Los Angeles local civil form — To prevent other people from seeing what you entered on your form, (LASC LACIV 100)

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NAME, ADDRESS, AND TELEPHONE NUMBER OF ATTORNEY OR PARTY WITHOUT ATTORNEY: STATE BAR NUMBER Reserved for Clerk’s File Stamp

To prevent other people from seeing what you

ATTORNEY FOR (Name): entered on your form, SUPERIOR COURT OF CALIFORNIA, COUNTY OF LOS ANGELES please press the Clear COURTHOUSE ADDRESS: This Form button at the end of this form when PLAINTIFF/PETITIONER: finished.

DEFENDANT/RESPONDENT:

CASE NUMBER:

REQUEST FOR ENTRY OF JUDGMENT, JUDGMENT, AND NOTICE OF ENTRY OF JUDGMENT – BUSINESS AND PROFESSIONS CODE SECTION 12015.3 AND ISSUANCE OF A WRIT OF EXECUTION AND/OR OTHER ENFORCEMENT

REQUEST FOR ENTRY OF JUDGMENT

1. The Department of Agricultural Commissioner/Weights and Measures has complied with the provisions of Business and Professions Code section 12001 et seq.

2. The 30-day period to appeal the Notice of Decision and Order of the Hearing Officer has expired. The Notice of Decision and Order of the Hearing Officer is now final. (Bus. & Prof. Code, § 12015.3(c).)

3. Unpaid penalties and fees have accrued in the sum of $ plus civil filing fee and administrative charge of $ _______________________ plus interest at the legal rate.

4. The clerk is requested to enter judgment in favor of the Department of Agricultural Commissioner/Weights and Measures against the above named defendant.

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Dated: Agricultural Commission/Director of Weights and Measures

SIGN

By: Inspector

SCLAC LACIV 100 Rev. 04/26 REQUEST FOR ENTRY OF JUDGMENT, JUDGMENT, Bus. & Prof. Code, § 12015.3; For Optional Use AND NOTICE OF ENTRY OF JUDGMENT - Gov. Code, § 6103.5(d) BUSINESS AND PROFESSIONS CODE SECTION 12015.3 Page 1 of 2

PLAINTIFF/PETITIONER (Name): CASE NUMBER

DEFENDANT/RESPONDENT (Name):

JUDGMENT AND NOTICE OF ENTRY OF JUDGMENT

Judgment entered in favor of the Department of Agricultural Commissioner/Weights and Measures against the defendant, as follows:

a. Principal..............................................................................................$

b. Costs (including civil filing fee and administrative charge).................$

c. Total amount of judgment…………………………………...……………$

d. Plus interest after judgment at the legal rate.

Judgment entered on . All fees waived by the court must be reimbursed upon partial or full recovery of judgment.

Dated: DAVID W. SLAYTON, Executive Officer/Clerk of Court

By: Deputy Clerk

CERTIFICATE OF MAILING

I, the below-named Executive Officer/Clerk of Court of the above-entitled court, do hereby certify that I am not a party to the cause herein, and that on this date I served the (begin underline) Request for Entry of Judgment, Judgment, and Notice

(begin underline) Request for Entry of Judgment, Judgment,upon each party or counsel named below by depositing

in the United States mail at the courthouse in , California, one copy of the original filed/

entered herein in a separate sealed envelope to each address as shown below with postage thereon fully prepaid.

DAVID W. SLAYTON, Executive Officer/Clerk of Court

SIGN

By: Deputy Clerk

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SCLAC LACIV 100 Rev. 04/26 REQUEST FOR ENTRY OF JUDGMENT, JUDGMENT, Bus. & Prof. Code, § 12015.3; For Optional Use AND NOTICE OF ENTRY OF JUDGMENT - Gov. Code, § 6103.5(d) BUSINESS AND PROFESSIONS CODE SECTION 12015.3 Page 2 of 2 Clear This Form Print This Form