NAME AND ADDRESS OF ATTORNEY(S): TELEPHONE NO.: FOR COURT USE ONLY ATTORNEY(S) 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(S)/PETITIONER: DEFENDANT(S)/RESPONDENT: DECLARATION AND ORDER FOR ISSUANCE OF WRIT OF EXECUTION/ABSTRACT OF JUDGMENT I, CASE NUMBER: , say: That declarant is in the above entitled action; that the following (judgment) (order) was made, and entered ACIS Code 37012 + 37013(02) 13-1961-360 Rev. 11/94 SB-12 2002 © American LegalNet, Inc. (Where payments accrue at different times, fill in data below; in other cases, strike out inapplicable portions.) Failure to claim interest shall be deemed a waiver thereof. That the payments accrued and interest thereon, and the payments made and interest thereon, are as follows: PAYMENTS ACCRUALS DATE DUE AMOUNT INTEREST DATE PAID That there is actually due on said order the sum of $ $ AMOUNT BALANCE DUE INTEREST principal, $ attorney fees and $ costs, interest, for which sum affiant prays that a Writ of Execution/ Abstract of Judgment issue in favor of to County I declare under penalty of perjury that the foregoing is true and correct. . Executed on , at , California. Signature ORDER FOR ISSUANCE OF WRIT OF EXECUTION/ABSTRACT OF JUDGMENT Upon reading the declaration of and good cause appearing therefor, it is ordered that a Writ of Execution/Abstract of Judgment issue in the sum of $ principal; $ , cost; $ , attorney fees; and $ , , interest; in favor of to Dated County . Judge 2002 © American LegalNet, Inc.