SUPERIOR COURT OF CALIFORNIA
Reserved for Clerk's Stamp
COUNTY OF LOS ANGELES
COURT ADDRESS:
PLAINTIFF:
DEFENDANT:
CASE NUMBER:
CIVIL DEPOSIT
CLERK: PREPARE A FORM FOR EACH DEPOSITOR PAYING SEPARATELY
PLEASE REPORT TO THE CLERK'S OFFICE/CASHIER:
Room 102, Central Civil
Clerk's Office , Room____________
Department Number____________
Distribution Codes
Amt Due
Distribution Codes
Amt Due
251
DAILY JURY FEES
74
DEPOSIT IN TRUST
Dates:____________________
# of day(s)_________x$________
72
JURY FEES
101
FIRST PAPERS-
Trial Date:____________________
GENERAL JURISDICTION
(Initial Deposit) $____________
REPORTERS FEES
101
FIRST PAPERS-LIMITED OVER $10,000
252
Dates:____________________
With declaration Limited to $10,000
141
(per B&P 6322.1(a))
# of 1/ 2 day(s)__________x$_________
130
Limited to $10,000
Full Day_________
721
SANCTIONS ORDERED ON
211
RECLASSIFICATION FEE
Date:_____________
213
MOTIONS/APPLICATION TO CONT. HEARING
150
COMPLEX LITIGATION TRIAL/PLAINTIFF
200
MOTIONS/APPLICATION TO CONT.TRIAL
151
COMPLEX LITIGATION TRIAL/DEFENDANT
Other:
Cash
Check
Certified Check/Money Order
Credit Card
To be paid via:
On or Before________________
Forthwith
Plaintiff___________________
Defendant____________________
Payment will be made by
JOHN A. CLARKE, Executive Officer/Clerk
DATE
BY:
Deputy Clerk
TO BE COMPLETED BY DEPOSITOR
CASHIER'S VALIDATION
Depositor's Name:
Plaintiff in Pro Per
Defendant in Pro Per
Counsel for
Plaintiff
Name of Party
Defendant
Name of Party
Address of depositor
Street
City/State/Zip
CIVIL DEPOSIT
CIV 083 03-04 (Rev. 05/06)
LASC Approved
Distribution: Original - Case File Copy-Customer