EJ-190
`
`ATTORNEYOR PARTY WITHOUT ATTORNEY(Name, address, and State Bar number):
`After recording, return to:
`
`Steven Adelson, Senior Collection Officer
`CCSF - Office of Treasurer/Tax Collector
`
`1 Dr. Carlton B. Goodlett Place, Room 110
`San Francisco, CA 94102
` TEL NO.: 415-554-4624
`FAX NO.(optional):
`
`E-MAIL ADDRESS: steven.adelson@
`LC] ATTORNEY Lx] JUDGMENT C_] ASSIGNEE
`FOR OF RECORD CREDITOR
`
`
`SUPERIOR COURTOF CALIFORNIA, COUNTY OF SAN FRANCISCO
`
`
`STREET ADDRESS: 400 McAllister Street
`MAILING ADDRESS:
`
`
`
`CITY AND zIP CODE: San Francisco, CA 94102
`
`BRANCH NAME: Small Claims Division
`FOR RECORDER'S USE ONLY
`
`
`
`PLAINTIFF: CITY & COUNTY OF SAN FRANCISCO
`
`
`
`
`CASE NUMBER:
`
`
`
`
`APPLICATION FOR AND RENEWALOF JUDGMENT
`
`
`[x] Judgmentcreditor
`[__] Assigneeof record
`applies for renewal of the judgmentasfollows:
`1. Applicant (name and address):
`CCSF - Office of Treasurer/Tax Collector
`1 Dr. Carlton B. Goodlett Place, Room 110
`San Francisco, CA 94102
`
`FOR COURT USE ONLY
`
`
`
`e SMALL CLAIMS
`SujttiorCostcho
`
`
`Countyof Ser Froneirn=
`
`JAN 2 0 ie.
`
`2.
`
`Judgment debtor (name and last known address):
`Taylor Johnson
`125 6th St, Apt 403
`San Francisco, CA 94103
`
`3. Original judgment
`
`a. Case number(specify): CSM-12-842407
`b. Entered on (date): 1/24/2013
`c. Recorded:
`
`(1) Date: 11/25/2013
`(2) County: San Francisco
`(3)
`Instrument No.: unknown
`4, [__] Judgment previously renewed (specify each case number and date):
`
`5. [x] Renewal of money judgment
`a. Totaljudgment..............-...0005- $ 5,065.50
`b. Costs after judgment.................. $ 0.00
`c. Subtotal (add aandb)................. $_ 5,065.50
`d. Credits after judgment................. $ 0.00
`e. Subtotal (subtract dfromc)............. $ 5,065.50
`f.
`Interest after judgment................. $ 5,059.88
`g.
`Feeforfiling renewal application......... $ 0.00
`h. Total renewed judgment (add e, f andg)
`$ 10,125.38
`[__] The amountscalled forin items a-h are different for each debtor.
`These amounts are stated for each debtor on Attachment 5.
`
`Form Approved for Optional Use
`Judicial Council of California
`EJ-190 (Rev. January 1, 2023]
`
`APPLICATION FOR AND RENEWAL OF JUDGMENT
`
`Page 1 of 2
`Code of Civil Procedure, § 683.110 et seq.
`www.courts.ca.gov
`
`

`

`SHORTTITLE:
`CITY AND COUNTYOFSF VS. TAYLOR JOHNSON
`
`CASE NUMBER:
`CSM-12-842407
`
`5.
`
`j. The money judgment(checkall that apply)
`
`(1) [_] has a principal amount remaining unsatisfied of under $50,000 andis for a claim related to personaldebt.
`(2) [¢] hasa principal amount remaining unsatisfied of under $200,000 andis for a claim related to medical expenses.
`(3)
`[__] relates to any otherclaims, including claims for personal debt or medical expensesthat do not otherwisefit within
`items (1) or (2).
`,
`
`‘
`
`Note: From the point whenthe unsatisfied principal amount is below $50,000 for personal debt claims or $200,000 for medical
`expenseclaims, a judgment against a natural person may only be renewedonce,forfive years from the date an applicationis
`filed. (Code Civ. Proc., §§ 683.110-683.120.)
`
`6.
`
`[__] Renewal of judgment for
`
`[__] possession.
`[__] sale.
`
`a. [x] If judgment was not previously renewed, terms of judgment as entered:
`$5,000.00 principal, $65.50 costs,total judgment $5,065.50
`
`b.
`
`[__] If judgment was previously renewed, termsof judgment as last renewed:
`
`c. [x] Termsof judgment remaining unsatisfied:
`$5,000.00principal, $65.50 costs, total judgment $5,065.50
`
`| declare under penalty of perjury underthe lawsof the State of California that the foregoing is true and correct.
`
`Date:
`
`January 20, 2023 Steven Adelson
`
`(TYPE OR PRINT NAME)
`
`:
`(SIGNATURE OF DECLARANT)
`
`EJ-190[Rev. January 1, 2023
`
`APPLICATION FOR AND RENEWALOF JUDGMENT
`
`Page 2 of 2
`
`