Attorney or Party without Attorney (Name/Address) Court Use Only Telephone No.: E-mail: Fax No.: State Bar No.: SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN MATEO Small Claims Division 400 County Center, Redwood City, CA 94063 (650) 261-5015 Plaintiff/Petitioner: Defendant/Respondent: DECLARATION OF LOST COPY OF COURT RECORD Case Number: I is true and correct: , declare under penalty of perjury, that the following On Plaintiff/Defendant received a which was a copy of the original on file heein; that subsequent to and rior to service, said copy was lost. It is therefore requested that the court issue another copy of said document. Declarant agrees to hold the court and clerks harmless from any liability. Executed and sworn on this Day of ,2 . Declarant (Print Name) Form adopted for Mandatory Use SC-31 [Rev.5/10] DECLARATION OF LOST COPY OF COURT RECORD www.sanmateocourt.org American LegalNet, Inc. www.FormsWorkFlow.com