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CIV-110

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):

Lawrance A. Bohm, Esq. (SBN208716) BOHM LAW GROUP 4600 Northgate Blvd. #210 Sacramento, CA 95834 T E L E P H O N E N O . ; 91 6-927-5574
E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name):

FOR COUESJSBSNLY

FMm. (Oplional): 916-927-2046


.Ill,

Plaintiff Sokphy Tin

SUPERIOR COURT OF CALIFORNIA, COUNTY OF SacraiTiento STREET ADDRESS: 720 Ninth Street
MAILING ADDRESS: S a m C

C I T YA N DZ I PC O D E : Sacramento, CA 95814 B R A N C H N A M E : Gordon D. Schaber


PLAINTIFF/PETITIONER: S O K P H Y T f N DEFENDANT/RESPONDENT: P A N D A EXPRESS, INC., et al. REQUEST FOR DISMISSAL CASE NUMBER: I Personal Injury, Property Damage, or Wrongful Death 34-2010-00090959 Motor Vehicle C I I I Other I I Family Law | | Eminent Domain 1 / I Other (specify): Employment A conformed copy will not be returned by the clerk unless a method of return is provided with the document. I 1. TO THE CLERK: Please dismiss this action as follows: a. (1) I / I With prejudice (2) | | Without prejudice b. (1) [ Z ] Complaint (2) d H ] Petition (3) I I Cross-complaint filed by (name): (4) I I Cross-complaint filed by (name): (5) I / I Entire action of all parties and all causes of action on (date): on (date):

(6) I / I Other (specify):* Each side to bear their own fees and costs.
2. (Complete in all cases except family law cases.) Court fees and costs were waived for a party in this case. (This information may be obtained from the clerk. If this box is checked, the declaration on the back of this form must be completed). j.

Date: May 4,2012 Lawrance A. Bohm, Esq.


(TYPE OR PRINT NAME OF I / I ATTORNEY | | PARTY WITHOUT ATTORNEY)

'
(SIGNATURE)

^ ^ ^ ^ ^ ^ ^

If dismissal requested is of specified parties only of specified causes of action JVuoffiey or party without attorney for: only, or of specified cross-complaints only, so state and identify tlie parties, ^ j ^ - ' p - r i , . . i 1

causes of action, or cross-complaints to be dismissed. 3. TO THE CLERK: Consent to the above dismissal is hereby given.' Date:
(TYPE OR PRINT NAME OF ATTORNEY

I / I Plaintiff/Petitioner

| Defendant/Respondent

PARTY WITHOUT ATTORNEY)

(SIGNATURE)

' If a cross-complaint - or Response (Family Law) seel^ing affirmative relief - is on file, the attomey for cross-complainant (respondent) must sign ttiis consent if required by Code of Civil Procedure section 581 (i)

or(i).

Attorney or party without attorney for: I I Plaintiff/Petitioner | | Defendant/Respondent I I Cross-Complainant

(To be cpiftpleted by clerk) 4. \ Dismissal entered as requested on (da}e)\y J 2012] 5 I I Dismissal entered on fdafej: as to only frame): 6. I I Dismissal not entered as requested for the following reasons (specify): 7. a. I b. I I Attorney or party without attorney notified on fdafej: I Attorney or party without attorney not notified. Filing party failed to provide I I a copy to be conformed i I means to return confonned copy

ate:

" 7 2012

Clerk, by REQUEST FOR DISMISSAL

, Deputy
Page 1 of 2 Code of Civil Procedure, 581 et seq.; Gov. Code, 68637(c); Cal. Rules of Court, rule 3.1390 www.courtinfo.ca.gov

Form Adopted for Mandatory Use Judicial Council of California CIV-110 (Rev. July 1,2009]

CIV-110 PLAINTIFF/PETITIONER: S O K P H Y T I N DEFENDANT/RESPONDENT; P A N D A EXPRESS, I N C . , et al. CASE NUMBER:

34-2010-00090959

Declaration Concerning Waived Court Fees


The court has a statutory lien for waived fees and costs on any recovery of $10,000 or more in value by settlement, compromise, arbitration award, mediation settlement, or other recovery. The court's lien must be paid before the court will dismiss the case. 1. The court waived fees and costs in this action for (name): 2. The person in item 1 {check one): a. I I is not recovering anything of value by this action. b. I I is recovering less than $10,000 in value by this action. c. I I is recovering $10,000 or more in value by this action. (If item 2c is checked, item 3 must be completed.) 3.1 I All court fees and costs that were waived in this action have been paid to the court (check one): I I Yes | | No

I declare under penalty of perjury under the laws of the State of California that the information above is true and correct. Date:

(TYPE OR PRINT NAME OF |

| ATTORNEY [

| PARTY MAKING DECLARATION)

(SIGNATURE)

CIV-110 [Rev. July 1,2009)

REQUEST FOR DISMISSAL

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