devices may not be removed prior to (specify a date no later than three years from the date of conviction):

7. Defendant's employer requires defendant to drive a motor vehicle owned by the employer within the course and scope of defendant's

employment. Defendant must provide the employer with the Notice to Employers of Ignition Interlock Restriction (form CR-226)

no later than (specify date):
Interlock Restriction in defendant's possession or keep the original or a copy in the employer's vehicle.

. Defendant must keep a copy of the Notice to Employers of Ignition

8. Defendant must maintain current insurance and registration on all vehicles owned.

9. Other (specify):

I acknowledge receipt of this order.

(TYPE OR PRINT NAME OF DEFENDANT)

(DEFENDANT'S SIGNATURE)

Form Approved for Optional Use
Judicial Council of California
CR-221 [Rev. January 1, 2021]

ORDER TO INSTALL IGNITION INTERLOCK DEVICE

JUDICIAL OFFICER OF THE SUPERIOR COURT

Page 1 of 2

Vehicle Code, §§ 23575, 23576

www.courts.ca.gov

ORDER TO INSTALL IGNITION INTERLOCK DEVICE

CASE NUMBER:

What is a violation of this order?

1. Failure to have ignition interlock devices installed as ordered.

2. Failure to show proof of installation to the court within the time limit specified in this order.
3. Failure to comply three or more times with any requirement for the maintenance or calibration of the ignition interlock devices.
4.

If defendant has a valid driver's license, driving any vehicle without an ignition interlock device except for employer-owned vehicles
required to be operated within the course and scope of employment. A motor vehicle owned by a business entity that is all or partly
owned or controlled by defendant is not a motor vehicle owned by an employer subject to the exemption.

Under Vehicle Code section 23575, if a defendant fails to comply with this court order the court must notify the Department of
Motor Vehicles.

What will happen if you violate this order?

Violation of the following is a misdemeanor and can be punished by imprisonment in the county jail and/or a fine:

1. Failure to notify any person who rents, leases, or loans a motor vehicle to defendant of the restriction imposed by this order.

2. Requesting or soliciting any person to blow into an ignition interlock device or to start a motor vehicle equipped with the device for

the purpose of providing defendant with an operable motor vehicle.

3. Operating a vehicle not equipped with a functioning ignition interlock device.

4. Removing, bypassing, or tampering with an ignition interlock device.

Defendant: Call the ignition interlock device installer and arrange for the installation of the device(s).
The court will provide you with a list of manufacturers certified by the Department of Motor Vehicles.
Contact a certified manufacturer to locate an installer.

CR-221 [Rev. January 1, 2021]

ORDER TO INSTALL IGNITION INTERLOCK DEVICE

Page 2 of 2

Order to Install Ignition Interlock Device

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the California state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from selfhelp.courts.ca.gov (2023-03)
Page(s): 2
Fields(s): 46
Average fields per page: 23
Reading Level: Grade 10
LIST Grouping(s): Unknown

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

c_r_page_p_case_number was CR-221[0].Page1[0].P1Caption[0].CaseNumber[0].CaseNumber[0] (0.58 conf)
c_r_page_p_info_county was CR-221[0].Page1[0].P1Caption[0].CourtInfo[0].CrtCounty[0] (0.31 conf)
c_r_page_p_caption_street was CR-221[0].Page1[0].P1Caption[0].CourtInfo[0].CrtStreet[0] (0.31 conf)
c_r_page_p_caption_info__1 was CR-221[0].Page1[0].P1Caption[0].CourtInfo[0].CrtMailingAdd[0] (0.40 conf)
c_r_page_p_caption_court_info_crt_city_zip was CR-221[0].Page1[0].P1Caption[0].CourtInfo[0].CrtCityZip[0] (0.33 conf)
c_r_page_p_info_state was CR-221[0].Page1[0].P1Caption[0].CourtInfo[0].State[0] (0.38 conf)
c_r_page_p_caption_info__2 was CR-221[0].Page1[0].P1Caption[0].CourtInfo[0].Zip[0] (0.38 conf)
c_r_page_p_caption_info__3 was CR-221[0].Page1[0].P1Caption[0].CourtInfo[0].CrtBranch[0] (0.31 conf)
c_page_p_party_info_name was CR-221[0].Page1[0].P1Caption[0].AttyPartyInfo[0].Name[0] (0.40 conf)
c_r_page_p_party_info__1 was CR-221[0].Page1[0].P1Caption[0].AttyPartyInfo[0].Street[0] (0.40 conf)
c_r_page_p_party_info__2 was CR-221[0].Page1[0].P1Caption[0].AttyPartyInfo[0].mailing[0] (0.37 conf)
c_page_p_party_info_city was CR-221[0].Page1[0].P1Caption[0].AttyPartyInfo[0].City[0] (0.40 conf)
c_page_p_party_info_state was CR-221[0].Page1[0].P1Caption[0].AttyPartyInfo[0].State[0] (0.40 conf)
c_r_page_p_caption_info__4 was CR-221[0].Page1[0].P1Caption[0].AttyPartyInfo[0].Zip[0] (0.40 conf)
c_r_page_p_party_info__3 was CR-221[0].Page1[0].P1Caption[0].AttyPartyInfo[0].Phone[0] (0.40 conf)
c_r_page_p_party_info__4 was CR-221[0].Page1[0].P1Caption[0].AttyPartyInfo[0].Fax[0] (0.40 conf)
c_page_p_party_info_email was CR-221[0].Page1[0].P1Caption[0].AttyPartyInfo[0].Email[0] (0.40 conf)
c_r_page_p_party_info__5 was CR-221[0].Page1[0].P1Caption[0].AttyPartyInfo[0].AttyFor[0] (0.39 conf)
c_r_page_list_lia_fill_text__1 was CR-221[0].Page1[0].List[0].Lia[0].FillText1[0] (0.39 conf)
c_r_page_list_lia_fill_text__2 was CR-221[0].Page1[0].List[0].Lia[0].FillText2[0] (0.39 conf)
c_r_page_list_lia_fill_text__3 was CR-221[0].Page1[0].List[0].Lia[0].FillText3[0] (0.39 conf)
c_r_page_list_lia_fill_text__4 was CR-221[0].Page1[0].List[0].Lia[0].FillText4[0] (0.39 conf)
c_r_page_list_lia_fill_text__5 was CR-221[0].Page1[0].List[0].Lia[0].FillText5[0] (0.39 conf)
c_r_page_list_lib_fill_text__1 was CR-221[0].Page1[0].List[0].Lib[0].FillText6[0] (0.39 conf)
c_r_page_list_lib_fill_text__2 was CR-221[0].Page1[0].List[0].Lib[0].FillText7[0] (0.39 conf)
c_r_page_list_lib_fill_text__3 was CR-221[0].Page1[0].List[0].Lib[0].FillText8[0] (0.39 conf)
c_r_page_list_lib_fill_text__4 was CR-221[0].Page1[0].List[0].Lib[0].FillText9[0] (0.39 conf)
c_r_page_list_lib_fill_text__5 was CR-221[0].Page1[0].List[0].Lib[0].FillText10[0] (0.39 conf)
c_r_page_list_lic_fill_text__1 was CR-221[0].Page1[0].List[0].Lic[0].FillText11[0] (0.39 conf)
c_r_page_list_lic_fill_text__2 was CR-221[0].Page1[0].List[0].Lic[0].FillText12[0] (0.39 conf)
c_r_page_list_lic_fill_text__3 was CR-221[0].Page1[0].List[0].Lic[0].FillText13[0] (0.39 conf)
c_r_page_list_lic_fill_text__4 was CR-221[0].Page1[0].List[0].Lic[0].FillText14[0] (0.39 conf)
c_r_page_list_lic_fill_text__5 was CR-221[0].Page1[0].List[0].Lic[0].FillText15[0] (0.39 conf)
c_r_page_list_item_date__1 was CR-221[0].Page1[0].List2[0].item2[0].Date1[0] (0.34 conf)
c_r_page_list_item_date__2 was CR-221[0].Page1[0].List4[0].item4[0].Date2[0] (0.34 conf)
c_r_page_list_item_ch__1 was CR-221[0].Page1[0].List5[0].item5[0].Ch1[0] (0.34 conf)
c_r_page_list_item_ch__2 was CR-221[0].Page1[0].List5[0].item5[0].Ch1[1] (0.34 conf)
c_page_list_item_text_field was CR-221[0].Page1[0].List5[0].item5[0].TextField1[0] (0.39 conf)
c_r_page_list_item_fill_text__1 was CR-221[0].Page1[0].List6[0].item6[0].FillText16[0] (0.37 conf)
c_r_page_list_item_date__3 was CR-221[0].Page1[0].List7[0].item7[0].Date3[0] (0.34 conf)
c_r_page_list_item_fill_text__2 was CR-221[0].Page1[0].List9[0].item9[0].FillText17[0] (0.37 conf)
c_r_page_sign_sig_date was CR-221[0].Page1[0].sign[0].SigDate[0] (0.28 conf)
c_r_page_sign_sig_name was CR-221[0].Page1[0].sign[0].SigName[0] (0.28 conf)
c_r_page_sign_date was CR-221[0].Page1[0].sign[0].Date4[0] (0.32 conf)
c_page_header_order_fill_text was CR-221[0].Page2[0].Header[0].Order[0].FillText18[0] (0.39 conf)
c_r_page_header_case_number was CR-221[0].Page2[0].Header[0].CaseNumber[0].CaseNumber[0] (0.42 conf)

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Order to Install Ignition Interlock Device

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The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02