Kern — KC CLERK CI-115

Source: https://www.kern.courts.ca.gov/system/files/affidavit_for_issuance_of_writ_of_execution_and_order.pdf

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, state bar number, and address) : SPACE BELOW FOR USE OF COURT CLERK ONLY

TELEPHONE NO.: FAX NO. (Optional):

E-MAIL ADDRESS (Optional):

Attorney(s) for

SUPERIOR COURT OF CALIFORNIA, COUNTY OF KERN
1415 TRUXTUN AVENUE, BAKERSFIELD, CALIFORNIA 93301
ENTERED

Plaintiff(s) vs. No.

AFFIDAVIT FOR ISSUANCE OF
WRIT OF EXECUTION
Defendant(s) AND ORDER

(Abbreviated Title)

STATE OF CALIFORNIA, ss. County of Kern }

being first duly sworn

deposes and says:

That affiant is

in the above entitled action; that the following = judgment = order was made, and entered :

KC Clerk CI 115 (2M Rev. 9-73) AFFIDAVIT FOR ISSUANCE OF WRIT (Optional Form)

(Where payments are ordered to be paid 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 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 on principal on interest on principal on interest

I, the undersigned, state:

That there is actually due on said order the sum of $ principal, $

costs, $ attorney fees and $ interest, for which sum it is prayed that a writ of

execution issue in favor of

to (County) Dated: Dated:

(SIGNATURE) I certify (or declare) under penalty of perjury that the foregoing

Subscribed and sworn to before me is true and correct. day of .

(SIGNATURE)

Notary Public in and for the County of Kern, State of California

(Seal)

ORDER FOR ISSUANCE OF WRIT OF EXECUTION

Upon reading the affidavit of

and good cause appearing therefor, it is ordered that a writ of execution issue in the sum of $ , principal;

$ , costs; $ , attorney fees; and $ , interest, in favor of

to (County)

Dated: Judge

KC Clerk CI 115 (2M Rev. 9-73) (back) AFFIDAVIT FOR ISSUANCE OF WRIT (Optional Form)