CSD 3030 [02/01/17] Name, Address, Telephone No. & I.D. No. UNITED STATES BANKRUPTCY COURT SOUTHERN DISTRICT OF CALIFORNIA 325 West F Street, San Diego, California 92101-6991 In Re BANKRUPTCY NO. Debtor. ADVERSARY NO. Plaintiff(s) V. Defendants(s) REQUEST TO ENTER DEFAULT TO THE APPLICANT: applicable boxes: BOX 1 The following statements must all be true in order to enter the default. Please verify by checking BOX 2 BOX 3 BOX 4 BOX 5 BOX 6 BOX 7 BOX 8 The defendant named above did not file a motion or an answer to the complaint within 30 days of issuance of the summons pursuant to FRBP 7012. The United States, its offices and agencies, have 35 days to file a motion or answer. If the defendant is an individual, he/she is not entitled to benefits of military status. The Declaration of Non-Military Status has been completed on page 2 of this Request. Proof of Service of the Summons and Complaint has been filed with the court pursuant to LBR 9006-2. Service of Summons and Complaint on defendant was made within 7 days of issuance of the summons pursuant to FRBP 7004(e). If the defendant is also the debtor, service of Summons and Complaint was made on the attorney for debtor/defendant pursuant to FRBP 7004(g). Service of Summons and Complaint was made at the defendant's dwelling house, usual place of abode or the place where the defendant regularly conducts business pursuant to FRBP 7004(b). The defendant is not a minor or incompetent person. If so, he/she must be represented by a general guardian, conservator, or other like fiduciary who has appeared as Fed.R.Civ.P. 55(b) requires. The declaration or affidavit in support of this Request is filed concurrently as LBR 7055-1(b) requires. TO THE CLERK: Please enter the default in the above-entitled complaint of the following-named Defendant(s) ONLY. (If additional space is needed, attach an exhibit listing all Defendants for which a default is requested): [See footnote1 before completing.] DATED: Signature of (Attorney for) Plaintiff 1 The word "plaintiff" includes cross-complainant, "defendant" includes cross-defendant, singular includes the plural. NOTE: Moving party must complete declarations on reverse side, if applicable. American LegalNet, Inc. www.FormsWorkFlow.com CSD 3030 CSD 3030 (Page 2) [02/01/17] DECLARATION OF MAILING [Complete if default is requested AFTER defendant entered appearance (Fed.R.Civ.P. 55(b)(1).] On , a copy of this Request to Enter Default was mailed (by first-class mail or airmail, postage prepaid) to the defendant, if the debtor, and attorney for each defendant against whom the default is requested, at the last known address of each, addressed as follows: The address of the following defendant and defendant's attorney of record is unknown to plaintiff and plaintiff's attorney: on I certify (or declare) under penalty of perjury that the foregoing is true and correct, and that this declaration is executed , at , (City) (State and ZIP) (Type or Print Name) (Signature of Declarant) MEMORANDUM OF COSTS Costs and disbursements are listed as follows: a. Clerk's Filing Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ b. Process Server's Fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ c. ...................................................................... $ d. ...................................................................... $ e. TOTAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2$ I am (the attorney or agent for): , the party who claims these costs. To the best of my knowledge and belief the foregoing items of cost are correct and have been necessarily incurred in this action. I certify (or declare) under penalty of perjury that the foregoing is true and correct, and that this declaration is executed , at , (City) (State and ZIP) on Type or Print Name) 2 (Signature of Declarant) Include a blank space in judgment for inclusion of costs, as awarded. DECLARATION OF NON-MILITARY STATUS [Not required if the defendant is a partnership, corporation or trustee in bankruptcy.] As defined by the Servicemember's Civil Relief Act of 2003, the defendant(name): is is not in military service or the plaintiff is unable to determine the defendant's military status and recognizes that it may be required to post a bond before entry of a default judgment. I certify (or declare) under penalty of perjury that the foregoing is true and correct, and that this declaration is executed , at , (City) (State and ZIP) on (Type or Print Name) (Signature of Declarant) American LegalNet, Inc. www.FormsWorkFlow.com CSD 3030