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M C-3 56ATTO RNEY O R P AR TY W IT H O UT A TTO RNEY ( N am e, s ta te b ar n um ber, a nd a ddre ss):F O R C O URT U SE O NLYT E LE PH O NE N O .FA X N O . ( O ptio nal) :E -M AIL A D DR ESS ( O ptio nal) :A TTO RNEY F O R ( N am e):S U PER IO R C O URT O F C ALIF O RNIA , C O UNTY O F STR EE T A D DRESSM AIL IN G A D D RESSC IT Y A N D Z IP C O DEBR AN CH N AM EC ASE N AM E:R EC EIP T A N D A C KN O W LE D G M EN T O F O RDER F O R T H E D EPO SIT O F MONEY I N TO B LO CKED A C CO UNTCASE N UM BER(A tta ch a c o py o f t h e O rd er t o D ep o sit M oney I n to B lo cked A cco unt t o t h is r e ceip t)1 . I a ckn ow le d ge r e ceip t o f t h e O rd er t o D ep osit M oney I n to B lo cked A cco unt, a c o py o f w hic h i s a tta ch ed .2. T h e a cco unt d escrib ed b elo w i n w hic h f u nds h ave b een d ep osit e d u nder t h e c o urt's o rd er i s a f e d era lly i n su re d , b lo cked a cco unt.3 . N am e a n d t it le o n t h e a cco unt:4 . N am e o f d ep osit o ry :a. Branch:b. Address:5. A cco unt n um ber:6 . D ate a cco unt o pen ed :7. A m ount o f i n it ia l d ep osit : $8 . P re sen t b ala n ce: $I c ertif y t h at I a m a u th oriz e d t o e xe cu te t h is r e ceip t a n d a ckn ow le d gm en t, a n d t h at n o w it h dra w al o f p rin cip al o r i n te re st f r o m t h is ac co unt w ill b e p erm it te d w it h out a s ig ned c o urt o rd er u nder t h is c ase n am e a n d n um ber, b earin g t h e s eal o f t h is c o urt.D ate :(T Y PE O R P R IN T N AM E)(A U TH O RIZ E D S IG NATU RE)T it le :Page 1 o f 1F orm A dopte d fo r M andato ry U se Ju dic ia l C ouncil o f C alif o rn ia MC -3 56 [R ev. J a nuary 1 , 2 007]R EC EIP T A ND A CKNO W LE D G M EN T O F O RDER F O R T H E DEPO SIT O F M ONEY I N TO B LO CKED A CCO UNTCod e o f C iv il P ro ce dure , § 3 72 P ro bate C ode, § 3 600 a t s e q. ,C al. R ule s o f C ourt, ru le s 3 .1 384, 7 .9 5.3 electronic form 2001-7 WWW.LawCA.com Law Publishers