ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY TELEPHONE NO: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): FAX NO. (Optional) SUPERIOR COURT OF CALIFORNIA, COUNTY OF MENDOCINO ADDRESS: CITY AND ZIP CODE: BRANCH NAME: CASE NUMBER: PETITIONER/PLAINTIFF: ___________________________________________ RESPONDENT/DEFENDANT: HEARING DATE: TIME: DEPT.: NOTICED REQUEST FOR ENTRY OF JUDGMENT PURSUANT TO DEFAULT AND SUPPORTING DECLARATION (Unlawful Detainer) I, __________________________________, request that the court issue a judgment for writ of possession and/or money judgment, to be executed forthwith, for the reasons stated below: 1. I am the owner of (address) ___________________________________ 2. On the hearing date for this unlawful detainer, (date) agreement in this matter. Settlement agreement is attached. 3. In the agreement, Defendant(s) agreed to pay me (amount, if applicable) $ 4. Defendant(s) agreed to vacate the premises no later than (date) 5. Defendant(s) (names) ________________________________________________ 7. Defendant(s) were notified of this request as follows: . defaulted on the agreement as follows: ________ __________. . __________. , the parties signed a settlement . 8. Plaintiff requests judgment for immediate possession of the premises, and if applicable, a money judgment for $___________________ pursuant to the stipulated agreement and the default as stated above. 9. I understand that I must supply the court clerk with a self-addressed envelope in order to be sent a copy of the signed judgment. I declare under penalty of perjury that the foregoing is true and correct. Date: Print name MUD-103-local (new 0109) Sign name American LegalNet, Inc. www.FormsWorkflow.com