Free Uninsured Motorist Statement (CMP) (CV\E-132) - California

SUPERIOR COURT OF CALIFORNIA
County of Sacramento 720 Ninth Street, Room 102 Sacramento, CA 95814-1380 (916) 874-5522--Website www.saccourt.com
Attorney or Party Without Attorney (Name, State Bar # and Address):

For Court Use Only

Telephone No.: E-Mail Address: Attorney for (Name): Plaintiff: Defendant:

Fax No.:

Case Number:

Assigned Dept:

Uninsured Motorist Statement
Plaintiff certifies that this is an uninsured motorist claim as defined in Government Code section 68609.5 and Insurance Code section 11580.2. Plaintiff requests that this matter be stayed for 180 days as prescribed in California Rule of Court 3.712(b) and Local Rule11.04.5. If within 180 days no party files a request that the case remain open, the case shall be dismissed without prejudice. The dismissal may be set aside on noticed motion.

I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct:

Dated

Signature of attorney or party without attorney

Uninsured Motorist Statement CV\E-132 (Rev 08.05.08) Local Form Adopted for Mandatory Use

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