NAME AND ADDRESS OF ATTORNEY: FOR COURT USE ONLY ATTORNEY FOR: SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN BERNARDINO 351 North Arrowhead Avenue, San Bernardino, CA 92415-0210 8303 Haven Avenue, Rancho Cucamonga, CA 91730 14455 Civic Drive, Victorville, CA 92392 235 East Mountain View, Barstow, CA 92311 6527 White Feather Road, Star Route 1, Box 60, Joshua Tree, CA 92252 216 Brookside Avenue, Redlands, CA 92373 17780 Arrow Highway, Fontana, CA 92335 13260 Central Avenue, Chino, CA 91710 PLAINTIFF (ABBREVIATED): DEFENDANT (ABBREVIATED): CASE NUMBER: APPLICATION FOR JUDGMENT FOR RESTITUTION OF PREMISES ONLY, PURSUANT TO C.C.P. 1169 I am the Plaintiff/Attorney in the above-entitled action. Defendant(s) was/were served with a summons and complaint on and has/have not appeared and/or answered the complaint. Proof of service of the three-day/thirty-day notice to pay or quit and proof of service of summons and complaint have been filed with the clerk. Pursuant to C.C.P. 1169, Request to Enter Default having been filed, I, the undersigned, request that default and default judgment be entered for restitution of the premises located at , California, and that a writ of execution issue for possession of premises only. The defendant(s) is are in possession of the premises. I certify, under penalty of perjury, that the foregoing is true and correct. Executed on at , California. Signature 13-16418-360 Rev. 8/94 (CIVIL) Print Name SB-349 2002 © American LegalNet, Inc.