SUPERIOR COURT OF THE STATE OF CALIFORNIA, COUNTY OF PLACER Form Adopted for Optional Use www.placer.courts.ca.gov Superior Court of California, County of Placer Form No. PL-FL001 Effective 10-01-2018 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar Number, and Address): TELEPHONE NO.: FAX NO.: EMAIL ADDRESS: FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF PLACER 10820 Justice Center Drive 2501 N. Lake Blvd. P.O. Box 619072 P.O. Box 5669 Roseville, CA 95661-9072 Tahoe City, CA 96145 PETITIONER: RESPONDENT: FAMILY LAW 226 REQUEST FOR DEFAULT SETTING CASE NUMBER: DEPARTMENT: TO THE CLERK OF THE COURT: I request that this case be set for a default hearing. The hearing is estimated to take: 15 minutes or less More than 15 minutes Date: Signed: Attorney Party FOR CLERK222S USE ONLY Set for Hearing: DATE: TIME: DEPT. Notice mailed to party or attorney at address shown above on: Party waives service by mail. Party was provided a copy of this Request for Default Setting at the counter on: / /20 Jake Chatters, Clerk of the Placer County Superior Court By: , Deputy Clerk American LegalNet, Inc. www.FormsWorkFlow.com