Reserved for Clerk's File Stamp ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, address, telephone number, and attorney State Bar number): ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF ALAMEDA COURT ADDRESS PLAINTIFF DEPARTMENT NUMBER DEFENDANT APPLICATION/STIPULATION FOR RETURN OF EXHIBITS AND ORDER (Civil and Small Claims) CASE NUMBER 1. I am the attorney for plaintiff defendant other (specify): 2. I apply for a court order for release of the following exhibits currently in the custody of the clerk: other (specify): a. All exhibits introduced by plaintiff defendant b. Hospital records from (name of hospital): c. Other (specify): 3. The judgment in this case was entered on (date) expired with no notice of appeal having been filed. 4. I request that the exhibits be delivered to: me (the applicant) other (specify): , and the time for filing an appeal has a representative of the hospital named above I declare under penalty of perjury, under the laws of the State of California, that the foregoing is true and correct. DATE TYPE OR PRINT NAME OF PARTY OR ATTORNEY SIGNATURE OF PARTY OR ATTORNEY DATE TYPE OR PRINT NAME OF PARTY OR ATTORNEY SIGNATURE OF PARTY OR ATTORNEY DATE TYPE OR PRINT NAME OF PARTY OR ATTORNEY SIGNATURE OF PARTY OR ATTORNEY I agree to the return of the exhibits identified above. ORDER THE COURT ORDERS the exhibits described above returned to the person identified in the application. No exhibit shall be released by the clerk without obtaining a signed receipt. Date: Judge Commissioner RECEIPT DATE EXHIBIT(S) RECEIVED FORM NO. AC-004 (New 4-00) TYPE OR PRINT NAME OF PERSON RECEIVING EXHIBIT(S) SIGNATURE OF PERSON RECEIVING EXHIBIT(S) APPLICATION/STIPULATION FOR RETURN OF EXHIBITS AND ORDER (Civil and Small Claims) Rule 243(c) and 531(c), Cal. Rules of Court AL-004