__________________________________________________________________________________________________________________
Form L-0292
Optional Form
Revised February 4, 2014
DECLARATION IN SUPPORT OF MOTION
RE DISQUALIFICATION OF JUDICIAL OFFICER PURSUANT TO C.C.P. 170.6
I am a party the attorney for a party in the above entitled case and declare that
___________________________________________________, the judicial officer before whom the trial or hearing
in this action or special proceeding is pending, or to whom this case is assigned, is prejudiced against the party or
the party’s attorney, or the interest of the party or party’s attorney, such that the declarant cannot, or believes that
he/she cannot, have a fair and impartial trial or hearing before the judicial officer.
This judicial officer
has has not presided over a hearing, motion, or other proceeding in the past in this case.
Pursuant to the provisions of Code of Civil Procedure section 170.6, I request that this case be assigned to another
judicial officer for further proceedings.
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 of declarant)
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and
address):
TELEPHONE NO.: FAX NO. (Optional):
E-MAIL ADDRESS (Optional):
ATTORNEY FOR (Name): Bar No:
FOR COURT USE ONLY
SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE
JUSTICE CENTER:
Central - 700 Civic Center Dr. West, Santa Ana, CA 92701-4045
Harbor – Newport Beach Facility, 4601 Jamboree Rd., Newport Beach, CA 92660
Lamoreaux - 341 The City Drive South, Orange, CA 92868-3205
North – 1275 N. Berkeley Ave., P.O. Box 5000, Fullerton, CA 92838
West – 8141 13
th
Street, Westminster, CA 92683
PLAINTIFF/PETITIONER:
CASE NUMBER:
DEFENDANT/RESPONDENT:
JUDICIAL OFFICER:
DECLARATION IN SUPPORT OF MOTION
RE DISQUALIFICATION OF JUDICIAL OFFICER
PURSUANT TO C.C.P. 170.6
DEPARTMENT:
