declaration in support of default judgment

Cal. Super. - 1st Dist.August 9, 2019

1 Susan M. Benson, Esq. BENSON LEGAL, APC (SPACE BELOW FOR FILING STAMP ONLY) 2 3 4 5 6 7 8 9 10 6345 BALBOA BOULEVARD, SUITE 365. BLDG. 3 ENCINO, CALIFORNIA 91316 (818) 708-1250 BAR NO. 146837 Fie No. BF9533 ATTORNEY FOR: PLAINTIFF, FARMERS INSURANCE EXCHANGE SUPERIOR COURT OF THE STATE OF CALIFORNIA COUNTY OF SAN FRANCISCO FARMERS INSURANCE EXCHANGE; ) Plaintiff, ) Case No: CGC-18-572174 ) 11 vs. ) DECLARATION IN SUPPORT OF DEFAULT ) JlJDGMENT 1 2 CONVENIENT P ARIauihorized only io.pr-esenl and accept this form. Our preseniatlon and acceptanc.e of thfs.Jorm is neither ari admission hor denial of responsibll [ty. 3. The' applicable sections ofthrs form must pe completed to the best of your ability and submitted promptly In person to our employee{s•) at the lo~tlon ofttle:~lleged Incident. · Damage - vehicle 0 Dama.ge - other 1. Parking 0 Theft - vehicle 0 Theft- .other 0 Personal inju~ 0 c;>.ther (Specify): 2. Date of £'312 7 Po? 3. Time In Area _'79 .. ··!!----------- Driven by----------- 4. TIIT,le Out · . · Qiiven bY---.,..-------------------- 5. Was. Damage RI!!P.9rt~ Befo,re Cus.tomer C:eft Rremises? Full