ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address): TELEPHONE NO.: FOR COURT USE ONLY ATTORNEY FOR (Name): 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: DEFENDANT: DECLARATION AND ORDER RE: SATISFACTION OF JUDGMENT CASE NUMBER: I, , am the judgment Debtor in the above-named action and do hereby request that the Court order that Satisfaction of Judgment be entered pursuant to Sections 116.850(c) and 724.050(d) of the Civil Code of Procedure. I declare: 1. That the Judgment Creditor in this action has been paid, in full, the amount of said judgment and costs. 2. That Judgment Creditor has been requested to file a Satisfaction of Judgment and refused to do so or the present address of judgment creditor is unknown. 3. The documents attached to this statement constitute evidence of receipt of payment by creditor. I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE FOREGOING IS TRUE AND CORRECT. Date Date ACIS Code 36037(01) Declarant Judge/Commissioner/Judge Pro Tem DECLARATION AND ORDER RE: SATISFACTION OF JUDGMENT 13-19674-360 Rev. 6-95 SB-19674 2002 © American LegalNet, Inc.