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Here is the text we could read:

(Party without an attorney should provide this information on Confidential Information Form (form SH-001))

FOR COURT USE ONLY

SH-022

STATE BAR NUMBER:

STATE:

FAX NO.:

ZIP CODE:

ATTORNEY NAME:

FIRM NAME:

STREET ADDRESS:

CITY:

TELEPHONE NO.:

EMAIL ADDRESS:

ATTORNEY FOR (name):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

(Use Doe name where appropriate)

PLAINTIFF/PETITIONER:

DEFENDANT/RESPONDENT/ESTATE OF:

OTHER PARTY/PARENT:

DECLARATION IN SUPPORT OF MOTION TO PLACE DOCUMENTS 
UNDER SEAL UNDER CODE OF CIVIL PROCEDURE SECTION 367.3 
(SAFE AT HOME)

CASE NUMBER:

This form must be filed any time a Motion to Place Documents Under Seal Under Code of Civil 
Procedure Section 367.3 (Safe at Home) (form SH-020) is filed.

I declare as follows:

1. 

I have personal knowledge of the facts stated in this declaration and could and would testify competently to those facts.

2.

I am an active participant in the Secretary of State's confidential address program, Safe at Home.

3. 

I am seeking to have the court place under seal (make confidential) the documents identified on the Motion to Place 
Documents Under Seal Under Code of Civil Procedure Section 367.3 (Safe at Home) (form SH-020).

4.  Facts showing that there is an overriding interest in my safety or confidentiality that overcomes the right of public access to 
the records in this proceeding and that this overriding interest supports placing the documents under seal in this proceeding 
are as follows (specify):

a.

I am participating in the Safe at Home program.

b. Because of my participation, Code of Civil Procedure section 367.3 authorizes my name and identifying 

characteristics to be kept confidential in any civil action.

c.

Other (specify):

Continued on Attachment 4 (If you need more space, attach form MC-025.)

Form Adopted for Mandatory Use  
Judicial Council of California  
SH-022 [New January 1, 2021]

DECLARATION IN SUPPORT OF MOTION TO PLACE  DOCUMENTS 
UNDER SEAL UNDER CODE OF CIVIL PROCEDURE SECTION 367.3 
(SAFE AT HOME)

Code of Civil Procedure, § 367.3; 
Cal. Rules of Court, rules  2.550, 2.551
www.courts.ca.gov

Page 1 of 2

(Use Doe name where appropriate)

PLAINTIFF/PETITIONER:

DEFENDANT/RESPONDENT/ESTATE OF:

OTHER PARTY/PARENT:

CASE NUMBER:

SH-022

5.

Facts showing that there is a substantial probability that the overriding interest in my safety or confidentiality described in item 4 
will be prejudiced (harmed or impaired) if the records in this proceeding are not sealed (made confidential) are (specify):

Continued on Attachment 5. (If you need more space, attach form MC-025.)

The fact showing that an order sealing the records in this action is narrowly tailored to protect that overriding interest is that 
the versions of the documents that pseudonymous party has lodged (submitted) with the court redact (black out) only the 
pseudonymous party's identifying characteristics as provided under Code of Civil Procedure section 367.3.

The fact showing that there is no less restrictive means to protect that overriding interest than placing the record under seal 
is that the versions of the documents that the pseudonymous party has lodged (submitted) with the court do not redact 
(black out) any information other than the pseudonymous party's identifying characteristics as provided under Code of Civil 
Procedure section 367.3.

The number of pages attached is:  

(The pseudonymous party must sign here) 

 declare under penalty of perjury under the laws of the State of California that the foregoing, including statements on all attachments,  
is true and correct. I agree that when I sign this declaration using my Doe name, I sign as the party identified on the Confidential 
Information Form (form SH-001).

6.

7.

  I

Date:

(TYPE OR PRINT DOE NAME)

(SIGN DOE NAME)

 SH-022 [New January 1, 2021]

DECLARATION IN SUPPORT OF MOTION TO PLACE DOCUMENTS 
UNDER SEAL UNDER CODE OF CIVIL PROCEDURE SECTION 367.3 
(SAFE AT HOME)

Page 2 of 2

Declaration in Support of Motion to Place Documents Under Seal Under Code of Civil Procedure Section 367.3

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): 33
Average fields per page: 16
Reading Level: Grade 8
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_page_std_p_case_number was SC-022[0].Page1[0].StdP1Header_sf[0].CaseNumber[0].CaseNumber[0] (0.62 conf)
c_page_std_p_header_sf_name was SC-022[0].Page1[0].StdP1Header_sf[0].Atty[0].Name[0] (0.37 conf)
c_page_std_p_header_sf_bar was SC-022[0].Page1[0].StdP1Header_sf[0].Atty[0].BarNo[0] (0.38 conf)
c_page_std_p_header_sf_firm was SC-022[0].Page1[0].StdP1Header_sf[0].Atty[0].Firm[0] (0.37 conf)
c_page_std_p_header_street was SC-022[0].Page1[0].StdP1Header_sf[0].Atty[0].Street[0] (0.37 conf)
c_page_std_p_header_sf_city was SC-022[0].Page1[0].StdP1Header_sf[0].Atty[0].City[0] (0.37 conf)
c_page_std_p_header_state was SC-022[0].Page1[0].StdP1Header_sf[0].Atty[0].State[0] (0.37 conf)
c_page_std_p_header_sf_zip was SC-022[0].Page1[0].StdP1Header_sf[0].Atty[0].Zip[0] (0.37 conf)
c_page_std_p_header_phone was SC-022[0].Page1[0].StdP1Header_sf[0].Atty[0].Phone[0] (0.37 conf)
c_page_std_p_header_sf_fax was SC-022[0].Page1[0].StdP1Header_sf[0].Atty[0].Fax[0] (0.37 conf)
c_page_std_p_header_email was SC-022[0].Page1[0].StdP1Header_sf[0].Atty[0].Email[0] (0.37 conf)
c_page_std_p_header_sf_atty was SC-022[0].Page1[0].StdP1Header_sf[0].Atty[0].AttyFor[0] (0.41 conf)
c_page_std_p_info_county was SC-022[0].Page1[0].StdP1Header_sf[0].CourtInfo[0].CrtCounty_ft[0] (0.38 conf)
c_page_std_p_info_street was SC-022[0].Page1[0].StdP1Header_sf[0].CourtInfo[0].Street_ft[0] (0.41 conf)
c_page_std_p_header_info was SC-022[0].Page1[0].StdP1Header_sf[0].CourtInfo[0].MailingAdd_ft[0] (0.41 conf)
c_page_std_p_info_city was SC-022[0].Page1[0].StdP1Header_sf[0].CourtInfo[0].CityZip_ft[0] (0.39 conf)
c_page_std_p_info_branch was SC-022[0].Page1[0].StdP1Header_sf[0].CourtInfo[0].Branch_ft[0] (0.39 conf)
c_page_std_p_title_info__1 was SC-022[0].Page1[0].StdP1Header_sf[0].TitlePartyName[0].info1[0] (0.38 conf)
c_page_std_p_title_info__2 was SC-022[0].Page1[0].StdP1Header_sf[0].TitlePartyName[0].info2[0] (0.38 conf)
c_page_std_p_title_info__3 was SC-022[0].Page1[0].StdP1Header_sf[0].TitlePartyName[0].info3[0] (0.38 conf)
c_page_list_l_text_field was SC-022[0].Page1[0].List4[0].LI3[0].TextField1[0] (0.39 conf)
c_page_list_l_ch__1 was SC-022[0].Page1[0].List4[0].LI3[0].Ch2[0] (0.37 conf)
c_page_list_l_ch__2 was SC-022[0].Page1[0].List4[0].LI3[0].Ch1[0] (0.37 conf)
c_page_header_case_number was SC-022[0].Page2[0].Header[0].CaseNumber[0].CaseNumber[0] (0.37 conf)
page_header_title_party_name_info__1 was SC-022[0].Page2[0].Header[0].TitlePartyName[0].info1[0] (0.34 conf)
page_header_title_party_name_info__2 was SC-022[0].Page2[0].Header[0].TitlePartyName[0].info2[0] (0.34 conf)
page_header_title_party_name_info__3 was SC-022[0].Page2[0].Header[0].TitlePartyName[0].info3[0] (0.34 conf)
c_page_list_l_textfield was SC-022[0].Page2[0].List5[0].LI1[0].Textfield1[0] (0.37 conf)
c_page_list_l_ch__3 was SC-022[0].Page2[0].List5[0].LI1[0].Ch1[0] (0.37 conf)
c_page_sign_sub_ch was SC-022[0].Page2[0].SignSub[0].Ch2[0] (0.37 conf)
c_page_sign_sub_textfield was SC-022[0].Page2[0].SignSub[0].Textfield2[0] (0.37 conf)
c_page_sign_sub_date_field was SC-022[0].Page2[0].SignSub[0].DateField1[0] (0.40 conf)
c_page_sign_sub_fill_text was SC-022[0].Page2[0].SignSub[0].FillText1[0] (0.37 conf)

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

Declaration in Support of Motion to Place Documents Under Seal Under Code of Civil Procedure Section 367.3

About This Form:

Identified Data Fields:

Create an Interactive Version of this Form:

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