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L-0015 DECLARATION AND/OR ORDER FOR WRIT OF EXECUTION Page 2 of 2
Revised: 9/4/14 FAMILY LAW
Where payments are ordered to be paid at different times, fill in date below; in other cases, strike out inapplicable
portions.
Failure to claim interest shall be deemed a waiver thereof.
The installments ordered and interest thereon, and the installments paid and interest thereon, are as follows:
INSTALLMENTS ORDERED PAID
INSTALLMENTS ACTUALLY PAID
BALANCE DUE
DATE DUE AMOUNT INTEREST
DATE PAID PRINCIPAL INTEREST PRINCIPAL INTEREST
I, the undersigned do hereby declare:
That there is actually due on said
judgment order the sum of $_______________ principal,
$_________________ costs, $_______________ attorney fees and $_________________ interest, for which sum
declarant requests that a writ of execution issue in favor of _____________________________________________
to the Sheriff or any Marshal or Constable of the County of ____________________________________________.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:_________________ _______________________________________
(Signature of Declarant)
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FOR COURT USE:
Issued by Clerk Order of the Court
Writ of Execution shall issue.
Date: ___________________ ____________________________________________________
Signature
Judicial Officer Clerk, Deputy