Alameda — Jury Deposit Refund Form

Source: https://www.alameda.courts.ca.gov/system/files/jurydepositrefundform.pdf

Jury Fee Deposit Form ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address) FOR COURT USE ONLY

TELEPHONE NO.: FAX NO. (Optional):

E-MAIL ADDRESS (Optional):

ATTORNEY FOR (Name):

SUPERIOR COURT OF CALIFORNIA, ALAMEDA COUNTY

STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME

PLAINTIFF:

DEFENDANT:

OTHER:

CASE NUMBER:

DECLARATION AND ORDER FOR PAYMENT OF MONEY (Jury Fee Deposit)

1. I (name): declare that jury fees have been posted in strict compliance with Code of Civil Procedure § 631 in the above-captioned action. There has been no previous order to refund or forfeit the deposit and it is eligible for refund as provided under Code of Civil Procedure § 631.3.

Receipt No.: ______________________________ Dated: ______________________.

2. IT IS REQUESTED that the sum of $ ________________________ as deposited above be paid to:

Claimant: ____________________________________________________________________________________

Address: _____________________________________________________________________________________

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3. I declare under penalty of perjury under the law of the State of California that the forgoing is true and correct.

Executed at: _______________________________________, California, on ____________________________.

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CLAIMANT / DECLARANT

FOR COURT USE ONLY

Jury Fee Deposit – Eligible for Refund.

Request is over 20 days from date case settled/dismissed/continued – Not Eligible for Refund.

Jury Fee Deposit previously refunded on _______________________ – Not Eligible for Refund.

Other: ___________________________________________________________________________

Verified by: _______________________________________________________ Date: _________________________

Superior Court of California, DECLARATION AND ORDER FOR PAYMENT OF MONEY
County of Alameda (Jury Fee Deposit)

Jury Fee Deposit Form

PLANTIFF: CASE NUMBER:

DEFENDANT:

ORDER FOR PAYMENT OF MONEY

The request for refund of the jury fee deposit is GRANTED. DENIED.

Date: _________________________________________________________

JUDGE OF THE SUPERIOR COURT

Superior Court of California, DECLARATION AND ORDER FOR PAYMENT OF MONEY
County of Alameda (Jury Fee Deposit)