STATE BAR NUMBER

NAME, ADDRESS, AND TELEPHONE NUMBER OF ATTORNEY OR PARTY WITHOUT ATTORNEY:

Reserved for Clerks File Stamp

ATTORNEY FOR (Name):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF LOS ANGELES

COURTHOUSE ADDRESS:
PLAINTIFF:
DEFENDANT:
CASE NUMBER:

APPLICATION & ORDER TO WITHDRAW EXHIBITS

APPLICATION

_________________________________________, requests the release of the following described Exhibits:

Exhibit No.
Description
Exhibit No.
Description
____________
_____________________________
_____________
_________________________
____________
_____________________________
_____________
_________________________
____________
_____________________________
_____________
_________________________
To the possession of: __________________________________________________________________________
In above entitled action, judgment was entered on ___________________________ and it appears that a
Notice of Appeal has not been filed.
Dated: ___________________

Signature: ____________________________________________
ORDER

Denied as to:___________________________

Temporary release to be returned by:____________________

Date
The evidence described herein having been produced as Exhibit(s) before the court, it is hereby ordered that
possession thereof be given or restored to ___________________________________________________.
Dated:__________________

Trial Judge/Commissioner:_________________________________________
RECEIPT

Exhibits described above were received on: ____________ by______________________

Date
Print Name

________________________
Signature

Temporarily released Exhibits were returned: ___________ by _____________________

Date
Print Name

_______________________
Signature

JOHN A. CLARKE, Executive Officer/Clerk

By: Exhibit Custodian: _______________________________________

__________________________
Dated

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LACIV 037 (Rev. 01/07)
LASC Approved 12-03

APPLICATION & ORDER TO WITHDRAW EXHIBITS

Code Civ. Proc., 1952 (a)