Free Microsoft Word - LACIV 033 01-05 _08,08_ - California

SUPERIOR COURT OF CALIFORNIA COUNTY OF LOS ANGELES
COURTHOUSE ADDRESS:

Reserved for Clerk's File Stamp

PLAINTIFF/PETITIONER:

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DEFENDANT/RESPONDENT:

CASE NUMBER:

REQUEST FOR COPIES
I request copies of the following document(s):
DATE COPIES Register Page Dissolution Support Order Complaint/Answer Judgments Dismissal Will Letters Decree Records Search Minute Order Order Order Order Entire File TOTAL # PGS. CERT DUP. TOTAL

PAYMENT: Check Money Order Cash ; Exempt

#_______________

#______________

Fee Waiver:

Plaintiff

Defendant

Date Fee Waiver Granted: ______________ SPECIAL INSTRUCTIONS: ___________________________________ ___________________________________ ___________________________________

DATE: _________________________ SIGNATURE: _____________________________________ NAME: _____________________________________ ADDRESS: _____________________________________ _____________________________________ PHONE:

_________________________________

Fee Waiver (check one):

Gov. Code, § 6103.4

Gov. Code, § 68511.3 / Cal. Rules of Court, rules 3.50-3.63

Date Received: ____________________

Received by: ____________________________________ (signature)

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LACIV 033 (Rev. 08/08) LASC Approved 01-05

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REQUEST FOR COPIES
CUSTOMER COPY / WORK COPY / CONTROL COPY