SAN BERNARDINO COUNTY SHERIFF'S DEPARTMENT COURT SERVICES DIVISION LEVY INSTRUCTIONS BANK / THIRD PARTY LEVY John McMahon, Sheriff Plaintiff/Petitioner: Defendant/Debtor: Case No. By the authority granted under the accompanying writ, you are hereby instructed to perform the following: Serve and Levy on: Name of the judgment debtor(s) whose property is subject to this levy: Debtor's last known Address: Name of the Financial Institution / Third Party Name Address of the Financial Institution / Third Party Address Account No(s). if known / Property Description Type of Bank Accounts Personal/Business Checking Savings Money Market Other If the bank account or safe deposit account stands in the name of a person other than the defendant, either alone or together with other third persons, provide the name and address of the third person(s): Does the Sheriff currently hold an existing writ? Yes If yes, please indicate below the type of levy performed on the existing writ: No ATTORNEY OR PLAINTIFF'S INFORMATION: (NO REFUNDS AFTER PROCESSING) PRINT NAME SIGNATURE DATE MAILING ADDRESS CITY/STATE/ZIP DAYTIME PHONE NUMBER/CELL PHONE NUMBER FOR OFFICE USE ONLY Received By: Rev. 11/5/2014 Date: CIV-004 American LegalNet, Inc. www.FormsWorkFlow.com