FOR COURT USE ONLY ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): TELEPHONE NO.: FAX NO.(Optional): E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, COUNTY COURTHOUSE, 220 W. BROADWAY, SAN DIEGO, CA 92101 CENTRAL DIVISION, HALL OF JUSTICE, 330 W. BROADWAY, SAN DIEGO, CA 92101 CENTRAL DIVISION, FAMILY COURT, 1501 6TH AVE., SAN DIEGO, CA 92101 CENTRAL DIVISION, MADGE BRADLEY, 1409 4TH AVE., SAN DIEGO, CA 92101 CENTRAL DIVISION, KEARNY MESA, 8950 CLAIREMONT MESA BLVD., SAN DIEGO, CA 92123 CENTRAL DIVISION, JUVENILE COURT, 2851 MEADOW LARK DR., SAN DIEGO, CA 92123 NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 RAMONA BRANCH, 1428 MONTECITO RD., RAMONA, CA 92065 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910 PLAINTIFF(S) DEFENDANT(S) JUDGE IN THE MATTER OF DEPT A MINOR CASE NUMBER PEREMPTORY CHALLENGE ____________________________________________________________, is a party an attorney for a party in the above-entitled case and declares that _____________________________________________, the judge to whom this case is assigned, is prejudiced against the party or the party's attorney or the interests of the party or the party's attorney such that the said party or parties believe(s) that a fair and impartial trial or hearing cannot be had before such judge. WHEREFORE, pursuant to the provisions of Code Civ. Proc. §170.6, I respectfully request that this court issue its order reassigning said case to another, and different, judge for further proceedings.. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: Signature ORDER OF THE COURT GRANTED - This case is referred to Presiding/Supervising Department for reassignment and a notice will be mailed to counsel. DENIED Date: Judge/Commissioner/Referee of the Superior Court FOR OFFICE USE ONLY This case has been reassigned to Judge _____________________________ per Presiding/Supervising Judge ________________________ on __________________________. SDSC CIV-249 (Rev. 10/10) PEREMPTORY CHALLENGE Code Civ. Proc. § 170.6 American LegalNet, Inc. www.FormsWorkFlow.com