PARTY INFORMATION (Name and address): TELEPHONE NO: FAX NO. (Optional) EMAIL ADDRESS (Optional): SUPERIOR COURT OF CALIFORNIA COUNTY OF SANTA CRUZ Watsonville Branch 1 Second Street, Room 300 Watsonville, CA 95076 PLAINTIFF/PETITIONER : vs. DEFENDANT/RESPONDENT : CASE NUMBER: FOR COURT USE ONLY DECLARATION OF JUDGMENT DEBTOR AND REQUEST TO ENTER SATISFACTION OF JUDGMENT I, the undersigned Judgment Debtor in the above entitled action declare: 1. Judgment was entered against me on ( date) in the amount of $ Form Adopted for OPT IONAL USE Superior Court of Santa Cruz County SUP SC 013 11 / 02 / 18 DECLARATION OF JUDGMENT DEBTOR AND REQUEST TO ENTER SATISFACTION OF JUDGMENT Page 1 of 2 1. I have satisfied the judgment as follows (s tate when and how paid - - check, money order , cash, etc. ) : 2. Proof of Payment is attached . Number of pages attached . 3. On (date) , I requested that the Judgment Creditor file an A cknowle dgement of Satisfaction of Judg ment (if not, explain attempts to contact Creditor) : 4. As of the date of this Declaration, the Judgment Creditor refuses or has failed to file a Satisfaction of Judgment. 5. Therefore, I request that the Clerk of the Court enter Satisfaction of Judgment pursuant to Code of Civil Procedure 247 116.850(c) . On the date indicated below, I am mailing a copy of this Declaration to the Judgment Creditor at the following current or last known address (Creditor N ame and Address): American LegalNet, Inc. www.FormsWorkFlow.com PLAINTIFF/PETITIONER: DEFENDANT/RESPONDENT : CASE NUMBER : Form Adopted for OPT IONAL USE Superior Court of Santa Cruz County SUP SC 013 11 / 02 / 18 DECLARATION OF JUDGMENT DEBTOR AND REQUEST TO ENTER SATISFACTION OF JUDGMENT Page 2 of 2 I declare under penalty of perjury under the laws of the state of California that the foregoing is true and correct. Date: Print your name Sign here For Court Use Only CERTIFICATION I certify that this document is a true and correct copy of the original on file with this court. (Seal) Clerk, By,Deputy SATISFACTION OF JUDGMENT (1) Full Satisfaction of Judgment entered as to judgment debtor (name): on (date): (2) Full Satisfaction of Judgment NOT entered as requested (state reason): Clerk, by, Deputy American LegalNet, Inc. www.FormsWorkFlow.com