Request DismissalCal. Super. - 6th Dist.March 30, 2021Electronically Filed by Superior Court of CA, County of Santa Clara, on 8/30/2021 6:06 PM Reviewed By: A. Nakamoto Case #21CV381487 Envelope: 7170789 21CV381487 Santa Clara - Civil A. Nakamoto 8/30/2021 6:06 PM 8/30/2021 6:06 PM X 8/30/2021 6:06 PM A. Nakamoto X ‘1 ““34 A‘ FWW‘CC’ ((cu‘M #7 70 0 0V '7JICU’74 cw-11o Plaintiff/Petitioner; Jerome Andrew Ward gqsécggefi‘m Defendanthespondent: Maria Zavala, Ericka Acosta. and Does 1-60, Inclusive. COURT‘S RECOVERY OF WAIVED COURT FEES AND COSTS If a party whose court fees and costs were initially waived has recovered or will recover $10,000 or more in value by way of settlement, compromise, arbitration award, mediation settlement. or other means. the court has a statutoxy lien on that recovery. The court may refuse to dismiss the case until the lien is satisfied. (Gov. Code, § 68637.) Declaration Concerning 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): a. E not recovering anything of value by thus action. b. E recovering less than $10,000 in value by mis action. c. E recovering $10.000 or more in value by this adion. (If item 20 is checked, item 3 must be completed.) 3. E AII c0urt fees and court costs that were waived in this action have been paid to the court (check one): Yes No l declare under penalty of perjury under the laws of the State of California that the information above is true and corred. D (mas on PRINT NAME 0F E AnoaNEY E pARTV MAKING DECLARATION) (SIGNATURE) Date: CIV-Ho (Rev. January 1. 20131 REQUEST FOR DISMISSAL "'9' 2 “2
