REC-003 SUPERIOR COURT OF CALIFORNIA, COUNTY OF DEPARTMENT AND DIVISION: JUDICIAL DISTRICT OR BRANCH COURT: MAILING ADDRESS: STREET ADDRESS: CITY AND ZIP CODE: TELEPHONE: FAX: REPORT TO THE JUDICIAL COUNCIL: SUPERIOR COURT RECORDS DESTROYED, PRESERVED, AND TRANSFERRED 1. You are hereby notified, as required by rule 10.855 of the California Rules of Court, that the following superior court records were (check only one category per report): a. Destroyed by court order (date of order): and preserved in another medium (specify): b. Preserved for the comprehensive or if different from the court address above). sample court records (specify the location of the records below, c. Transferred to an entity under rule 10.856 (specify location of the records below if different from the organization's address). Attach a copy of Judicial Council Form REC-002(R). Beginning and Ending Case Numbers Beginning and Ending Month and Year Record Type 2. Medium Paper Microfilm Electronic Other (specify): Location: 3. Paper Microfilm Electronic Other (specify): Location: 4. Paper Microfilm Electronic Other (specify): Location: Date: Clerk, by , Deputy (If necessary, use the reverse of this page to continue) Form Adopted for Mandatory Use Judicial Council of California REC-003 [Rev. January 1, 2007] Page 1 of 2 Calif. Rules of Court, rule 10.855 www.courtinfo.ca.gov American LegalNet, Inc. www.FormsWorkflow.com REPORT TO THE JUDICIAL COUNCIL: SUPERIOR COURT RECORDS DESTROYED, PRESERVED, AND TRANSFERRED REC-003 Record Type 5. Beginning and Ending Case Numbers Beginning and Ending Month and Year Medium Paper Microfilm Electronic Other (specify): Location: 6. Paper Microfilm Electronic Other (specify): Location: 7. Paper Microfilm Electronic Other (specify): Location: 8. Paper Microfilm Electronic Other (specify): Location: 9. Paper Microfilm Electronic Other (specify): Location: 10. Paper Microfilm Electronic Other (specify): Location: 11. Paper Microfilm Electronic Other (specify): Location: 12. Paper Microfilm Electronic Other (specify): Location: REC-003 [Rev. January 1, 2007] REPORT TO THE JUDICIAL COUNCIL: SUPERIOR COURT RECORDS DESTROYED, PRESERVED, AND TRANSFERRED Page 2 of 2