Fill and Sign the Notice Entry Form

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Mailing Address) : TELEPHONE NO.: ––––– ––––– ––––– ––––– ––––– ATTORNEY FOR (Name) : ––––– FOR COURT USE ONLY Insert name of court and name of judicial district and branch court if any: ––––– ––––– PLAINTIFF/PETITIONER: ––––– ––––– DEFENDANT/RESPONDENT: ––––– ––––– NOTICE OF ENTRY OF DISMISSAL AND PROOF OF SERVICE Personal Injury, Property Damage, or Wrongful Death Motor Vehicle Other Family Law Eminent Domain Other (specify) : ––––– CASE NUMBER: ––––– TO ATTORNEYS AND PARTIES WITHOUT ATTORNEYS: A dismissal was entered in this action by the clerk as shown on the Request for Dismissal (Attach a copy completed by the clerk.) Date: ––––– ––––– (TYPE OR PRINT NAME OF ATTORNEY PARTY WITHOUT ATTORNEY) (SIGNATURE) PROOF OF SERVICE 1. I am over the age of 18 and not a party to this cause. I am a resident of or employed in the county where the mailing occurred. My residence or business address is: ––––– ––––– 2. I served a copy of the Notice of Entry of Dismissal and Request for Dismissal by mailing them, in a sealed envelope with postage fully prepaid, as follows: a. I deposited the envelope with the United States Postal Service. b. I placed the envelope for collection and processing for mailing following this business’s ordinary practice with which I am readily familiar. On the same day correspondence is placed for collection and mailing, it is deposited in the ordinary course of business with the United Sates Postal Service. c. Date of deposit: ––––– d. Place of deposit (city and state) : ––––– e. Addressed as follows (name and address) : ––––– ––––– ––––– ––––– 3. I served a copy of the Notice of Entry of Dismissal and Request for Dismissal by personally delivering copies to the person served as shown below: Name: Date: Time: Address: ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– 4. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: ––––– ––––– (TYPE OR PRINT NAME) (SIGNATURE OF PETITIONER) Form Adopted by the Judicial Council of California CIV-120 [Rev. January 1, 2007] NOTICE OF ENTRY OF DISMISSAL AND PROOF OF SERVICE Code of Civil Procedure, § 581 et seq. Cal. Rules of Court, rules 383, 1233 electronic form ã 2001 WWW.LawCA.co m Law Publishers CIV-120