Mc 012 Form PDF Details

Are you looking to fill out Mc 012 Form but don't know where to start? You're not alone! A lot of people find the process of filling out this particular form daunting and confusing. In fact, it is one of the most complex forms associated with any paperwork related to Medicare coverage. Fortunately, this blog post will walk you through the Mc 012 Form step-by-step so that you can rest assured that your application is completed in a timely manner and all necessary information has been accounted for. Whether you are completing an application for yourself or representing someone else, read on for a helpful guide designed to make navigating this form easier than ever before.

QuestionAnswer
Form NameMc 012 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesmc 012 form, california mc 012, california memorandum, mc 012 form california

Form Preview Example

MC-012

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

FOR COURT USE ONLY

 

 

 

TELEPHONE NO.:

FAX NO.:

 

 

 

 

ATTORNEY FOR (Name):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF COURT:

 

 

 

 

 

 

 

STREET ADDRESS:

 

 

 

 

 

 

MAILING ADDRESS:

 

 

 

 

 

 

CITY AND ZIP CODE:

 

 

 

 

 

 

 

 

BRANCH NAME:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PLAINTIFF:

 

 

 

 

DEFENDANT:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MEMORANDUM OF COSTS AFTER JUDGMENT, ACKNOWLEDGMENT

CASE NUMBER:

 

 

 

 

 

 

 

 

 

 

OF CREDIT, AND DECLARATION OF ACCRUED INTEREST

 

 

 

1. I claim the following costs after judgment incurred within the last two years (indicate if there

 

 

 

are multiple items in any category):

 

 

Dates Incurred

Amount

 

 

 

 

 

 

 

 

 

 

 

a

 

Preparing and issuing abstract of judgment

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

b

 

Recording and indexing abstract of judgment

 

 

 

$

 

 

 

 

 

 

 

 

 

 

c

 

Filing notice of judgment lien on personal property

 

 

$

 

 

 

 

 

 

 

 

 

 

d

 

Issuing writ of execution, to extent not satisfied by Code Civ. Proc., § 685.050

 

 

$

 

 

 

 

(specify county):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

e

 

Levying officers fees, to extent not satisfied by Code Civ. Proc., § 685.050 or wage

 

 

$

 

 

 

 

garnishment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

f

 

Approved fee on application for order for appearance of judgment debtor, or other

 

 

$

 

 

 

 

approved costs under Code Civ. Proc., § 708.110 et seq.

 

 

 

 

 

 

 

 

 

 

 

 

 

g

 

Attorney fees, if allowed by Code Civ. Proc., § 685.040

 

 

$

 

 

 

 

 

 

 

 

 

 

 

h

 

Other:

(Statute authorizing cost):

 

 

$

 

 

 

 

 

 

 

 

 

 

i

 

Total of claimed costs for current memorandum of costs (add items a-h)

 

 

$

 

 

 

 

 

 

 

 

 

2.

 

All previously allowed postjudgment costs:

$

 

 

 

3.

Total of all postjudgment costs (add items 1 and 2): . . . . . . . . . . . . . . . . . . . . . . . . . . . . TOTAL

$

 

 

 

 

 

 

 

 

 

4. Acknowledgment of Credit. I acknowledge total credit to date (including returns on levy process and direct payments) in the amount of: $

5. Declaration of Accrued Interest. Interest on the judgment accruing at the legal rate from the date of entry on balances due after partial satisfactions and other credits in the amount of: $

6. I am the

judgment creditor

agent for the judgment creditor

attorney for the judgment creditor.

I have knowledge of the facts concerning the costs claimed above. To the best of my knowledge and belief, the costs claimed are correct, reasonable, and necessary, and have not been satisfied.

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 DECLARANT)

NOTICE TO THE JUDGMENT DEBTOR

If this memorandum of costs is filed at the same time as an application for a writ of execution, any statutory costs, not exceeding $100 in aggregate and not already allowed by the court, may be included in the writ of execution. The fees sought under this memorandum may be disallowed by the court upon a motion to tax filed by the debtor, notwithstanding the fees having been included in the writ of execution. (Code Civ. Proc., § 685.070(e).) A motion to tax costs claimed in this memorandum must be filed within 10 days after service of the memorandum. (Code Civ. Proc., § 685.070(c).)

(Proof of service on reverse)

Form Adopted for Mandatory Use

Judicial Council of California MC-012 [Rev. January 1, 2011]

MEMORANDUM OF COSTS AFTER JUDGMENT, ACKNOWLEDGMENT

OF CREDIT, AND DECLARATION OF ACCRUED INTEREST

Code of Civil Procedure § 685.070 www.courts.ca.gov

MC-012

SHORT TITLE:

CASE NUMBER:

PROOF OF SERVICE

Mail

Personal Service

1.At the time of service I was at least 18 years of age and not a party to this legal action.

2.My residence or business address is (specify):

3.I mailed or personally delivered a copy of the Memorandum of Costs After Judgment, Acknowledgment of Credit, and Declaration of Accrued Interest as follows (complete either a or b):

a.

 

Mail. I am a resident of or employed in the county where the mailing occurred.

 

(1)

I enclosed a copy in an envelope AND

 

 

(a)

 

deposited the sealed envelope with the United States Postal Service with the postage fully prepaid.

 

 

 

 

 

 

 

placed the envelope for collection and mailing on the date and at the place shown in items below following

 

 

(b)

 

 

 

 

 

 

our ordinary business practices. I am readily familiar with this business's practice for collecting and processing

 

 

 

 

 

correspondence for mailing. On the same day that correspondence is placed for collection and mailing, it is

 

 

 

 

 

deposited in the ordinary course of business with the United States Postal Service in a sealed envelope with

 

 

 

 

 

postage fully prepaid.

 

(2)

The envelope was addressed and mailed as follows:

 

 

(a) Name of person served:

 

 

(b) Address on envelope:

 

 

(c) Date of mailing:

 

 

(d) Place of mailing (city and state):

 

 

Personal delivery. I personally delivered a copy as follows:

b.

 

 

(1)

Name of person served:

 

(2)

Address where delivered:

 

(3)

Date delivered:

 

(4)

Time delivered:

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 DECLARANT)

MC-012 [Rev. January 1, 2011]

MEMORANDUM OF COSTS AFTER JUDGMENT, ACKNOWLEDGMENT

OF CREDIT, AND DECLARATION OF ACCRUED INTEREST

Page two

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If you want to fill out this document, ensure that you type in the required details in each and every area:

1. To begin with, when filling in the mc 012 fillable, begin with the page that includes the following blanks:

Completing segment 1 in memorandum costs

2. Given that the last section is done, you're ready to insert the needed specifics in Issuing writ of execution to, e Levying officers fees to extent, garnishment, f Approved fee on application for, approved costs under Code Civ Proc, Attorney fees if allowed by Code, Other Total of claimed costs for, Statute authorizing cost, All previously allowed, Total of all postjudgment costs, TOTAL, Acknowledgment of Credit I, amount of, Declaration of Accrued Interest, and partial satisfactions and other so you're able to go to the third step.

garnishment, partial satisfactions and other, and Declaration of Accrued Interest inside memorandum costs

3. Throughout this part, look at SHORT TITLE, CASE NUMBER, PROOF OF SERVICE, Mail, Personal Service, At the time of service I was at, My residence or business address, I mailed or personally delivered, Mail I am a resident of or, a b, deposited the sealed envelope with, The envelope was addressed and, a Name of person served, and b Address on envelope. Every one of these should be filled in with utmost focus on detail.

memorandum costs conclusion process described (portion 3)

Always be really careful while filling in My residence or business address and a b, because this is where most people make some mistakes.

4. This next section requires some additional information. Ensure you complete all the necessary fields - c Date of mailing d Place of, Personal delivery I personally, Address where delivered, Date delivered, Time delivered, I declare under penalty of perjury, Date, TYPE OR PRINT NAME, and SIGNATURE OF DECLARANT - to proceed further in your process!

Date, Time delivered, and SIGNATURE OF DECLARANT in memorandum costs

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