Name and Address of Attorney (or Defendant Without Attorney): Telephone No.: For Court Use Only Attorney For: Name of Court, Branch, Judicial District, Mailing and Street Address: Plaintiff: Defendant: MEMORANDUM OF COSTS AND DISBURSEMENTS The following costs are claimed by: 1. Court fees 2. Sheriff's or Marshal's fees 3. Surety bond premium(s) 4. SERVING PROCESS Process Served Persons Served Place Served Fees CASE NUMBER: $ $ $ $ Miles (One Way) 5. 6. 7. 8. ; ; ; ; Nature of Document ; ; ; ; NOTARY FEES ;$ ;$ ;$ ;$ ; ; ; ; @ @ @ @ $ $ $ $ Number of Affidavits 9. 10. 11. 12. Witnesses ; ; ; ; WITNESS FEES AND MILEAGE Dates in Court Fees Miles Traveled (One Way Only) $ $ @$ @$ @ @ Place From Which Claimed $ $ $ $ 13. ; 14. ; 15. ; 16. ; 17. Reporter's Fees: Dates 18. Jury Fees: Dates Jury mileage 19. 20. 21. ;$ ;$ ;$ ;$ ; ; ; ; ; ; at 20 ¢ at 20 ¢ at 20 ¢ at 20 ¢ days at $ days at $ $ $ $ $ $ $ $ MISCELLANEOUS ITEMS $ $ $ TOTAL $ COSTS TAXED AT $ I am of the party or parties claiming costs herein; to the best of my knowledge and belief the foregoing items of costs are correct and have been necessarily incurred in the above-entitled action. Executed on at , California Date Place I declare under penalty of perjury that the foregoing is true and correct. Signature of Declarant NOTE: A notice of motion to tax costs shall specifiy the items of the cost bill to which objection is made. (Rule 503(d), Rules for the Supreme Courts). 14-8912-349 Rev. 12/88 (CIV) SB-8912 2002 © American LegalNet, Inc. ACKNOWLEDGEMENT OF SERVICE Received copy of the foregoing Memorandum of Costs on on , , , Attorney for , Attorney for DECLARATION OF SERVICE BY MAIL My address is I am, and was at the time the herein mentioned mailing took place, a citizen of the United States, in the County where said mailing occurred, over the age of eighteen years and not a party to the above entitled cause. On , I served the foregoing Memorandum of Costs by depositing a copy thereof, enclosed in separate, sealed envelope, with the postage thereon fully prepaid, in the United States mail at , County of , California, each of which envelopes was addressed respectively as follows: Executed on , at , California. I declare under penalty of perjury that the foregoing is true and correct. (SIGNATURE OF DECLARANT) 2002 © American LegalNet, Inc.