SUPERIOR COURT OF CALIFORNIA County of Sacramento 720 Ninth Street, Room 102 Sacramento, CA 95814-1380 (916) 874-5522--Website www.saccourt.ca.gov Attorney or Party Without Attorney (Name, State Bar # and Address): For Court Use Only Telephone No.: E-Mail Address: Attorney for (Name): Plaintiff: Defendant: Fax No.: Case Number: Assigned Dept: Uninsured Motorist Statement Plaintiff certifies that this is an uninsured motorist claim as defined in Government Code section 68609.5 and Insurance Code section 11580.2. Plaintiff requests that this matter be stayed for 180 days as prescribed in California Rule of Court 3.712(b) and Local Rule 2.49. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct: Dated Signature of attorney or party without attorney Uninsured Motorist Statement CV\E-132 (Rev 10.27.15) Local Form Adopted for Mandatory Use Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com