Free Affidavit Of Predjudice Peremptory Challenge To Judicial Officer (C.C.P., § 170.6) - California

NAME, ADDRESS, AND TELEPHONE NUMBER OF ATTORNEY OR PARTY WITHOUT ATTORNEY:

STATE BAR NUMBER

Reserved for Clerk's File Stamp

ATTORNEY FOR (Name):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF LOS ANGELES
COURTHOUSE ADDRESS: PLAINTIFF: DEFENDANT:

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AFFIDAVIT OF PREJUDICE PEREMPTORY CHALLENGE TO JUDICIAL OFFICER

CASE NUMBER:

(Code Civ. Proc., § 170.6)

Name of Judicial Officer

Dept./Div. Number

Judge

Commissioner

Referee

I am a party (or attorney for a party) to this action or special proceeding. The judicial officer named above, before whom the trial of, or a hearing in, this case is pending, or to whom it has been assigned, is prejudiced against the party (or his or her attorney) or the interest of the party (or his or her attorney), so that declarant cannot, or believes that he or she cannot, have a fair and impartial trial or hearing before the judicial officer.

I declare under penalty of perjury, under the laws of the State of California that the foregoing is true and correct. Date: Signature of Declarant

________________________
(Name of Party)

Plaintiff Defendant

Cross Complainant Cross Defendant

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LACIV 015 (Rev. 01/07) LASC Approved 04-04

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Code Civ. Proc., § 170.6

AFFIDAVIT OF PREJUDICE PEREMPTORY CHALLENGE TO JUDICIAL OFFICER