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OA
SUPERIOR COURT OF CALIFORNIA
COUNTY OF SAN FRANCISCO
Document Scanning Lead Sheet
Oct-24-2017 9:06 am
Case Number: CSM-17-856549
Filing Date: Oct-24-2017 9:03
Filed by: PAUL FIOL
Image: 06076227
CLAIM OF PLAINTIFF
CCSF / TAX COLLECTOR'S OFFICE VS. TYANA CRAWFORD
001006076227
Instructions:
Please place this sheet on top of the document to be scanned.Plaintiff's Claim and ORDER
hee ay to Go to Small Claims Court
Notice to the person being sued:
+ You are the defendant if your name is listed in (2) on page 2 of this form:
The person suing you is the plaintiff, listed in (1) on page 2.
* You and the plaintiff must go to court on the trial date listed below. If you
do not go to court, you may lose the case.
* Ifyou lose, the court can order that your wages, money, or property be
taken to pay this claim. ‘
* Bring witnesses, receipts, and any evidence you need to prove your case.
* Read this form and all pages.attached to understand the claim against you
and to protect your rights.
Aviso al Demandado:
* Usted es el Demandado si su nombre figura en @ de Ja pagina 2 de este
formulario. La persona que lo demanda es el Demandante, la que figura en
(®) de Ja pagina 2.
* Usted y el Demandante tienen que presentarse en Ja corte en la fecha del
juicio indicada a continuacidén. Sino se presenta, puede perder el caso.
* Si pierde el caso la corte podria ordenar que le quiten de su sueldo, dinero u
Clerk stamps dete here when form is filed.
San ‘LE, E | D
OCT 2'4 2017
CLERK OF THE COURT
BY: .
jeputy Clerk
Fill in court name and street address:
Superior Court of California, County of
SMALL CLAIMS
“UPERIOR COURT
30 McALLISTER, ROOM 103
wid FRANCISCO, CALIFORNIA 94102
Court fills in case number when form is filed.
“=XESN-17 856549
Case Name:
otros bienes para pagar este reclamo. .
Lleve testigos, recibos y cualquier otra prueba que necesite para probar su
caso.
* Lea este formulario y todas las paginas adjuntas para entender la demanda en su contra y para proteger sus derechos.
LOlxsI-Taa CoM Clem Com@rel liad
The people in (1) and (2) must go to court: (Clerk fills out section below}
COSF VS. CHAS FORD
Department
[2Opw_ SOG
Name and address of court, if different from above
Bit FLUX
3.
Date: OCT 2 ¥2017
Clerk, by OP FLI- Deputy
instructions for the person suing:
+ You are the plaintiff. The person you are suing is the defendant.
+ Before you fill out this form, read form SC-100-INFO, Information for the Plaintiff. to know your rights. Get
SC-100-INFO at any courthouse or county Jaw library, or go to www.courts.ca. gow/smallclaims/forms,
Fill out pages 2 and 3 of this form. Then make copies of all pages of this form. (Make one copy for each party named in
this case and an extra copy for yourself.) Take or mail the original and these copies to the court clerk’s office and pay
the filing fee. The clerk will write the date of your trial in the box above.
+ You must have someone at least 18—not you or anyone else listed in this case—give each defendant a court-stamped
copy of all five pages of this form and any pages this form tells you to attach. There are special rules for “serving,” or
delivering, this form to public entities, associations, and some businesses. See forms SC-104, SC-104B, and SC-104C.
+ Go to court on your trial date listed above. Bring witnesses, receipts, and any evidence you need to prove your case.
Judicial Council of California, wanw.couris.ca. gov
Revised January 7, 2017, Mandatory Fonn
Code of Civil Procecure, §§ 116.110 st seq,
116.2200}, 116.340(¢)
Plaintiff's Claim and ORDER
to Go to Small Claims Court
(Small Claims)
$C-100, Page 1 of 5
>Plaintiff (list names): Case Number:
(4) The plaintiff (the person, business, or public entity that is suing) is:
Name: CCSF / Tax Collector's Office Phone: 415-554-6482
Street address: 1 Dr. Carlton B. Goodlett Ple., Rm#110 San Francisco CA 94102
Street City State Zip
Mailing address (if different): P.O. Box 7027 San Francisco CA 94120-7027
Street city State Zip
Hf more than one plaintiff, list next plaintiff here:
Name: Phone:
Street address:
Street city State Zip
Mailing address (if different):
Stroot City State Zip
OO Check here if more than two plaintiffs and attach form SC-100A.
C1 Check here if either plainiiff listed above is doing business under a fictitious name. If so, attach form SC-103.
(0 Check here if any plaintiff is a “licensee” or “deferred deposit originator” (payday lender) under Financial
Code sections 23000 et seq.
@) The defendant(the person, business, or public entity being sued) is:
Name: Tyana Crawford Phone: 415-684-0810
Street address; 2228 Great Highway #D San Francisco CA 94116
Street City State Zip
Mailing address (if different):
Street City State Zip
If the defendant is a corporation, limited fiability company, or public entity, list the person
or agent authorized for service of process here:
Name: Job title, if known:
Address:
Street city Stata Zip
(0 Check here if your case is against more than one defendant, and attach form SC-100A.
(2 Cheek here if any defendant is on active military duty, and write his or her name here:
@) The plaintiff claims the defendant owes $ 2,283.00 . (Explain below):
a. Why does the defendant owe the plaintiff money?
Per unpaid services rendered to defendant by Zuckerberg San Francisco General Hospital
When did this happen? (Date): 08/03/2016
b, Ifno specific date, give the time period: Date started: Through:
c. How did you calculate the money owed to you? (Do not include court costs or fees for service.)
Per itemized statement provided by Zuckerberg San Francisco General Hospital
C1 Check here if you need more space. Attach one sheet of paper or form MC-031 and write “SC-100, Item 3” at
the top.
Revised Jersey 1.2017 Plaintiff's Claim and ORDER to Go to Small Claims Court SC-100, Page 2 of 5
(Small Claims)Plaintiff (list names): Case Number:
@) You must ask the defendant (in person, in writing, or by phone) to pay you before you
sue. If your claim is for possession of property, you must ask the defendant to give you
the property. Have you done this?
[xj Yes [J] No Tf no, explain why not:
®) Why are you filing your claim at this courthouse?
This courthouse covers the area (check the one that applies):
a. (1) Where the defendant lives or does business. (4) Where a contract (written or spoken) was made,
(2) Where the plaintiff's property was damaged, signed, performed, or broken by the defendant or
(3) Where the plaintiff was injured. where the defendant lived or did business when the
. defendant made the contract.
b. [2 Where the buyer or lessee signed|the contract, lives now, or lived when the contract was made, if this claim,
is about an offer or contract for personal, family, or household goods, services, or loans. (Code Civ. Proc.,
§ 395(b).)
c. [J] Where the buyer signed the contract, lives now, or lived when the contract was made, if this claim is about a
retail installment contract (like a credit card). (Civ Code, § 1812.10.)
d. [] Where the buyer signed the contract, lives now, or lived when the contract was made, or where the vehicle is
permanently garaged, if this claim is about a vehicle finance sale. (Civ Code, § 2984.4.)
e. [] Other (specify):
(6) List the zip code of the place checked in © above (ifyou inow): 94116
@ Is your claim about an attorney-client fee dispute? [J Yes [kK] No
If yes, and if you have had arbitration, fill out form SC-101; attach it to this form, and check here: (]
Are you suing a public entity? [Yes {kJ No
If yes, you must file a written claim with the entity first. 1] A claim was filed on (date):
Ifthe public entity denies your claim or does not answer within the time allowed by law, you can file this form.
@) Have you filed more than 12 other small claims within the last 12 months in California?
—] Yes [J] No Ifyes, the filing fee for this case will be higher.
is your claim for more than $2,500? [1 Yes [xj No
If yes, I have not filed, and understand that I cannot file, more than two small claims cases for more than $2,500 in
California during this calendar year.
} understand that by filing a claim in small claims court, | have no right to appeal this
claim.
I declare, under penalty of perjury under California State law, that the information above an t attachments to this
form is true and correct.
Date: 10/24/2017 Sarah Heyworth Og
Plaintiff types or prints name here Hainif, signs here
Date:
Second plaintiff types or prints name here Second plaintiff signs here
Requests for Accommodations
[Assistive listening systems, computer-assisted real-time captioning, or sign language interpreter
services are available if you ask at least five days before the trial. Contact the clerk’s office for form
IMC-410, Request for Accommodations by Persons With Disabilities and Response. (Civ. Code, § 54.8.)
Revised January 1, 2097 Plaintiff's Claim and ORDER to Go to Small Claims Court SC-100, Page 3 of 5
(Small Claims)oT oma Tilt) Information for the defendant (the person being sued)
“Small claims court" is a special court where claims for
$10,000 or less are decided. Individuals, including “natural
persons" and sole proprietors, may claim up to $10,000.
Corporations, partnerships, public entities, and other businesses
are limited to claims of $5,000. (See below for exceptions.*) The
process is quick and:cheap. The rules are simple and informal.
‘You are the defendant—the person being sued. The person who is
suing you is the plaintiff.
Do | need a lawyer? You may talk to a lawyer before or after
the case. But you may not have a lawyer represent you in court
(unless this is an appeal from a small claims case).
How do | get ready for court? You don't have to file any
papers before your trial, unless you think this is the wrong court
for your case. But bring to your trial any witnesses, receipts, and
evidence that supports your case. And read “Be Prepared for Your
Tria?’ at www.courts.ca.gov/smaliclaims/prepare.
What if | need an accommodation? If you have a
disability or are hearing impaired, fill out form MC-410, Request for
Accommodations. Give the farm to your court clerk or the ADA/
Access Coordinator.
What if | don’t speak English well? Ask the court clerk
as soon as possible if your court has a court-provided interpreter
available and how to request one. A court-provided interpreter may
not be available. Aitematively, you may bring an adult who is not a
witness or an attorney to interpret for you or ask the court for a list
of interpreters for hire.
Where can | get the court forms | need? Go to any
courthouse or your county law library, or print forms at www.
courts.ca.gov/smaliclaims/forms:
What happens at the trial? The judge will listen to both
sides. The judge may make a decision at your trial or mail the
decision to you later.
What if | lose the case? If you lose, you may appeal. You'll
have to pay a fee. (Plaintiffs cannot appeal their own claims.)
+ If you were at the trial, file form SC-140, Notice of Appeal. You
must file within 30 days after the clerk hands or mails you the
judge's decision Gudgment) on form SC-200 or form SC-130,
Notice of Entry of Judgment.
If you were not at the trial, fili out and file form SC-135, Notice of
Motion to Vacate Judgment and Declaration, to ask the judge to
cancel the judgment (decision). If the judge does not give you a
new trial, you have 10 days to appeal the decision. File form
SC-140.
For more information on appeals, see www.courts.ca.gov/
smaliclaims/appeals.
Do | have options?
Yes, If you are being sued, you can:
+ Settle your case before the trial. If you and the
plaintiff agree on how to settle the case, the plaintiff must file
form CIV-110, Request for Dismissal, with the clerk. Ask the
Small Claims Advisor for help.
+ Prove this is the wrong court, Send a letter to the court
before your trial explaining why you think this is the wrong court.
Ask the court to dismiss the claim. You must serve (give) a copy
of your letter (by mail or in person) to all parties. (Your letter to
the court must say you have done so.)
+ Go to the trial and try to win your case. Bring
witnesses, receipts, and any evidence you need to prove your
case. To have the court order a witness to go to the trial, fill out
form SC-107 (Small Claims Subpoena) and have it served on
the witness.
Sue the person who is suing you. If you have a claim
against the plaintiff, and the claim is appropriate for small claims
court as described on this form, you may file Defendant's Claim
(form SC-120) and bring the claim in this action. If your claim is
for more than allowed in small claims court, you may still file it in
small claims court if you give up the amount over the small
claims value amount, or you may file a claim for the full value of
the claim in the appropriate court. If your claim is for more than
allowed in small claims court and relates to the same contract,
transaction, matter, or event that is the subject of the plaintiff's
claim, you may file your claim in the appropriate court and file a
motion to transfer the plaintiff's 's claim to that court to resolve
both matters together. You can see @ description of the amounts
allowed in the paragraph above titled “Small Claims Court.”
+ Agree with the plaintiffs claim and pay the
money. Or, if you can’t pay the money now, go to your trial
and say you want to make payments.
+ Let the case "default." If you don’t settle and do not go to
the trial (default), the judge may give the plaintiff what he or she
is asking for pius court costs. If this happens, the plaintiff can
legally take your money, wages, and property to pay the
judgment.
What if | need more time?
You can change the trial date if: 5
You cannot go to court on the scheduled date (you will have to
pay a fee to postpone the trial), or
+ You did not get served (receive this order to go to court) at least
15 days before the trial (or 20 days if you live outside the
county), or
+ You need more time to get an interpreter. One postponement is
allowed, and you will not have to pay a fee to delay the trial.
Ask the Small Claims Clerk about the rules and fees for
postponing a trial. Or fill out form SC-150 (or write a letter) and
mail it to the court and to all other people listed on your court
papers before the deadline. Enclose a check for your court fees,
unless a fee waiver was granted.
Need help?
Your county's Small Claims Advisor can help for free.
—
[_
Or go to www. courts.ca.gov/smaliciaims/advisor.
+
J
* Exceptions: Different limits apply in an action against a defendant who is a guarantor, (See Code Civ. Proc., § 116.220(c).)
Revised January 1, 2017
Plaintiff's Claim and ORDER to Go to Small Claims Court
(Small Claims)
SC-100, Page 4 of 5
>
KorInformaci6n para el demandado (la persona demandada)
La “Corte de reclamos menores” es una corte especial donde se
deciden casos por $10,000 0 menos. Los individuos, o sea las.
“personas fisicas’ y los propietarios por cuenta propia, pueden
reclamar hasta $10,000. Las corporaciones, asociaciones, entidades
publicas y otras empresas solo pueden reciamar hasta $5,000. (Vea
abajo para las excepciones.*) El proceso es rapido y barato. Las
reglas son sencillas e informales. Usted es el Demandado—la
persona que se esta demandando. La persona que lo esta
demandando es el Demandante,
eNecesito un abogado? Puede hablar con un abogado antes o
después del caso. Pero no puede tener a un abogado que lo
represente ante la corte (a menos que se trate de una apelacién de un
caso de reclamos menores).
~Cémo me preparo para ira la corte? No tiene que presentar
ningunos papeles antes del juicio, a menos que piense que ésta es la
corte equivocada para su caso. Pero lieve al juicio cualquier testigos,
recibos y pruebas que apoyan su caso. Y lea “Esté preparado para su
juicio” en www.courts.ca.gov/reclamosmenores/preparese.
éQué hago si necesito una adaptaci6n? Si tiene una discapacidad
© tiene impedimentos de audicién, ilene el formulario MC-410,
Request for Accomodations. Entregue el formulario at secretario de la
corte 0 al Coordinador de Acceso/ADA de su corte.
Qué pasa si no hablo bien inglés? Preguntele al secretario de la
corte lo mas pronto posible si en el juzgado habra un intérprete
disponible y cémo solicitarlo, No siempre estan disponibles los
intérpretes de la corte. Otra opcién es llevar a un adulto que pueda
interpretar para usted siempre que esa persona no sea un testigo ni
un abogado. O puede pedir a ia corte una lista de intérpretes
particulares disponibles para contratar.
~éDénde puedo obtener los formularios de la corte que necesito?
Vaya a cualquier edificio de la corte, la biblioteca legal de su condado,
‘0 imprima los formularios en www.courts.ca.gov/ smailclains/forms
(pagina esta en inglés).
Qué pasa en el juicio? El juez escuchara a ambas partes. El juez
puede tomar su decisién durante la audiencia o enviarsela por correo
después.
2Qué pasa si pierdo el caso? Si pierde, puede apelar, Tendré que
pagar una cuota. (El Demandante no puede apelar su propio reclamo.)
Si estuvo presente en el juicio, Ilene el formulario SC-140, Aviso de
apelacién (Notice of Appeal). Tiene que presentarlo dentro de 30
dias después de que el secretario le entregue o envie la decisién
{fallo) del juez en el formulario SC-200 0 SC-130, Aviso de
publicacién del fallo (Notice of Entry of Judgment).
Si no estuvo en el juicio, ilene y presente el formulario SC-135,
Aviso de peticién para anular el fallo y Declaracién para pedirle al
juez que anule el fallo (decisién). Si la corte no le otorga un nuevo
juicio, tiene 10 dias para apelar la decision, Presente el formulario
SC-140,
Para obtener mas informacién sobre las apelaciones, vea www.
courts.ca.gowreclamosmenores/apelaciones.
éTengo otras opciones? SI. Si lo estan demandando, puede:
« Resolver su caso antes del juicio. Si usted y el Demandante se
ponen de acuerdo en cémo resolver el caso, el Demandante tiene
que presentar el formulario CIV-110, Solicitud de desestimacién
(Request for Dismissal) ante el secretario de la corte. Pidale al
Asesor de Reclamos Menores que lo ayude.
+ Probar que es la corte equivocada. Envie una carta a la corte
antes del juicio explicando por qué cree que es la corte
equivocada. Pidale a la corte que despida el reclamo.Tiene que
entregar (dar) una copia de su carta (por correo o en persona) a
todas jas partes. (Su carta a la corte tiene que decir que hizo la
entrega.) .
. Iraljuicio y tratar de ganar el caso. Lleve testigos, recibos y
cualquier prueba que necesite para probar su caso. Si desea que
la corte emita una orden de comparecencia para que los testigos
vayan al juicio, lene el formulario SC-107, Citatorio de reclamos
menores (Small Claims Subpoena) y entrégueselo legalmente al
testigo.
» Demandar a la persona que lo demandé. Si tiene un reclamo
contra e] Demandante, y el reclamo se puede presentar en ia
corte de reclamos menores, tal como se describe en este
formulario, puede presentar el formulario SC-120, Reciamo del
demandado (Defendant's Claim) y presentarlo en este mismo
caso. Si su reclamo excede el limite permitico en la corte de
reclamos menores, puede igualmente presentarlo en la corte de
teclamos menores si esta dispuesto a limitar su reclamo al
maximo permitido, o puede presentar un reclamo por el monto
total en la corte apropiada. Si su reclamo excede et limite
permitido en la corte de reciamos menores y esta relacionado con
el mismo contrato, transaccién, asunto 0 acontecimiento que el
reclamo del Demandante, puede presentar su reclamo en [a corte
apropiada y presentar una mocidn para transferir el reclamo del
Demandante a dicha corte, para poder resolver los dos reclamos
juntos. Puede ver una descripcién de los montos permifidos en e}
parrafo anterior titulado “Corte de reclamos menores*.
+ Aeptar ef reclamo del Demandante y pagar el dinero. O, sino
puede pagar en ese momento, vaya al juicio y diga que quiere
hacer los pagos.
+» Noir al juicio y aceptar el failo por falta de comparecencia. Si
no llega a un acuerdo con el Demandante y no va al juicio (fallo
por falta de comparecencia), el juez le puede otorgar al
Demandante lo que esta reclamando mas los costos de la corte.
En ese caso, e! Demandante legalmente puede tomar su dinero,
‘su sueido o sus bienes para cobrar él fallo.
Qué hago si necesito mas tiempo? Puede cambiar la fecha del
Juicio si:
* No puede ir ala corte en la fecha programada (tendré que pagar
una cuota para aplazar el juicio), o
+ No le entregaron los documentos legalmente (no recibid la orden
para ir a la corte) por lo menos 15 dias antes del juicio (6 20 dias __
si vive fuera del condado), o
Necesita mas tiempo para conseguir intérprete. (Se permite un
solo aplazamiente sin tener que pagar cuota para aplazar el
julcio).
Preguntele al secretario de reclamos menores sobre las regias y las
cuotas para aplazar un juicio. O tlene el formulario SC-150 (0 escriba
una carta) y envielo antes del piazo a la corte y a todas las otras
Personas que figuran en sus papeles de la corte. Adjunte un cheque
para pagar los costos de la corte, a menos que le hayan dado una
exencion. .
eNecesita ayuda? El Asesor de Reclamos Menores de su
condado le puede ayudar sin cargo.
_
O visite wwv.courts.ca.gov/reclamosmenores/asesores,
* Excepciones: Existen diferentes limites en un reciamo contra un garante. (Vea e! Cédigo de Procedimiento Civil, eecsion 146.220 (c),)
Revised January 1, 2017
Reclamo del Demandante y ORDEN
SC-100, Page 5 of 5
Para Ir a la Corte de Reclamos Menores
(Reclamos Menores)
N
Preview
OA SUPERIOR COURT OF CALIFORNIA COUNTY OF SAN FRANCISCO Document Scanning Lead Sheet Oct-24-2017 9:06 am Case Number: CSM-17-856549 Filing Date: Oct-24-2017 9:03 Filed by: PAUL FIOL Image: 06076227 CLAIM OF PLAINTIFF CCSF / TAX COLLECTOR'S OFFICE VS. TYANA CRAWFORD 001006076227 Instructions: Please place this sheet on top of the document to be scanned.Plaintiff's Claim and ORDER hee ay to Go to Small Claims Court Notice to the person being sued: + You are the defendant if your name is listed in (2) on page 2 of this form: The person suing you is the plaintiff, listed in (1) on page 2. * You and the plaintiff must go to court on the trial date listed below. If you do not go to court, you may lose the case. * Ifyou lose, the court can order that your wages, money, or property be taken to pay this claim. ‘ * Bring witnesses, receipts, and any evidence you need to prove your case. * Read this form and all pages.attached to understand the claim against you and to protect your rights. Aviso al Demandado: * Usted es el Demandado si su nombre figura en @ de Ja pagina 2 de este formulario. La persona que lo demanda es el Demandante, la que figura en (®) de Ja pagina 2. * Usted y el Demandante tienen que presentarse en Ja corte en la fecha del juicio indicada a continuacidén. Sino se presenta, puede perder el caso. * Si pierde el caso la corte podria ordenar que le quiten de su sueldo, dinero u Clerk stamps dete here when form is filed. San ‘LE, E | D OCT 2'4 2017 CLERK OF THE COURT BY: . jeputy Clerk Fill in court name and street address: Superior Court of California, County of SMALL CLAIMS “UPERIOR COURT 30 McALLISTER, ROOM 103 wid FRANCISCO, CALIFORNIA 94102 Court fills in case number when form is filed. “=XESN-17 856549 Case Name: otros bienes para pagar este reclamo. . Lleve testigos, recibos y cualquier otra prueba que necesite para probar su caso. * Lea este formulario y todas las paginas adjuntas para entender la demanda en su contra y para proteger sus derechos. LOlxsI-Taa CoM Clem Com@rel liad The people in (1) and (2) must go to court: (Clerk fills out section below} COSF VS. CHAS FORD Department [2Opw_ SOG Name and address of court, if different from above Bit FLUX 3. Date: OCT 2 ¥2017 Clerk, by OP FLI- Deputy instructions for the person suing: + You are the plaintiff. The person you are suing is the defendant. + Before you fill out this form, read form SC-100-INFO, Information for the Plaintiff. to know your rights. Get SC-100-INFO at any courthouse or county Jaw library, or go to www.courts.ca. gow/smallclaims/forms, Fill out pages 2 and 3 of this form. Then make copies of all pages of this form. (Make one copy for each party named in this case and an extra copy for yourself.) Take or mail the original and these copies to the court clerk’s office and pay the filing fee. The clerk will write the date of your trial in the box above. + You must have someone at least 18—not you or anyone else listed in this case—give each defendant a court-stamped copy of all five pages of this form and any pages this form tells you to attach. There are special rules for “serving,” or delivering, this form to public entities, associations, and some businesses. See forms SC-104, SC-104B, and SC-104C. + Go to court on your trial date listed above. Bring witnesses, receipts, and any evidence you need to prove your case. Judicial Council of California, wanw.couris.ca. gov Revised January 7, 2017, Mandatory Fonn Code of Civil Procecure, §§ 116.110 st seq, 116.2200}, 116.340(¢) Plaintiff's Claim and ORDER to Go to Small Claims Court (Small Claims) $C-100, Page 1 of 5 >Plaintiff (list names): Case Number: (4) The plaintiff (the person, business, or public entity that is suing) is: Name: CCSF / Tax Collector's Office Phone: 415-554-6482 Street address: 1 Dr. Carlton B. Goodlett Ple., Rm#110 San Francisco CA 94102 Street City State Zip Mailing address (if different): P.O. Box 7027 San Francisco CA 94120-7027 Street city State Zip Hf more than one plaintiff, list next plaintiff here: Name: Phone: Street address: Street city State Zip Mailing address (if different): Stroot City State Zip OO Check here if more than two plaintiffs and attach form SC-100A. C1 Check here if either plainiiff listed above is doing business under a fictitious name. If so, attach form SC-103. (0 Check here if any plaintiff is a “licensee” or “deferred deposit originator” (payday lender) under Financial Code sections 23000 et seq. @) The defendant(the person, business, or public entity being sued) is: Name: Tyana Crawford Phone: 415-684-0810 Street address; 2228 Great Highway #D San Francisco CA 94116 Street City State Zip Mailing address (if different): Street City State Zip If the defendant is a corporation, limited fiability company, or public entity, list the person or agent authorized for service of process here: Name: Job title, if known: Address: Street city Stata Zip (0 Check here if your case is against more than one defendant, and attach form SC-100A. (2 Cheek here if any defendant is on active military duty, and write his or her name here: @) The plaintiff claims the defendant owes $ 2,283.00 . (Explain below): a. Why does the defendant owe the plaintiff money? Per unpaid services rendered to defendant by Zuckerberg San Francisco General Hospital When did this happen? (Date): 08/03/2016 b, Ifno specific date, give the time period: Date started: Through: c. How did you calculate the money owed to you? (Do not include court costs or fees for service.) Per itemized statement provided by Zuckerberg San Francisco General Hospital C1 Check here if you need more space. Attach one sheet of paper or form MC-031 and write “SC-100, Item 3” at the top. Revised Jersey 1.2017 Plaintiff's Claim and ORDER to Go to Small Claims Court SC-100, Page 2 of 5 (Small Claims)Plaintiff (list names): Case Number: @) You must ask the defendant (in person, in writing, or by phone) to pay you before you sue. If your claim is for possession of property, you must ask the defendant to give you the property. Have you done this? [xj Yes [J] No Tf no, explain why not: ®) Why are you filing your claim at this courthouse? This courthouse covers the area (check the one that applies): a. (1) Where the defendant lives or does business. (4) Where a contract (written or spoken) was made, (2) Where the plaintiff's property was damaged, signed, performed, or broken by the defendant or (3) Where the plaintiff was injured. where the defendant lived or did business when the . defendant made the contract. b. [2 Where the buyer or lessee signed|the contract, lives now, or lived when the contract was made, if this claim, is about an offer or contract for personal, family, or household goods, services, or loans. (Code Civ. Proc., § 395(b).) c. [J] Where the buyer signed the contract, lives now, or lived when the contract was made, if this claim is about a retail installment contract (like a credit card). (Civ Code, § 1812.10.) d. [] Where the buyer signed the contract, lives now, or lived when the contract was made, or where the vehicle is permanently garaged, if this claim is about a vehicle finance sale. (Civ Code, § 2984.4.) e. [] Other (specify): (6) List the zip code of the place checked in © above (ifyou inow): 94116 @ Is your claim about an attorney-client fee dispute? [J Yes [kK] No If yes, and if you have had arbitration, fill out form SC-101; attach it to this form, and check here: (] Are you suing a public entity? [Yes {kJ No If yes, you must file a written claim with the entity first. 1] A claim was filed on (date): Ifthe public entity denies your claim or does not answer within the time allowed by law, you can file this form. @) Have you filed more than 12 other small claims within the last 12 months in California? —] Yes [J] No Ifyes, the filing fee for this case will be higher. is your claim for more than $2,500? [1 Yes [xj No If yes, I have not filed, and understand that I cannot file, more than two small claims cases for more than $2,500 in California during this calendar year. } understand that by filing a claim in small claims court, | have no right to appeal this claim. I declare, under penalty of perjury under California State law, that the information above an t attachments to this form is true and correct. Date: 10/24/2017 Sarah Heyworth Og Plaintiff types or prints name here Hainif, signs here Date: Second plaintiff types or prints name here Second plaintiff signs here Requests for Accommodations [Assistive listening systems, computer-assisted real-time captioning, or sign language interpreter services are available if you ask at least five days before the trial. Contact the clerk’s office for form IMC-410, Request for Accommodations by Persons With Disabilities and Response. (Civ. Code, § 54.8.) Revised January 1, 2097 Plaintiff's Claim and ORDER to Go to Small Claims Court SC-100, Page 3 of 5 (Small Claims)oT oma Tilt) Information for the defendant (the person being sued) “Small claims court" is a special court where claims for $10,000 or less are decided. Individuals, including “natural persons" and sole proprietors, may claim up to $10,000. Corporations, partnerships, public entities, and other businesses are limited to claims of $5,000. (See below for exceptions.*) The process is quick and:cheap. The rules are simple and informal. ‘You are the defendant—the person being sued. The person who is suing you is the plaintiff. Do | need a lawyer? You may talk to a lawyer before or after the case. But you may not have a lawyer represent you in court (unless this is an appeal from a small claims case). How do | get ready for court? You don't have to file any papers before your trial, unless you think this is the wrong court for your case. But bring to your trial any witnesses, receipts, and evidence that supports your case. And read “Be Prepared for Your Tria?’ at www.courts.ca.gov/smaliclaims/prepare. What if | need an accommodation? If you have a disability or are hearing impaired, fill out form MC-410, Request for Accommodations. Give the farm to your court clerk or the ADA/ Access Coordinator. What if | don’t speak English well? Ask the court clerk as soon as possible if your court has a court-provided interpreter available and how to request one. A court-provided interpreter may not be available. Aitematively, you may bring an adult who is not a witness or an attorney to interpret for you or ask the court for a list of interpreters for hire. Where can | get the court forms | need? Go to any courthouse or your county law library, or print forms at www. courts.ca.gov/smaliclaims/forms: What happens at the trial? The judge will listen to both sides. The judge may make a decision at your trial or mail the decision to you later. What if | lose the case? If you lose, you may appeal. You'll have to pay a fee. (Plaintiffs cannot appeal their own claims.) + If you were at the trial, file form SC-140, Notice of Appeal. You must file within 30 days after the clerk hands or mails you the judge's decision Gudgment) on form SC-200 or form SC-130, Notice of Entry of Judgment. If you were not at the trial, fili out and file form SC-135, Notice of Motion to Vacate Judgment and Declaration, to ask the judge to cancel the judgment (decision). If the judge does not give you a new trial, you have 10 days to appeal the decision. File form SC-140. For more information on appeals, see www.courts.ca.gov/ smaliclaims/appeals. Do | have options? Yes, If you are being sued, you can: + Settle your case before the trial. If you and the plaintiff agree on how to settle the case, the plaintiff must file form CIV-110, Request for Dismissal, with the clerk. Ask the Small Claims Advisor for help. + Prove this is the wrong court, Send a letter to the court before your trial explaining why you think this is the wrong court. Ask the court to dismiss the claim. You must serve (give) a copy of your letter (by mail or in person) to all parties. (Your letter to the court must say you have done so.) + Go to the trial and try to win your case. Bring witnesses, receipts, and any evidence you need to prove your case. To have the court order a witness to go to the trial, fill out form SC-107 (Small Claims Subpoena) and have it served on the witness. Sue the person who is suing you. If you have a claim against the plaintiff, and the claim is appropriate for small claims court as described on this form, you may file Defendant's Claim (form SC-120) and bring the claim in this action. If your claim is for more than allowed in small claims court, you may still file it in small claims court if you give up the amount over the small claims value amount, or you may file a claim for the full value of the claim in the appropriate court. If your claim is for more than allowed in small claims court and relates to the same contract, transaction, matter, or event that is the subject of the plaintiff's claim, you may file your claim in the appropriate court and file a motion to transfer the plaintiff's 's claim to that court to resolve both matters together. You can see @ description of the amounts allowed in the paragraph above titled “Small Claims Court.” + Agree with the plaintiffs claim and pay the money. Or, if you can’t pay the money now, go to your trial and say you want to make payments. + Let the case "default." If you don’t settle and do not go to the trial (default), the judge may give the plaintiff what he or she is asking for pius court costs. If this happens, the plaintiff can legally take your money, wages, and property to pay the judgment. What if | need more time? You can change the trial date if: 5 You cannot go to court on the scheduled date (you will have to pay a fee to postpone the trial), or + You did not get served (receive this order to go to court) at least 15 days before the trial (or 20 days if you live outside the county), or + You need more time to get an interpreter. One postponement is allowed, and you will not have to pay a fee to delay the trial. Ask the Small Claims Clerk about the rules and fees for postponing a trial. Or fill out form SC-150 (or write a letter) and mail it to the court and to all other people listed on your court papers before the deadline. Enclose a check for your court fees, unless a fee waiver was granted. Need help? Your county's Small Claims Advisor can help for free. — [_ Or go to www. courts.ca.gov/smaliciaims/advisor. + J * Exceptions: Different limits apply in an action against a defendant who is a guarantor, (See Code Civ. Proc., § 116.220(c).) Revised January 1, 2017 Plaintiff's Claim and ORDER to Go to Small Claims Court (Small Claims) SC-100, Page 4 of 5 > KorInformaci6n para el demandado (la persona demandada) La “Corte de reclamos menores” es una corte especial donde se deciden casos por $10,000 0 menos. Los individuos, o sea las. “personas fisicas’ y los propietarios por cuenta propia, pueden reclamar hasta $10,000. Las corporaciones, asociaciones, entidades publicas y otras empresas solo pueden reciamar hasta $5,000. (Vea abajo para las excepciones.*) El proceso es rapido y barato. Las reglas son sencillas e informales. Usted es el Demandado—la persona que se esta demandando. La persona que lo esta demandando es el Demandante, eNecesito un abogado? Puede hablar con un abogado antes o después del caso. Pero no puede tener a un abogado que lo represente ante la corte (a menos que se trate de una apelacién de un caso de reclamos menores). ~Cémo me preparo para ira la corte? No tiene que presentar ningunos papeles antes del juicio, a menos que piense que ésta es la corte equivocada para su caso. Pero lieve al juicio cualquier testigos, recibos y pruebas que apoyan su caso. Y lea “Esté preparado para su juicio” en www.courts.ca.gov/reclamosmenores/preparese. éQué hago si necesito una adaptaci6n? Si tiene una discapacidad © tiene impedimentos de audicién, ilene el formulario MC-410, Request for Accomodations. Entregue el formulario at secretario de la corte 0 al Coordinador de Acceso/ADA de su corte. Qué pasa si no hablo bien inglés? Preguntele al secretario de la corte lo mas pronto posible si en el juzgado habra un intérprete disponible y cémo solicitarlo, No siempre estan disponibles los intérpretes de la corte. Otra opcién es llevar a un adulto que pueda interpretar para usted siempre que esa persona no sea un testigo ni un abogado. O puede pedir a ia corte una lista de intérpretes particulares disponibles para contratar. ~éDénde puedo obtener los formularios de la corte que necesito? Vaya a cualquier edificio de la corte, la biblioteca legal de su condado, ‘0 imprima los formularios en www.courts.ca.gov/ smailclains/forms (pagina esta en inglés). Qué pasa en el juicio? El juez escuchara a ambas partes. El juez puede tomar su decisién durante la audiencia o enviarsela por correo después. 2Qué pasa si pierdo el caso? Si pierde, puede apelar, Tendré que pagar una cuota. (El Demandante no puede apelar su propio reclamo.) Si estuvo presente en el juicio, Ilene el formulario SC-140, Aviso de apelacién (Notice of Appeal). Tiene que presentarlo dentro de 30 dias después de que el secretario le entregue o envie la decisién {fallo) del juez en el formulario SC-200 0 SC-130, Aviso de publicacién del fallo (Notice of Entry of Judgment). Si no estuvo en el juicio, ilene y presente el formulario SC-135, Aviso de peticién para anular el fallo y Declaracién para pedirle al juez que anule el fallo (decisién). Si la corte no le otorga un nuevo juicio, tiene 10 dias para apelar la decision, Presente el formulario SC-140, Para obtener mas informacién sobre las apelaciones, vea www. courts.ca.gowreclamosmenores/apelaciones. éTengo otras opciones? SI. Si lo estan demandando, puede: « Resolver su caso antes del juicio. Si usted y el Demandante se ponen de acuerdo en cémo resolver el caso, el Demandante tiene que presentar el formulario CIV-110, Solicitud de desestimacién (Request for Dismissal) ante el secretario de la corte. Pidale al Asesor de Reclamos Menores que lo ayude. + Probar que es la corte equivocada. Envie una carta a la corte antes del juicio explicando por qué cree que es la corte equivocada. Pidale a la corte que despida el reclamo.Tiene que entregar (dar) una copia de su carta (por correo o en persona) a todas jas partes. (Su carta a la corte tiene que decir que hizo la entrega.) . . Iraljuicio y tratar de ganar el caso. Lleve testigos, recibos y cualquier prueba que necesite para probar su caso. Si desea que la corte emita una orden de comparecencia para que los testigos vayan al juicio, lene el formulario SC-107, Citatorio de reclamos menores (Small Claims Subpoena) y entrégueselo legalmente al testigo. » Demandar a la persona que lo demandé. Si tiene un reclamo contra e] Demandante, y el reclamo se puede presentar en ia corte de reclamos menores, tal como se describe en este formulario, puede presentar el formulario SC-120, Reciamo del demandado (Defendant's Claim) y presentarlo en este mismo caso. Si su reclamo excede el limite permitico en la corte de reclamos menores, puede igualmente presentarlo en la corte de teclamos menores si esta dispuesto a limitar su reclamo al maximo permitido, o puede presentar un reclamo por el monto total en la corte apropiada. Si su reclamo excede et limite permitido en la corte de reciamos menores y esta relacionado con el mismo contrato, transaccién, asunto 0 acontecimiento que el reclamo del Demandante, puede presentar su reclamo en [a corte apropiada y presentar una mocidn para transferir el reclamo del Demandante a dicha corte, para poder resolver los dos reclamos juntos. Puede ver una descripcién de los montos permifidos en e} parrafo anterior titulado “Corte de reclamos menores*. + Aeptar ef reclamo del Demandante y pagar el dinero. O, sino puede pagar en ese momento, vaya al juicio y diga que quiere hacer los pagos. +» Noir al juicio y aceptar el failo por falta de comparecencia. Si no llega a un acuerdo con el Demandante y no va al juicio (fallo por falta de comparecencia), el juez le puede otorgar al Demandante lo que esta reclamando mas los costos de la corte. En ese caso, e! Demandante legalmente puede tomar su dinero, ‘su sueido o sus bienes para cobrar él fallo. Qué hago si necesito mas tiempo? Puede cambiar la fecha del Juicio si: * No puede ir ala corte en la fecha programada (tendré que pagar una cuota para aplazar el juicio), o + No le entregaron los documentos legalmente (no recibid la orden para ir a la corte) por lo menos 15 dias antes del juicio (6 20 dias __ si vive fuera del condado), o Necesita mas tiempo para conseguir intérprete. (Se permite un solo aplazamiente sin tener que pagar cuota para aplazar el julcio). Preguntele al secretario de reclamos menores sobre las regias y las cuotas para aplazar un juicio. O tlene el formulario SC-150 (0 escriba una carta) y envielo antes del piazo a la corte y a todas las otras Personas que figuran en sus papeles de la corte. Adjunte un cheque para pagar los costos de la corte, a menos que le hayan dado una exencion. . eNecesita ayuda? El Asesor de Reclamos Menores de su condado le puede ayudar sin cargo. _ O visite wwv.courts.ca.gov/reclamosmenores/asesores, * Excepciones: Existen diferentes limites en un reciamo contra un garante. (Vea e! Cédigo de Procedimiento Civil, eecsion 146.220 (c),) Revised January 1, 2017 Reclamo del Demandante y ORDEN SC-100, Page 5 of 5 Para Ir a la Corte de Reclamos Menores (Reclamos Menores) N