Reserved for Clerk’s File Stamp
NAME, ADDRESS, AND TELEPHONE NUMBER OF ATTORNEY OR PARTY WITHOUT ATTORNEY:
STATE BAR NUMBER
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF LOS ANGELES
COURT ADDRESS:
PLAINTIFF:
DEFENDANT:
CASE NUMBER:
DECLARATION AND ORDER RE: ADVANCE JURY FEES
Declarant states:
,
1.
I, _______________________________________________
deposited advance jury fees in the amount of
(name)
$
, receipt number _______________ on behalf of
plaintiff
defendant on [date(s)]
________________________, ________________________, in the above-entitled case.
2.
The aforementioned deposited jury fees have not been applied as payment for services of jurors and have not
been previously ordered refunded or forfeited in this case.
3.
This case was never set for trial.
This case was set for trial on the following date(s) (include all continued settings - attach sheet if
necessary):
On all the trial dates listed above wherein jury trial was continued, vacated, or otherwise not held due to
request, agreement or jury waiver of this party, the court was notified in accordance with Section 631.3 of the
Code of Civil Procedure that a jury would not be needed for the trial.
On all the trial dates listed above in which jury trial was continued, vacated, or otherwise not held, it was not
by request, agreement or jury waiver of this party.
LACIV 099 (Rev.12/14)
Code Civ. Proc., § 631.3
DECLARATION AND ORDER
LASC Approved 04-05
Local Rule 2.19(e)
RE: ADVANCE JURY FEES
For Optional Use
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