California Code, Penal Code - PEN § 877a

When the commitment is made under the provisions of section 859a of this code, it must be made to the following effect:

County of __________ (as the case may be).

The people of the State of California to the sheriff of the county of __________.

A. B. having pleaded guilty to the offense of (stating briefly the nature of the offense, and giving as near as may be the time when and the place where the same was committed), you are commanded to receive him into your custody and detain him until he is legally discharged.

Dated this ___ day of ______ nineteen ___.