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      6. Number of pages attached:   M C-3 58ATTO 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:CASE N UM BERO RDER F O R W IT H DRAW AL O F F U NDS F R O M B LO CKED A C CO UNT1. T he p etit io n o f ( n am e):fo r w it h dra w al o f f u ndsa.b.w as h eard e x p arte . cam e o n r e gula rly f o r h earin g in t h is c o urt o n ( d ate ):T H E C O URT O RDER S2. P etit io ner is a uth oriz e d t o w it h dra w f u nds a nd t h e d eposit o ry is o rd ere d t o a llo w t h e p etit io ner t o w it h dra w f u nds, u pon p re se nta tio nof a f ile d e ndors e d c o py o f t h is o rd e r, in t h e t o ta l a m ount o f: $3 . T he f u nds a re lo ca te d in t h e f o llo w in g a cco unt:a. Name and title on the account:b. D eposit o ry ( n a m e):(1) Branch:(2) Address:c. Account number:4. T he f u nds a re t o b e d is tr ib ute d b y t h e d eposit o ry , r e m it ta nce p aya ble a s f o llo w s:a. Payee (name):Amount: $b. Payee (name):Amount: $c. Payee (name):Amount: $d. Payee (name):Amount: $Addit io nal p aye es a nd a m ounts t o b e d is tr ib ute d a re lis te d o n A tta ch m ent 4 .5.T he c o urt f u rth er o rd ers :D ate : JU DG E O F T H E S U PER IO R C O URT SIG NATU RE F O LLO W S L A ST A TTA C HM EN T 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 58 [R ev. J a nuary 1 , 2 007]O RDER F O R W IT H DRAW AL O F F U NDS FRO M B LO CKED A C CO UNTCal. R ule s o f C ourt, r u le s 3 .1 384, 7 .9 54electronic form 2001-7 WWW.LawCA.com Law Publishers