NAME, ADDRESS, AND TELEPHONE NUMBER OF ATTORNEY OR PARTY WITHOUT ATTORNEY: STATE BAR NUMBER Reserved for Clerk's File Stamp ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF LOS ANGELES COURTHOUSE ADDRESS: PLAINTIFF/PETITIONER: DEFENDANT/RESPONDENT: CASE NUMBER: REQUEST FOR ENTRY OF JUDGMENT, JUDGMENT, AND NOTICE OF ENTRY OF JUDGMENT ­ BUSINESS AND PROFESSIONS CODE SECTION 12015.3 AND ISSUANCE OF A WRIT OF EXECUTION AND/OR OTHER ENFORCEMENT REQUEST FOR ENTRY OF JUDGMENT 1. The Department of Agricultural Commissioner/Weights and Measures has complied with the provisions of Business and Professions Code section 12001 et seq. 2. The 30-day period to appeal the Notice of Decision and Order of the Hearing Officer has expired. The Notice of Decision and Order of the Hearing Officer is now final. (Bus. & Prof. Code, § 12015.3(c).) 3. Unpaid penalties and fees have accrued in the sum of $ charge of $ _______________________ plus interest at the legal rate. plus civil filing fee and administrative 4. The clerk is requested to enter judgment in favor of the Department of Agricultural Commissioner/Weights and Measures against the above named defendant. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Dated: Agricultural Commission/Director of Weights and Measures By: Inspector LACIV 100 (Rev. 09/13) LASC Approved 07-05 REQUEST FOR ENTRY OF JUDGMENT, JUDGMENT, AND NOTICE OF ENTRY OF JUDGMENT BUSINESS AND PROFESSIONS CODE SECTION 12015.3 Bus. & Prof. Code, § 12015.3; Gov. Code, § 6103.5(d) Page 1 of 2 PLAINTIFF/PETITIONER (Name): DEFENDANT/RESPONDENT (Name): CASE NUMBER JUDGMENT AND NOTICE OF ENTRY OF JUDGMENT Judgment entered in favor of the Department of Agricultural Commissioner/Weights and Measures against the defendant, as follows: a. b. c. d. Principal..............................................................................................$ Costs (including civil filing fee and administrative charge).................$ Total amount of judgment.........................................................$ Plus interest after judgment at the legal rate. . All fees waived by the court must be reimbursed upon partial or full SHERRI R. CARTER, Executive Officer/Clerk By: Deputy Clerk Judgment entered on recovery of judgment. Dated: CERTIFICATE OF MAILING I, the below-named Executive Officer/Clerk of the above-entitled court, do hereby certify that I am not a party to the cause herein, and that on this date I served the Request for Entry of Judgment, Judgment, and Notice of Entry of Judgment ­ Business and Professions Code section 12015.3 upon each party or counsel named below by depositing in the United States mail at the courthouse in , California, one copy of the original filed/entered herein in a separate sealed envelope to each address as shown below with postage thereon fully prepaid. SHERRI R. CARTER, Executive Officer/Clerk By: Deputy Clerk LACIV 100 (Rev. 09/13) LASC Approved 07-05 REQUEST FOR ENTRY OF JUDGMENT, JUDGMENT, AND NOTICE OF ENTRY OF JUDGMENT BUSINESS AND PROFESSIONS CODE SECTION 12015.3 Bus. & Prof. Code, § 12015.3; Gov. Code, § 6103.5(d) Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com