L-0015 DECLARATION AND/OR ORDER FOR WRIT OF EXECUTION Page 1 of 2 Revised: 9/4/14 FAMILY LAW Name, Address and Telephone Number of Attorney(s) or Party without Attorney TELEPHONE NO. ATTORNEY FOR (Name) Attorney Bar # SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE JUSTICE CENTER: Central - 700 Civic Center Dr. West, Santa Ana, CA 92701-4045 Lamoreaux - 341 The City Drive South, Orange, CA 92868-3205 PETITIONER: RESPONDENT: DECLARATION FOR WRIT OF EXECUTION AND ORDER CASE NUMBER: 1. The undersigned declares under penalty of perjury under the laws of the State of California: That declarant is in the above-entitled action; that the following judgment order was made and entered on (date) : JUDGMENT DEBTOR(S) NAME(S) ADDRESS(ES) Additional names and addresses of Judgment Debtors on attached sheet. American LegalNet, Inc. www.FormsWorkFlow.com L-0015 DECLARATION AND/OR ORDER FOR WRIT OF EXECUTION Page 2 of 2 Revised: 9/4/14 FAMILY LAW Where payments are ordered to be paid at different times, fill in date below; in other cases, strike out inapplicable portions. Failure to claim interest shall be deemed a waiver thereof. The installments ordered and interest thereon, and the installments paid and interest thereon, are as follows: INSTALLMENTS ORDERED PAID INSTALLMENTS ACTUALLY PAID BALANCE DUE DATE DUE AMOUNT INTEREST DATE PAID PRINCIPAL INTEREST PRINCIPAL INTEREST I, the undersigned do hereby declare: That there is actually due on said judgment order the sum of $ principal, $ costs, $ attorney fees and $ interest, for which sum declarant requests that a writ of execution issue in favor of to the Sheriff or any Marshal or Constable of the County of . I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: (Signature of Declarant) FOR COURT USE: Issued by Clerk Order of the Court Writ of Execution shall issue. Date: Signature Judicial Officer Clerk, Deputy American LegalNet, Inc. www.FormsWorkFlow.com