San Diego — Request for Payment of Trust Funds/Refund CIV-180 (Rev: 01/24)

Source: https://www.sdcourt.ca.gov/sites/default/files/sdcourt/generalinformation/forms/civilforms/civ180.pdf

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ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY

TELEPHONE NO.: FAX NO. (Optional):

EMAIL ADDRESS (Optional):

ATTORNEY FOR (Name):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, CENTRAL COURTHOUSE, 1100 UNION ST., SAN DIEGO, CA 92101 CENTRAL DIVISION, HALL OF JUSTICE, 330 W. BROADWAY, SAN DIEGO, CA 92101 CENTRAL DIVISION, KEARNY MESA, 8950 CLAIREMONT MESA BLVD., SAN DIEGO, CA 92123 CENTRAL DIVISION, JUVENILE COURT, 2851 MEADOW LARK DR., SAN DIEGO, CA 92123 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910 PLAINTIFF(S)/PETITIONER(S)

DEFENDANT(S)/RESPONDENT(S)

CASE NUMBER

REQUEST FOR PAYMENT OF TRUST FUNDS / REFUND

DECLARATION

I, , Court Reporter Party Attorney Other: for: declare that the sum of $ is presently due and owing to the payee noted below by reason of: I declare under penalty of perjury, under the laws of the State of California, that the forgoing is true and correct.

Date: Signature of Requester

Payee Name: (Last) (First) (MI) (Tel. No.) Address: (Street) (City) (State) (Zip Code) If court order provided for interest, provide payee’s tax I.D.# and mailing address for tax reporting:

(Tax ID #) (Street) (City) (State) (Zip Code)

FOR COURT USE ONLY

I certify that the sum of $ is presently due and payable to the payee noted above by reason of: attached order other: FMS CCMS V3 ODY Receipt Number , dated .

Clerk of the Superior Court

Date: by , Deputy

Approved Denied:

Date: Signature of Supervisor or Manager SDSC CIV-180 (Rev. 1/24) REQUEST FOR PAYMENT OF TRUST FUNDS / REFUND Cal. Rules of Ct., rule 8.130, Gov. Code § 69953, & Code Civ. Proc. § 631.3 Clear This Form