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.: FINDINGS AND ORDER AFTER HEARING 1. This proceeding was heard: on (date): _________________________________ at (time): ______________________ in Department: ___________________ by Judge (name): __________________________________ Temporary Judge (name) ________________________________ Petitioner/Plaintiff present Attorney present (name): ________________________________ Respondent/Defendant present Attorney present (name): ________________________________ Other Present Attorney present (name): ________________________________ On the order to show cause or motion for ______________________________________________________________________ filed on: (date) _______________________, 20_____ by (party) _____________________________________, the Court Orders: 1. ________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ 2. ________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ 3. Continued on Attachment 3. Date: _____________________________ ___________________________________ Judicial Officer The proposed order was submitted to the other party for approval as conforming to court order on ___________________, 20_____. The response of the other party was none _________________________________________________________. ______________________ Date Eff. 07/01/2010 ­ Optional form __________________________________________ Signature of Attorney for Petitioner/Plaintiff Respondent/Defendant California Rules of Court, Rule 3.1312 American LegalNet, Inc. www.FormsWorkFlow.com