San Bernardino — 13-18605-360

Source: https://sanbernardino.courts.ca.gov/system/files/13-18605-360vexatiouslitigantworksheet.pdf

CCP §§ 391 - 391.8 VEXATIOUS LITIGANT WORKSHEET DATE RECEIVED: NAME: CASE NUMBER:

TO BE FILLED OUT BY THE FILING PARTY:

1. Have you filed any complaint/petition/application or motion (except a discovery motion) in any other county within the past five years? YES NO

2. If you answered yes to Question 1, complete the following (provide all available

   information): FILING

No. DATE CASE NAME CASE NUMBER COUNTY

I have filed more than three. (You must add the additional cases on an attachment)

3. Within the past twelve months, has a court denied your Request to Vacate a Pre-filing

   Order? YES NO

4. If you answered yes to Question 3, please identify the

   court(s):____________________________________________

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FOR CLERK USE ONLY

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Action and Minute Inquiry (;210) and Register of Actions (;240) Attached: YES NO

OTHER CASES:

CHECKED VEXATIOUS LITIGANT LIST: YES NO

APPLICATION IS LISTED BY SAN BERNARDINO COUNTY: YES NO

IF LISTED BY ANOTHER COUNTY, WHAT COUNTY? _____________________________

NOTES:

DATE: CLERK

NAME OF JUDGE WHO ISSUED PRE-FILING ORDER: _____________________________

Form No. 13-18605-360 Rev.12-2017 Optional