NAME, ADDRESS, AND TELEPHONE NUMBER OF PARTY: RESERVED FOR CLERK'S FILE STAMP SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN JOAQUIN BRANCH NAME: MAILING ADDRESS: STREET ADDRESS: CITY AND ZIP CODE: PLAINTIFF: DEFENDANT: Declaration of Exemption CASE NUMBER: This matter shall be deemed exempt from Local Rule 3-102(A)(5), Administration of General Civil Litigation, for the following reason: Plaintiff certifies that this is an uninsured motorist claim. Plaintiff certifies that this is an eminent domain case. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Dated: Signed: Signature of attorney or party without an attorney Civil Declaration of Exemption Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com