Statement Re Warrant {VN065}

VN065 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address) Telephone Number FOR COURT USE ONLY ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF VENTURA 800 SOUTH VICTORIA AVE. VENTURA, CA 93009 3855 ­ F ALAMO ST. SIMI VALLEY, CA 93063-2110 PLAINTIFF/PETITIONER DEFENDANT/RESPONDENT CASE NUMBER: STATEMENT RE: WARRANT NOTICE TO JUDGMENT CREDITOR OR PLAINTIFF YOU ARE REQUIRED TO FURNISH THE FOLLOWING INFORMATION Time recommended for examination before the Judge after termination of contempt proceedings is _________________________________________________________________________________________________ (Select date approximately three weeks from date) I, ___________________________________________________________________________ , represent to the Court: 1. That I am the attorney for the party who procured the order for examination herein. 2. ________________________ was ordered to appear for examination in (Name of Debtor) Ventura Simi, California before a judge of the above-name court under the provisions of C.C.P. _________________________on (date) _______________ at __________.M. 3. That said party failed to appear at said time and place. 4. That said party presently resides at or may be found at ____________________________________________ . 5. That neither said party nor their representative have been told or led to believe that such party need not appear at said hearing. 6. That $ _________ or property consisting of was paid or given to the party procuring said order or to the attorney, agent or representative of said party after the said order had been served upon the party failing to appear. Dated ________________ Signature of Judgment Creditor or Attorney ________________________________________ Address __________________________________________________________________________________________ NOTE: WARRANT MAY NOT BE SERVED IF ADEQUATE INFORMATION IS NOT PROVIDED --------------------------------------------------------------------------------------------------------------------------------Information for Officer: Sex _____________ , Race ___________ , Age ___________ , Height ___________ , Weight __________ , Eyes _____________ , Hair ___________ , Last Employed by _________________________________________ Other identification and information (scars, tattoo marks, etc.) _______________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ I certify under Penalty of Perjury that the foregoing is true and correct. Dated: ___________________ Optional Form VN065 (Rev. 07/16) ______________________________________________ Signature of Judgment Creditor or Attorney STATEMENT RE: WARRANT Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com