ATTORNEY OR PARTY WITHOUT ATTORNEY (Name & 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
Civil Complex Center - 751 W. Santa Ana Blvd., Santa Ana, CA 92701-4512
Harbor-Newport Beach Facility - 4601 Jamboree Rd., Newport Beach, CA 92660-2595
Lamoreaux - 341 The City Drive, Orange, CA 92868-3205
North - 1275 N. Berkeley Ave., P. O. Box 5000, Fullerton, CA 92838-0500
West - 8141 13
th
Street, Westminster, CA 92683-4593
PLAINTIFF:
DEFENDANT:
CASE NUMBER:
DECLARATION RE: DEFAULT IN PAYMENTS/PARTIAL
SATISFACTION
Unlimited civil actions only. Case assigned to:
Judge:
Department:
Date complaint filed:
Hearing/trial date:
The undersigned
Judgment creditor Attorney for judgment creditor in the above-entitled action declares:
Judgment was entered against the following named defendant(s):
on for $ . The Court ordered the judgment paid in installments of $ per
commencing . To date, $ has been received in partial satisfaction
of the judgment and the installment due on has not been paid.
Therefore, judgment creditor requests that a writ of execution issue.
Complete if Partial Satisfaction:
Full name and address of judgment creditor or assignee of record:
Full name and address of judgment debtor being partially released:
Judgment entered or renewal entered on (date):
An Abstract of Judgment has been recorded as follows (complete all information for each county where recorded):
COUNTY DATE OF RECORDING BOOK NUMBER PAGE NUMBER
A Notice of Judgment Lien has been filed in the office of the Secretary of State as file number (specify):
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 JUDGMENT CREDITOR OR ATTORNEY)
Approved for Optional Use
L1061 (Rev. July 1, 2013)
DECLARATION RE: DEFAULT IN
PAYMENTS/PARTIAL SATISFACTION
Code of Civil Procedure, § 724.120
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