APPLICATION FOR JUDGMENT FOR RESTITUTION OF PREMISES ONLY, PURSUANT TO C.C.P. 1169
13-16418-360 SB-349 (Civil) Rev 08-2013
Attorney or Party without Attorney
(
Name, Address and Telephone number
)
For Court Use Only
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN
BERN
A
RDIN
O
Barstow District, 235 East Mountain View, Barstow, CA 92311
Fontana District, 17780 Arrow Blvd, Fontana, 92335
Joshua Tree District, 6527 White Feather Road, Joshua Tree, CA 92252
Rancho Cucamonga District, 8303 Haven Avenue, Rancho Cucamonga, CA 91730
Victorville District, 14455 Civic Drive, Victorville, CA 92392
Title of Case (abbre
v
iated)
APPLICATION FOR JUDGMENT FOR RESTITUTION OF PREMISES ONLY
PURSUANT TO C.C.P. 1169
CASE NUMBER:
I am the plaintiff/attorney in the above-entitled action. Defendant(s)
was/were served with a summons and complaint on and has/have
not
appeared and/or answered the complaint. Proof of service of the three-day/thirty day notice to pay
or quit and Proof of Service of Summons and Complaint have been filed with the clerk. Pursuant to
C.C.P. 1169, Request to Enter Default having been filed, I, the undersigned, request that the default and
default judgment be entered
for restitution of the premises located at _____________________
,
California, and that a Writ of Execution issue for possession of premises only.
The defendant(s)
is/are in possession of the premises.
I certify, under penalty of perjury, that the foregoing is true and correct.
Executed on at , California.
Signature
Print Name