Request DismissalCal. Super. - 6th Dist.April 23, 2021Electronically Filed by Superior Court of CA, County of Santa Clara, on 1/21/2022 8:01 AM Reviewed By: A. Floresca Case #21CV381188 Envelope: 8106593 21CV381188 Santa Clara - Civil A. Floresca 1/21/2022 8:01 AM 1/21/2022 8:01 AM X 1/21/2022 8:01 AM A. Floresca X , . . ....... . ‘ CIVQ1 1 0‘ PLNNTlFF/PETmONER Discover Bank ' CASE NUMBER: . DEFENDANIIRESPONDENTmzequia Jacinto Ocampo N 210V38'1 188 COURTS RECOVERY 0F WANED COURT FEES AND COSTS if 'a party whose court fees and ooSts were initially waived has recovered or will recover $1.0 000 or more in value by way of settlement compromise. arbitration award, mediation settlement, or other means. the court has a statutory lien on that recovery. The court may refuse to dismiss the mse until the" lien. Is Satisfied. (Gov. Code, § 68637) Declaration, Cancernihg Waived Court Fees 1'. The Court waived court fees and costs in this action for (name): 2. The person named in item 1 is‘ (check one Below): 3- E] not recovering anything of value by this anion. b.E recovering less than $1 0,000 In value by this action. ,c ,E recoven'ng $10[000. or more in value b'y thi's action. (ffitem 2c is checked, item 3, must be completed) 3.,1D All court fees, and court costs that Iwere waived in' this-action have been paid't’o the-court (check one); D Yes. E: No l declare under penalty of penjury under the laws of the Sta'te of California ‘that the infomafion above is fme and correct. Date': i (WPE 0R PRINT NAME 0F 5E ATrORNEXE PARTY MAKING DECLARAmN) (S‘GNATURE) crv-‘n’q (Rev. January 1. 20131 REQUEST- FOR DISMISSAL " , ' H emu” I
