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 Page 1 of 1 Form No. PL-FL015 Effective 07-01-2015 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar Number, and Address): TELEPHONE NO.: FAX NO.: EAL ADDRESS: MI SPERIOR COURT OF CALI, OUNTY OF PLACER UFORNIAC 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/PLAINTIFF: RESPONDENT/DEFENDNT: FOR COURT USE ONLY WRITTEN STIPULATION AND AGREEMENT CASE NUMBER: Plaintiff / Petitioner present not present - represented by attorney Defendant / Respondent present not present - represented by attorney THE PARTIES HEREBY STIPULATE AND AGREE AS FOLLOWS: See attached. Continued to: Department: at Attorney for Plaintiff / Petitioner Attorney for Defendant / Respondent SIGNATURE OF PARTIES We have read the entire stipulation and agreement. We understand it fully and request the Court to make our stipulation and agreement the Court222s order. We understand that willful failure to comply with the provisions of this order will be a contempt of court and may be punished by fine and imprisonment. We waive all further notice of this order. Plaintiff / Petitioner Defendant / Respondent IT IS SO ORDERED this day of, 20. Judge/Commissioner of the Superior Court American LegalNet, Inc. www.FormsWorkFlow.com