NAME AND ADDRESS: FOR COURT USE ONLY TELEPHONE NO: NAME OF COURT: STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: PLAINTIFF: Superior Court of California, County of Stanislaus 300 Starr Avenue 300 Starr Avenue Turlock, CA 95380 Turlock Division VS. DEFENDANT: DECLARATION OF JUDGMENT DEBTOR FOR REQUEST TO ENTER SATISFACTION OF JUDGMENT (CCP § 116.850 (C)) Small Claims CASE NUMBER 1. I am the judgment debtor in this case. 2. Judgment was entered against me on . 3. I have satisfied (paid) the judgment, as follows: Fully, including accrued interest and costs. Partially in the amount of $ . The judgment creditor refuses to accept any more payments. 4. I have requested that the judgment creditor file an acknowledgment of satisfaction of judgment. I made my request orally in writing on (date) . As of the date of this declaration, the judgment creditor has failed or refused to comply with my request. I have been unable to contact the judgment creditor because his/her present address is unknown. Other . 5. The following document(s), which constitutes evidence of full partial payment of the judgment, is attached: Cancelled Check Check Money Order written by me after judgment and payable to, and endorsed by the judgment creditor. Cash receipt for the amount paid, signed by the judgment creditor. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: (TYPE OR PRINT NAME) (SIGNATURE) CLERK'S NOTATION OF ENTRY OF SATISFACTION Satisfaction of judgment entered in register of actions pursuant to C.C.P. §116.850 (c), as follows: Full satisfaction. Partial satisfaction in the amount of $ . CLERK OF THE SUPERIOR COURT, STATE OF CALIFORNIA, COUNTY OF STANISLAUS DATE: By: Deputy Clerk ______ SC 002 OPTIONAL FORM DECLARATION OF JUDGMENT DEBTOR American LegalNet, Inc. www.FormsWorkFlow.com (REV JAN-16)