ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, Address, Telephone Number, and State Bar membership number): COURT USE ONLY ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SONOMA 600 Administration Drive Santa Rosa, Ca 95403 Telephone: (707) 565-1100 PLAINTIFF(S)/PETITIONER: DEFENDANT(S)/RESPONDENT: Case Number: DECLARATION RE: CIVIL WARRANT FAILURE TO APPEAR FOR ORDER OF EXAMINATION (CCP §708.170) I, , am the judgment creditor in the above-entitled action. (Name) On , an Order to Produce Statement of Assets and to Appear for Examination (Filing date) was duly signed by the Honorable directing the judgment debtor, (Judge’s name) to appear before this court on (Name) and then (Date of hearing) and there submit himself/herself to examination in proceedings supplemental to enforcement of judgment. A true copy of said order was served upon the judgment debtor on at , (Date of service) (City) California. The judgment debtor refused to obey the order and refused to appear before the court. FAILURE TO APPEAR PURSUANT TO COURT ORDER OR SUBPOENA (CCP §1993) I, , am the (Name) entitled action. On in the above(Plaintiff/Defendant) an order to appear in court subpoena to appear in court was (Date) served on directing him/her to appear on (Name) . (Date of hearing) Said person refused to obey the order and refused to appear before the court. Wherefore Declarant prays that the defendant may be arrested and punished for a contempt of this court. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Dated: Signature of Declarant CV–30 [Revised 6/20/06] DECLARATION RE CIVIL WARRANT CCP §708.170 CCP §1993 American LegalNet, Inc. www.FormsWorkflow.com