SHORT TITLE CASE NUMBER DECLARATION OF IN SUPPORT OF APPLICATION FOR NUNC PRO TUNC ORDER I, (Name of Declarant) (name) , hereby declare as follows: I have read the foregoing and I certify that the same is true of my own knowledge, except as to those matters which are stated on information and belief, and as to those matters, I believe them to be true. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this day of , 2____, at (City and State) (Signature) Declaration in Support of Application for Nunc Pro Tunc Order PRO 051 02/12 American LegalNet, Inc. www.FormsWorkFlow.com