ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar Number and address) FOR COURT USE ONLY TELEPHONE NO.: FAX NO. (Optional): EMAIL ADDRESS (Optional): ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF HUMBOLDT 825 5TH STREET EUREKA, CA 95501 PLAINTIFF(s)/PETITIONER(s): DEFENDANT(s)/RESPONDENT(s): CASE No.: DECLARATION IN SUPPORT OF EXEMPTION I,_________________________________________ , declare: I am the Attorney/Plaintiff/ Defendant for: Plaintiff ________________________________________ CrossComplainant ______________________________ Defendant_________________________________________ CrossDefendant ___________________________, herein. I am able to competently testify to the facts and information set forth in this declaration. The above captioned case is scheduled for a Case Management Conference on _______________________, 20_____. This case should be exempt from the Trial Delay Reduction Rules because: ______ a. ______ b. Explain: I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on _____________________, 20_____, at ____________________________, California. ____________________________________ Signature ORDER _______ The foregoing request for exemption is granted on the grounds that the interest of justice requires a modification of the routine processes as prescribed by Trial Delay Reduction Rules. _______ The Case Management Conference has been rescheduled to _________________ _________________ Date Time _______ The foregoing request for exemption is denied. The Case Management Conference date remains as scheduled. Date:________________________________ Eff. 07/01/1994; as amended, eff. 07/01/2010 ­ Mandatory Form American LegalNet, Inc. www.FormsWorkFlow.com It is an uninsured/underinsured motorist case. One or more of the defendants, specifically, is under Bankruptcy stay order from the Federal Court. (Copy of Bankruptcy Order must be attached.) ____________________________________ Judge of the Superior Court