ATTORNEY OR PARTY WITHOUT ATTORNEY (NAME AND ADDRESS): TELEPHONE NO.: FOR COURT USE ONLY ATTORNEY FOR (NAME): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA BARBARA STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: PLAINTIFF: DEFENDANT: CASE NUMBER: SMALL CLAIMS DECLARATION RE: DEFAULT IN PAYMENTS The undersigned judgment creditor in the above-entitled action declares: That the judgment was entered against judgment debtor ___________________________________ ________________________________________________________________________________ on _________________________ for $___________________; that the Court ordered the judgment be paid by installments of $_______________________ per _______________________________, begining on (date): ________________________________________________________________ and on the (specify day) ___________________ day of each month thereafter until paid in full. If any payment is missed, the entire balance may become due immediately. That $_________________________________________________ has been paid on the judgment: That the installment due on __________________________________________ has not been paid. THEREFORE, judgment creditor requests that execution be issued. Executed on _______________________, at __________________________________, California. I declare under penalty of perjury that the foregoing is true and correct. _____________________________________ Judgment Creditor SC-7009 [Rev. July 1, 1999] SMALL CLAIMS DECLARATION RE: DEFAULT IN PAYMENTS CCP 116.620, 116.860 2001 © American LegalNet, Inc.