signed rfd200115

Cal. Super. - 1st Dist.January 16, 2020

ATTORNEY OR PARTY WITHOUT ATTORNEY (Nsma. Sl le Bar puml e, a d addmpsl. Richard L. Mahfouz II (Bar No. 246739); Andrew Dorr (Bar No. 317546) Clerkin, Sinclair & Mahfouz, LLP 530 B Street, 8'loor San Diego, CA 92101 rELEPHONE Hop (619) 308-6550 Fax uo lapicc i): (619) 923-3413 E-MAIL ADDRESS (Opaopag: ATTDRNEYFDR (Na I Plaintiff State Farm Mutual Automobile Insurance SUPERIOR COURT OF CALIFORNIA, COUNTY OF San Francisco sTREET ADDREss: 400 McAllister Street MAILING ADDREsa 400 McAllister Street clTY AND zip coDE: San Francisco, CA 941 02 BRANCH NAME'LAINTIFF/pETITIQNER: State Farm Mutual Automobile Insurance Company DEFENDANT/REsPoNDENT: Shawn Patterson REQUEST FOR DISMISSAL FOR COURT USE ONLY CASE NUMBER CGC-18-569330 CIV-110 A conformed copy will not be returned by the clerk unless a method of return is provided with the document. This form may not be used for dismissal of a derivative action or a class action or of any party or cause of action in a class action. (Cal. Rules of Court, rules 3.760 and 3.770.) 1. TO THE CLERK: Please dismiss this action as follows: a. (1) H With prejudice (2) Without prejudice b. (1) Complaint (2) Petition (3) Cross-complaint filed by (name): on (dale): (4) Cross-complaint filed by (name): on (date): (5) H Entire action of all parties and all causes of action (6) Other (specify):* 2. (Complete in a/I cases except family law cases.) The court did H did nat waive court fees and costs for a party in this case. (This /nfarmat/on may be obtained from the clerk. If court fees and costs were waived, the declaration on the back of this form must be completed Date: 01/14/2020 Richard L. Mahfouz II, Esq. I (TYPE OR PRINT NAME OF Iyhj ATTORNEY PARTY wlTHOUT ATTORNEY) *If dismissal requested is of speafied parties ooiy of spealied causes ot action Auarney ar Party ' I etta ey onlY or of speafied cross-complaints only, so stale acd identifY the parties'ER pl ''ff/p titioner Defendant/Respondentcauses of acuou, or cross-complaints to be dismissed H ain i e i Cross-Complainant 3. TO THE CLERK: Consent to the above dismissal is hereby given.* Date: (TYPE OR PRINT NAME DF ATTORNEY PARTYWITHOUTATTORNEY) If a cross-complaint - or Response (Family Law) seeklug affirmative relief- is on file, the attorney for cross-complainant (respondent) must sign this consent if required by Code of Civil Procedure section 531 (i) or 9) (To be completed by clerk) 4. Dismissal entered as requested on (date): (SIGNATURE) Attorney or party without attorney for: Plaintiff/Petitioner Defendant/Respondent Cross-Complainant 5. Dismissal entered on (date): as to only (name): 6. Dismissal not entered as requested for the following reasons (specify): 7. a. Attorney or party without attorney notified on (dale): b. Attorney or party without attorney not notified. Filing party failed to provide a copy to be conformed means to return conformed copy Date: Clerk, by , Deputy (74794svtl Form Adopted for Mecdatow Use Judaical Coupal of California clv-110 [Rev J I, 2013) REQUEST FOR DISMISSAL Pagel of 2 Code f O I procedure, 3 531 el s q., Gov Code,gaassf(c),Cal Rules fcoud,rule313BO www cpudefp,c .gov ELECTRONICALLY F I L E D Superior Court of California, County of San Francisco 01/15/2020 Clerk of the Court BY: RAYMOND WONG Deputy Clerk DISMISSAL ENTERED 01/15/2020 By: RAYMOND WONG Deputy Clerk PLAINTIFF/PETITIONER; State Farm Mutual Automobile Insurance Company CASE NUMBER: L CGC-1 8-569330 DEFENDANT/RESPONDENT Shawn Patterson CIV-110 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 statutory lien on that recovery. The court may refuse to dismiss the case until the lien is satisf(ed. iGov. Code, 5 68637.) Declaration Concerning Waived Court Fees 1. The court waived fees and costs in this action for (name): 2. The person named in item 1 is (check one): a. is not recovering anything of value by this action. b. is recovering less than $ 10,000 in value by this action. c. is recovering $10,000 or more in value by this action, (if item 2cis checked, item 3 must be completed.) 3. All court fees and costs that were waived in this action have been paid to the court (check one): Yes No I declare under penalty of perjury under the laws of the State of California that the information above is true and correct. Date: (TYPE OR PRINT NAME OF ATTORNEY PARTY MAKING DECLARATION) (SIGNATURE) CIV-110 [ReY. Jaa. I, 201 3] I747948gtl REQUEST FOR DISMISSAL Page 2 of 2