Fillable SB-12fillable Attorney or Party Without An Attorney (Name, State Bar No

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SB-12fillable Attorney or Party Without An Attorney (Name, State Bar No

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SB-12 Rev.05/2013
-BLACK INK ONLY –
I, , say:
That declarant is
in the above entitled action; that the following (judgment) (order) was made, and entered:
Attorney or Party Without An Attorney (Name, State Bar No. & Address)
Telephone No.
Attorney for:
For Court Use Only
Superior Court of California, County of San Bernardino
Petitioner:
Respondent:
DECLARATION AND ORDER FOR ISSUANCE OF WRIT OF
EXECUTION/ABSTRACT OF JUDGMENT
CASE NUMBER
SB-12 Rev.05/2013
(Where payments accrue at different times, fill in data below; in other cases, strike out
inapplicable portions.) Failure to claim interest shall be deemed a waiver thereof.
That the payments accrued and interest thereon, and the payments made and interest thereon,
are as follows:
ACCRUALS
PAYMENTS
BALANCE DUE
DATE DUE
AMOUNT
DATE PAID
AMOUNT
INTEREST
That there is actually due on said order the sum of $ principal, $ costs, $
Attorney fees and $ interest, for which sum affiant prays that a Writ of Execution /
Abstract of Judgment issue in favor of
to _____________________________________________.
County
I declare under penalty of perjury that the foregoing is true and correct.
Executed on at , California.
________________________________________________
Signature
ORDER FOR ISSUANCE OF WRIT OF EXECUTION/ABSTRACT OF JUDGMENT
Upon reading the declaration of and good cause
Appearing therefore, it is ordered that a Writ of Execution/Abstract of Judgment issue is the
sum of $ , principal; $ , costs; $ , attorney fees; and $ ,
interest; in favor of
to ______________________________________
County
Dated ___________________________________ ____________________________________
Judge/Commissioner
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SB-12fillable Attorney or Party Without An Attorney (Name, State Bar No

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Completed 3 July 2020

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