Preview
Plaintiff's Claim and ORDER Clerk. F TLE
when formisDfiled.
to Go to Small Claims Court
Superior L of ED
Notice to the person being sued: Cc ‘Ounty of San Francisco.
. You-are the defendant if your name is listed in 2) on page 2 of this form or
on form SC-100A. The person suing you is the plaintiff, listed in
MAY 0°7 2024
on page 2. CLE! F THE COURT
BY:
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. If you lose, the court can order Deputy Clerk
that your wages, money, or property be taken to pay this claim.
Bring witnesses, receipts, and any evidence you need to prove your case.
Fillin court name and street address:
Read this form and all pages attached to understand the claim against you
= Superior Court of Califor ria, Ci eunty of
and to protect your rights.
LA
Aviso al Demandado:
. Usted es el Demandado si su nombre figura en ® de la pagina 2 de este
SUPERIOR COU!
formulario, o en el formulario SC-100A. La persona que lo demanda es el SAN FRANCISCO, CALIFORNIA 94404
Demandante, la que figura en (1) de la pagina 2.
Usted y el Demandante tienen que presentarse en la corte en la fecha del Court fills in case number when form is filed.
juicio indicada a continuacién. Si no se presenta, puede perder el caso. Si Case,; Number
pierde el caso, la corte podria ordenar que le quiten de su sueldo, dinero u
otros bienes para pagar este reclamo. CS H-24 86352
Lleve testigos, recibos y cualquier otra prueba que necesite para probar su caso| Case Name:
Lea este formulario y todas las paginas adjuntas para entender la demanda
en su-contra y para proteger sus derechos.
Yano sty vs. aed
LOTce(-1 mh CoM CLoR CoM Oot las
The people iin @ and @ must attend court: (Clerk fills out section below.)
> PaL ¥ 2 ee i | 28 Name and address of court, if different from above
2.
3
Date: MAY 07 2024 Clerk, by SASSANDRA VASQUE Seputy
Instructions for the person suing
Do not use this form to recover COVID-19 rental debt, which is unpaid rent or other financial obligations under a
tenancy due between March 1, 2020, and September 30, 2021. (See Code of Civil Procedure, §1179.02.) To recover
COVID-19 rental debt, use form SC-500, ’s Claim and O. R to
. 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. You can get
form $C-100-INFO at any courthouse or county law library, or go to www.court: w/form
Fill out pages 2, 3, and 4 of this form. Make copies of all the pages of this form and any attachments—one for each
party named in this case and an extra copy for yourself. Take or mail the original and the copies to the court clerk’
office and pay the filing fee. The clerk will write the date of your trial in the box above. Your court may allow
electronic filing. Check your local court website for information: www.courts.ca. gov/find-my-court.htm,
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 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 Califomia, www.courts.ca.gov Plaintiff's Claim and ORDER SC-100, Page 1 of 6
Rev. January 1, 2024, Mandatory Form
Cada of Givi Procedure, §§ 116,110 et seq.
116.220(c), 116.340(a) to Go to Small Claims Court >
Plaintiff (list names). Case Number:
@ The plaintiff (the person, nea or public entity that is suin ig) is:
Name: Phone: chop al
Street address: 7670 TA uN, SaFantsche (he
Street State
Mailing address (if different).
State Zp
Ernail address (if available). CS4|ScF@Yahon-c.6m
If more than one plaintiff, list next plaintiff here:
Name: Phone
Street address:
Street City State Zip
Mailing address (if different):
Street City State Zip
Email address (if available):
O Check here if more than two plaintiffs and attach form SC-100A
CO Check here if either plaintiff listed above is doing business under a fictitious name and 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 defi ndant leo’pe S mes or public entity being sued) i is:
Name: LeAlle Phone: b> 6- -S34\
Street address: 0 Se NLLoP crv AN uA)
A G 408
Street City State Zip
Mailing address (if different)
Street State Zp
If the defendant is a corporation, limited liability company, or public entity, list the person
or agent authorized for service of process here:
Name: se Job title, if known:
Address
Street Cit State Zip
(1..Check here if your case is against more than one defendant and attach form SC-100A.
Oo. ‘Check here if any defendant is on active military duty and write defendant’s name here:
The plaintiff claims the defendant owes $ 04.65 . (Explain below and on next page.)
(Note: A claim for COVID-19 rental debt cannot be made on this form. Use. form
SC-500, Plaintiff’s Claim and ORDER t (o Small Clai )
a,. Wh do {he d fendant owe the pla intiff money?
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150
Rev. tiperond
2008 oes Claim
Dea ne ORD x ‘10 Go.to Small reveCourt SC-100, Page 2
nesne, >
hyneload
Plaintiff (list names): Case Number:
® b.- When did this happen? (Dare): tO Y\ SO, Z.02M
Ifno specific date, give the time period: Date started: Y4 [20 Jey Through: G~7-74
c. How
lO ¢ you calculate the mo ne
6S Gar Soo, ane
owed to you?
emt,
(Do not include court costs
aN AES hrecs.
O 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.
’
@) 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?
Yes OJ No If no, explain why not:
Why are you filing your claim at this courthouse?
f
This courthouse covers the area (check the one that applies):
a. (1) Where the defendant livés or does business. \Where a contract (written or spoken) was made,
(2) Where the plaintiffs 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.
6 O 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).)
e O 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.)
4.0 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):
@) List the zip code of the place checked in © above (if you know): 4 Y | |b
ls your claim about an attorney-client fee dispute? [ Yes w No
If yes, and if you have had arbitration, fill out form SC-101, attach it to this form, and check here: (1
(8) Are you suing a public entity? 1 Yes mM No
Ifyes, you must file a written claim with the entity first. (] A claim was filed on (date):
ff the ‘public entity denies your claim or does not answer within the time allowed by law, you can file this form.
Rev. Janvary 1, 2024 Plaintiff's Claim and ORDER to Go to Small Claims Court SC-100, Page 3 of 6
>
Plaintiff (list names): Case Number:
”
Have you filed more than 1 2 other small claims within the last 12 months in California?
O Yes No Af yes, the filing fee for this case will be higher.
(10) Is your claim for more than $2,500? [] Yes ol no
If you answer yes, you also confirm that you have not filed, and you understand that you may not 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.
:
1 declare under penalty of perjury under the laws of the State of California that the information above and on any
attachments to this form is true and correct.
S
Date: S71 UW
Edad anoysky
Plaintiff types or prints name here laintiff sigh’ 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. For these and other accommodations,
contact the clerk’s office * form MC-410, Disability Accommodation Request. (Civ. Code,-§ 54.8.)
i!
Rev. January 1, 2026 Plaintiff's Claim and ORDER to Go to Small com Court SC-100, Page 4 of 6
>
Information for the defendant (the person being sued)
“Small-claims court" is a special court where claims for * Prove this is the wrong court. Send a letter fo the court
$12,500 or less are decided. Individuals, including "natural before your trial explaining why you think this is the wrong court.
persons" and sole proprietors, may claim up to $12,500. Ask the court to dismiss the claim. You must serve (give) a copy'.
Corporations, partnerships, public entities, and other businesses of your letter (by mail or in person) to all parties. (Your letter to
are limited to claims of $6,250. (See below for exceptions.*) The the court must say you have done so.)
process is quick and cheap. The rules are simple and informal.
You are the defendant—the person being sued. The person who is
Go to the trial and try to win your case. Bring
suing you is the plaintiff. 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
Do I need a lawyer? You may talk to a lawyer before or after form SC-107, Small Claims Subpoena and Declaration,
the case. But you may not have a lawyer represent you in court and have it served on the witness.
(unless this is an appeal from a small claims case).
Sue the person who is suing you. If you have a claim
How do I get ready for court? You don't have to file any
against the plaintiff, and the claim is appropriate for small claims
papers before your trial, unless you think this is the wrong court for
court as described on this form, you may file Defendant's Claim
your ca. But bring to your trial any witnesses, receipts, and
(form SC-120) and bring the claim in this action. If your claim is
evidence that support your case. an read “Be, Prepared for Your
for more than allowed in small claims court, you may still file it in
Trial” at.
‘small claims court if you give up the amount over the small
What if.| need an accommodation? ifyou have a claims value amount, or you may file a claim for the full value of
disabilty-of are hearing impaired,fill out form [4C-410, Disability the claim in the appropriate court. If your claim is for more than
jon Request. Give the form to your court clerk or the allowed in small claims court and relates to the same contract,
ADA aoe Coordinator. transaction, matter, or event that is the subject of the plaintiffs
What if | don’t speak English well? Ask the court clerk claim, you may file your claim in the appropriate court arid file a
as soon as possible for a court-provided interpreter. You may use motion to transfer the plaintiff's claim to that court to resolve
form 0. i or a local court form both matters together. You can see a description of the amounts
to request an interpreter. If a court interpreter is unavailable for allowed in the paragraph above, titled “Small Claims Court.”
your trial,-it may be necessary to reschedule your trial. You cannot . Agree with the plaintiff's claim and pay the
bring your own interpreter for the trial unless the interpreter has
money. Or, if you can’t pay the money now, go to your trial
been approved by the court as a certified, registered, or
provisionally qualified interpreter. (See Cal. Rules of Court, rule and say you want to make payments.
2.893, and form INT-140,) +» Let the case "default." If you don't settle and do not go to
Where can | get the court forms I need? Go to any the trial (default), the judge may give the plaintiff what he or she
courthouse or your county law library, or print'forms at is asking for plus court costs. If this happens, the plaintiff can
legally take your money, wages, and property to pay the
judgment.
What happens at the trial? The judge will listen to both
sides. The judge may make a decision at your trial or mail the What if I need more time?
decision‘to you later. You can change the trial date if:
+ You cannot go to court on the scheduled date (you will have to
What if lose the case? if you lose, you may appeal. You'll pay a fee to postpone the trial),
have to pay a fee. (Plaintiffs cannot appeal their own claims.)
+ You did not get served (receive this order to go to court) at least
« Ifyou were at the trial, file form SC-1
Notice40,
of Appeal, You 15 days before the trial (or 20 days if you live outside the
must file within 30 days after the clerk hands or mails you the county).
judge's decision judgment) ¢on form SC-200 or form SC-130, 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
« Ifyou Were not at the tial, fi out and file form SC-135, Notice of mail it to the court and to all other people listed on your court
Motion Vacate sdgment and aratic to ask the judge to pers before the deadline. Enclose a check for your court fees,
cancel the judgment (decision). if the judge'does not give you a unless a fee waiver was granted.
new trial, you have 10 days to appeal the decision. File form
St 140. Need help?
For more information on appeals, see www.courts.ca,gow Your county's Small Claims Advisor can help for free.
smallclaims/appeals. - 7
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 before the trial, the
plaintiff must file form ora L_
written and signed settlement agreement withwi the clerk. Ask the Or go to www.courts.ca.gov/smaliclaims/advisor,
Small Claims Advisor for help.
* Exceptions: Different limits apply in an action against a defendant who Is a guarantor. (See Code Civ. Proc., § 116.220(c).) Limits do not apply in an action to
recover COVID-19 rental debt. (See Code Civ. Proc., §§ 116.223 & 1179.02; form SC-500. )
Rev. January 1, 2026 Plaintiff's Claim and ORDER to Go Small
to Claims Court SC-100, Page 5 of 6
>
yore CIT!) Informacion para el demandado (la persona demandada)
“Corte de reclamos menores” es una corte especial donde se + Probar que es la corte equivocada. Envie una carta a la corte
deciden-casos por $12,500 o menos. Los individuos, o sea las antes del juicio explicando por qué cree que es la corte
‘personas fisicas” y los propletarios por cuenta propia, pueden equivocada. Pidale ala corte que despida el reclamo.Tiene que
reclamar hasta $12,500. Las corporaciones, asociaciones, entidades entregar (dar) una copia de su carta (por correo 0 en persona) a
pliblicas y otras empresas solo pueden reclamar hasta $6,250. (Vea todas las partes. (Su carta a la corte tiene que decir que hizo la
abajo para las excepciones.*) El proceso es rapido y econdmico. Las entrega.)
teglas son sencillas e informales. Usted es el Demandado—ia Ir al juicio y tratar de ganar el caso. Lleve testigos, recibos y
persona que se esta demandando. La persona que lo esta cualquier prueba que necesite para probar su caso. Si desea que
demandando es el Demandante. la corte emita una orden de comparecencia para que los testigos
2Necesito un abogado? Puede hablar con un abogado antes 0 vayan al juicio, Ilene el formulario SC-107, Citatorio de reclamos
después del caso. Pero no puede tener a un abogado que lo menores (Small Claims Subpoena) y entrégueselo legalmente al
tepresente ante la corte (a menos que se trate de una apelacién de un testigo.
caso de.reclamos menores). Demandar a la persona que lo demand6, Si tiene un reclamo
zCémo me preparo para ir ala corte? No tiene que presentar contra el Demandante, y el reclamo se puede presentar en la
ningun documento antes del juicio, a menos que piense que ésta es la
corte de reclamos menores, tal como se describe en este
corte equivocada para su caso. Pero lleve al juicio cualquier testigos,
formulario, puede presentar el formulario SC-120, Reclamo del
recibos y pruebas que apoyan su caso. Y lea “Esté preparado para su demandado (Defendant's Claim) y presentarlo en este mismo.
caso. Si su reclamo excede el limite permitido en la corte de
juicio” en www.courts.ca.gov/reclamosmenores/preparese.
éQué hago si necesito una modificacién? Si tiene una
reclamos menores, puede igualmente presentarlo en la corte de
reclamos menores si esta dispuesto a limitar su reclamo al
discapacidad 0 tiene impedimentos de audicién, liene e! formulario
MC-410, Solicitud de modificaciones para discapacidad. Entregue el
maximo permitido, o puede presentar un reclama por el monto
formulario al secretario de la corte o al Coordinador de Acceso/ADA total en la corte apropiada. Si su reclamo excede el limite
de su corte, permitido en la corte de reclamos menores y esta relacionado con
el mismo contrato, transaccién, asunto 0 acontecimiento que el
zQué pasa si no hablo bien inglés? Solicite un intérprete al
reclamo del Demandante, puede presentar su reclamo en la corte
secretario de la corte lo mas pronto posible. Puede usar el formulario
apropiada y presentar una mocidn para transferir el reclamo det
INT-300 6 un formulario de su corte local. Si no esta disponible un
Demandante a dicha corte, para poder resolver los dos reclamos
intérprete’de la corte para su juicio, es posible que se tenga que juntos. Puede ver una descripcién de los montos permitidos en el
cambiar la fecha de'su juicio. No puede llevar su propio intérprete parrafo anterior titulado “Corte de reclamos menores’
para el juicio a menos que el intérprete haya sido aprobado por la
corte como un intérprete certificado, registrado, o provisionalmente Aceptar el reclamo del Demandante y pagar el dinero. O, sino
calificado.:(Vea la regia 2.893 de las Reglas de la Corte de California, puede pagar en ese momento, vaya al juicio y diga que quiere
y el formulario INT-140.) hacer los pagos a plazos.
zD6nde puedo obtener los formularios de fa corte que necesito? No ir al juicio y aceptar el fallo por falta de comparecencia. Si
Vaya a cualquier edificio de la corte, la biblioteca. fegal de su condado, no llega a un acuerdo con el Demandante y no va al juicio (fallo
0 imprima los formularios en www.courts.ca. govismaliclaims/forms por falta de comparecencia), el juez le puede otorgar al
(pagina esta en inglés). Demandante lo que esta reclamando més los costos de la corte.
En ese caso, el Demandante legalmente puede tomar su dinero,
zQué pasa en el juicio? El juez escuchara a ambas partes. El juez
su sueldo o sus blenes para cobrar el fallo.
puede tomar su decision durante la audiencia o enviarsela por correo
después, ~Qué hago si necesito mas tiempo? Puede cambiar la fecha del
juicio si:
eQué pasa si plerdo el caso? Si pierde, puede apelar. Tendra que + No puede ir a la corte en la fecha programada (tendra que pagar
pagar una cuota. (El Demandante no puede apelar su propio reclamo.) una cuota para aplazar el juicio), 0
. Si estuvo presente en el juicio, llene el formulario SC-140, Aviso de + No le entregaron los documentos legalmente (no recibio la orden
apelacién (Notice of Appeal). Tiene que presentarlo dentro de 30 para ir a la corte) por lo menos 15 dias antes del juicio (6 20 dias
dias después de que el secretario le entregue o envie la decision si vive fuera de! condado).
(fallo) del juez en el formulario SC-200 o SC-130, Aviso de Preguntele al secretario de reclamos menores sobre las reglas y las
publicacién del fallo (Notice of Entry of Judgment). cuotas para aplazar un juicio. O Ilene el formulario SC-150 (0 escriba
Si no estuvo en el juicio, llene y presente el formulario SC-135, una carta) y envielo antes del plazo a la corte y a todas las otras
Aviso de peticién para anular el fallo y Declaraci6n para pedirle al personas que figuran en sus papeles de la corte. Adjunte un cheque
que anule el fallo (decision). Si la corte no le otorga un nuevo para pagar los costos de Ia corte, a menos que le hayan dado una
juicio, tiene 10 dias para apelarla decisi6n. Presente el formulario exencién,
SC-140.
2Necesita ayuda? El Asesor de Reclamos Menores de su
Para obtener mas informacién sobre las apelaciones, vea
www.courts.ca. gov/reclamosmenores/apelaciones.
condada le puede ayudar sin cargo.
4
eTengo 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 antes del juicio, el
Demandante tiene que presentar el formutario ClV-110 Solicitud de O visite www.courts.ca.gov/reclamosmenores/asesores.
desestimacién (Request for Dismissal) o un acuerdo de resolucién
escrito y firmado al secretario de la corte. Pidale al Asesar de * Excepelones: Existen diferentes limites en un raciama contra un garante. (Vea al Cédigo da
Reclamos Menores que lo ayude. Pracedimiento Civ, seccién 116,220 (c),) Los limites na se aptican a tas acciones para reclamar
una deuda de alquller del COVID-19. (Vea ef Cédiga de Pracedimlento Civil, secciones 116.223,
1179.02: y el formulario SC-500.)
Rev. January 1, 2024 SC-100, Page
6 of 6
Reclamo del Demandante y ORDEN Para Ir a la Corte de
Reclamos Menores
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Plaintiff's Claim and ORDER Clerk. F TLE when formisDfiled. to Go to Small Claims Court Superior L of ED Notice to the person being sued: Cc ‘Ounty of San Francisco. . You-are the defendant if your name is listed in 2) on page 2 of this form or on form SC-100A. The person suing you is the plaintiff, listed in MAY 0°7 2024 on page 2. CLE! F THE COURT BY: 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. If you lose, the court can order Deputy Clerk that your wages, money, or property be taken to pay this claim. Bring witnesses, receipts, and any evidence you need to prove your case. Fillin court name and street address: Read this form and all pages attached to understand the claim against you = Superior Court of Califor ria, Ci eunty of and to protect your rights. LA Aviso al Demandado: . Usted es el Demandado si su nombre figura en ® de la pagina 2 de este SUPERIOR COU! formulario, o en el formulario SC-100A. La persona que lo demanda es el SAN FRANCISCO, CALIFORNIA 94404 Demandante, la que figura en (1) de la pagina 2. Usted y el Demandante tienen que presentarse en la corte en la fecha del Court fills in case number when form is filed. juicio indicada a continuacién. Si no se presenta, puede perder el caso. Si Case,; Number pierde el caso, la corte podria ordenar que le quiten de su sueldo, dinero u otros bienes para pagar este reclamo. CS H-24 86352 Lleve testigos, recibos y cualquier otra prueba que necesite para probar su caso| Case Name: Lea este formulario y todas las paginas adjuntas para entender la demanda en su-contra y para proteger sus derechos. Yano sty vs. aed LOTce(-1 mh CoM CLoR CoM Oot las The people iin @ and @ must attend court: (Clerk fills out section below.) > PaL ¥ 2 ee i | 28 Name and address of court, if different from above 2. 3 Date: MAY 07 2024 Clerk, by SASSANDRA VASQUE Seputy Instructions for the person suing Do not use this form to recover COVID-19 rental debt, which is unpaid rent or other financial obligations under a tenancy due between March 1, 2020, and September 30, 2021. (See Code of Civil Procedure, §1179.02.) To recover COVID-19 rental debt, use form SC-500, ’s Claim and O. R to . 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. You can get form $C-100-INFO at any courthouse or county law library, or go to www.court: w/form Fill out pages 2, 3, and 4 of this form. Make copies of all the pages of this form and any attachments—one for each party named in this case and an extra copy for yourself. Take or mail the original and the copies to the court clerk’ office and pay the filing fee. The clerk will write the date of your trial in the box above. Your court may allow electronic filing. Check your local court website for information: www.courts.ca. gov/find-my-court.htm, 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 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 Califomia, www.courts.ca.gov Plaintiff's Claim and ORDER SC-100, Page 1 of 6 Rev. January 1, 2024, Mandatory Form Cada of Givi Procedure, §§ 116,110 et seq. 116.220(c), 116.340(a) to Go to Small Claims Court > Plaintiff (list names). Case Number: @ The plaintiff (the person, nea or public entity that is suin ig) is: Name: Phone: chop al Street address: 7670 TA uN, SaFantsche (he Street State Mailing address (if different). State Zp Ernail address (if available). CS4|ScF@Yahon-c.6m If more than one plaintiff, list next plaintiff here: Name: Phone Street address: Street City State Zip Mailing address (if different): Street City State Zip Email address (if available): O Check here if more than two plaintiffs and attach form SC-100A CO Check here if either plaintiff listed above is doing business under a fictitious name and 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 defi ndant leo’pe S mes or public entity being sued) i is: Name: LeAlle Phone: b> 6- -S34\ Street address: 0 Se NLLoP crv AN uA) A G 408 Street City State Zip Mailing address (if different) Street State Zp If the defendant is a corporation, limited liability company, or public entity, list the person or agent authorized for service of process here: Name: se Job title, if known: Address Street Cit State Zip (1..Check here if your case is against more than one defendant and attach form SC-100A. Oo. ‘Check here if any defendant is on active military duty and write defendant’s name here: The plaintiff claims the defendant owes $ 04.65 . (Explain below and on next page.) (Note: A claim for COVID-19 rental debt cannot be made on this form. Use. form SC-500, Plaintiff’s Claim and ORDER t (o Small Clai ) a,. Wh do {he d fendant owe the pla intiff money? [YIs. rh 4 KP MV Q A ANAC ct A WV va Oy SNSe,. Onn Vier Dinh Wie US hie etn Leek 9 Cue ash Ed od Over Ak OY (LSKOWVO A eae dl one 1A g a md tO} E46 rat A, Way lou don Text rrore/ 2) O ch pO Me \D \ECO Od hon AVrNieA YA Eich Ono 00) gor Mic erent utile \u AOTINO WOE AOD. Ab 150 Rev. tiperond 2008 oes Claim Dea ne ORD x ‘10 Go.to Small reveCourt SC-100, Page 2 nesne, > hyneload Plaintiff (list names): Case Number: ® b.- When did this happen? (Dare): tO Y\ SO, Z.02M Ifno specific date, give the time period: Date started: Y4 [20 Jey Through: G~7-74 c. How lO ¢ you calculate the mo ne 6S Gar Soo, ane owed to you? emt, (Do not include court costs aN AES hrecs. O 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. ’ @) 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? Yes OJ No If no, explain why not: Why are you filing your claim at this courthouse? f This courthouse covers the area (check the one that applies): a. (1) Where the defendant livés or does business. \Where a contract (written or spoken) was made, (2) Where the plaintiffs 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. 6 O 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).) e O 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.) 4.0 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): @) List the zip code of the place checked in © above (if you know): 4 Y | |b ls your claim about an attorney-client fee dispute? [ Yes w No If yes, and if you have had arbitration, fill out form SC-101, attach it to this form, and check here: (1 (8) Are you suing a public entity? 1 Yes mM No Ifyes, you must file a written claim with the entity first. (] A claim was filed on (date): ff the ‘public entity denies your claim or does not answer within the time allowed by law, you can file this form. Rev. Janvary 1, 2024 Plaintiff's Claim and ORDER to Go to Small Claims Court SC-100, Page 3 of 6 > Plaintiff (list names): Case Number: ” Have you filed more than 1 2 other small claims within the last 12 months in California? O Yes No Af yes, the filing fee for this case will be higher. (10) Is your claim for more than $2,500? [] Yes ol no If you answer yes, you also confirm that you have not filed, and you understand that you may not 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. : 1 declare under penalty of perjury under the laws of the State of California that the information above and on any attachments to this form is true and correct. S Date: S71 UW Edad anoysky Plaintiff types or prints name here laintiff sigh’ 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. For these and other accommodations, contact the clerk’s office * form MC-410, Disability Accommodation Request. (Civ. Code,-§ 54.8.) i! Rev. January 1, 2026 Plaintiff's Claim and ORDER to Go to Small com Court SC-100, Page 4 of 6 > Information for the defendant (the person being sued) “Small-claims court" is a special court where claims for * Prove this is the wrong court. Send a letter fo the court $12,500 or less are decided. Individuals, including "natural before your trial explaining why you think this is the wrong court. persons" and sole proprietors, may claim up to $12,500. Ask the court to dismiss the claim. You must serve (give) a copy'. Corporations, partnerships, public entities, and other businesses of your letter (by mail or in person) to all parties. (Your letter to are limited to claims of $6,250. (See below for exceptions.*) The the court must say you have done so.) process is quick and cheap. The rules are simple and informal. You are the defendant—the person being sued. The person who is Go to the trial and try to win your case. Bring suing you is the plaintiff. 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 Do I need a lawyer? You may talk to a lawyer before or after form SC-107, Small Claims Subpoena and Declaration, the case. But you may not have a lawyer represent you in court and have it served on the witness. (unless this is an appeal from a small claims case). Sue the person who is suing you. If you have a claim How do I get ready for court? You don't have to file any against the plaintiff, and the claim is appropriate for small claims papers before your trial, unless you think this is the wrong court for court as described on this form, you may file Defendant's Claim your ca. But bring to your trial any witnesses, receipts, and (form SC-120) and bring the claim in this action. If your claim is evidence that support your case. an read “Be, Prepared for Your for more than allowed in small claims court, you may still file it in Trial” at. ‘small claims court if you give up the amount over the small What if.| need an accommodation? ifyou have a claims value amount, or you may file a claim for the full value of disabilty-of are hearing impaired,fill out form [4C-410, Disability the claim in the appropriate court. If your claim is for more than jon Request. Give the form to your court clerk or the allowed in small claims court and relates to the same contract, ADA aoe Coordinator. transaction, matter, or event that is the subject of the plaintiffs What if | don’t speak English well? Ask the court clerk claim, you may file your claim in the appropriate court arid file a as soon as possible for a court-provided interpreter. You may use motion to transfer the plaintiff's claim to that court to resolve form 0. i or a local court form both matters together. You can see a description of the amounts to request an interpreter. If a court interpreter is unavailable for allowed in the paragraph above, titled “Small Claims Court.” your trial,-it may be necessary to reschedule your trial. You cannot . Agree with the plaintiff's claim and pay the bring your own interpreter for the trial unless the interpreter has money. Or, if you can’t pay the money now, go to your trial been approved by the court as a certified, registered, or provisionally qualified interpreter. (See Cal. Rules of Court, rule and say you want to make payments. 2.893, and form INT-140,) +» Let the case "default." If you don't settle and do not go to Where can | get the court forms I need? Go to any the trial (default), the judge may give the plaintiff what he or she courthouse or your county law library, or print'forms at is asking for plus court costs. If this happens, the plaintiff can legally take your money, wages, and property to pay the judgment. What happens at the trial? The judge will listen to both sides. The judge may make a decision at your trial or mail the What if I need more time? decision‘to you later. You can change the trial date if: + You cannot go to court on the scheduled date (you will have to What if lose the case? if you lose, you may appeal. You'll pay a fee to postpone the trial), have to pay a fee. (Plaintiffs cannot appeal their own claims.) + You did not get served (receive this order to go to court) at least « Ifyou were at the trial, file form SC-1 Notice40, of Appeal, You 15 days before the trial (or 20 days if you live outside the must file within 30 days after the clerk hands or mails you the county). judge's decision judgment) ¢on form SC-200 or form SC-130, 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 « Ifyou Were not at the tial, fi out and file form SC-135, Notice of mail it to the court and to all other people listed on your court Motion Vacate sdgment and aratic to ask the judge to pers before the deadline. Enclose a check for your court fees, cancel the judgment (decision). if the judge'does not give you a unless a fee waiver was granted. new trial, you have 10 days to appeal the decision. File form St 140. Need help? For more information on appeals, see www.courts.ca,gow Your county's Small Claims Advisor can help for free. smallclaims/appeals. - 7 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 before the trial, the plaintiff must file form ora L_ written and signed settlement agreement withwi the clerk. Ask the Or go to www.courts.ca.gov/smaliclaims/advisor, Small Claims Advisor for help. * Exceptions: Different limits apply in an action against a defendant who Is a guarantor. (See Code Civ. Proc., § 116.220(c).) Limits do not apply in an action to recover COVID-19 rental debt. (See Code Civ. Proc., §§ 116.223 & 1179.02; form SC-500. ) Rev. January 1, 2026 Plaintiff's Claim and ORDER to Go Small to Claims Court SC-100, Page 5 of 6 > yore CIT!) Informacion para el demandado (la persona demandada) “Corte de reclamos menores” es una corte especial donde se + Probar que es la corte equivocada. Envie una carta a la corte deciden-casos por $12,500 o menos. Los individuos, o sea las antes del juicio explicando por qué cree que es la corte ‘personas fisicas” y los propletarios por cuenta propia, pueden equivocada. Pidale ala corte que despida el reclamo.Tiene que reclamar hasta $12,500. Las corporaciones, asociaciones, entidades entregar (dar) una copia de su carta (por correo 0 en persona) a pliblicas y otras empresas solo pueden reclamar hasta $6,250. (Vea todas las partes. (Su carta a la corte tiene que decir que hizo la abajo para las excepciones.*) El proceso es rapido y econdmico. Las entrega.) teglas son sencillas e informales. Usted es el Demandado—ia Ir al juicio y tratar de ganar el caso. Lleve testigos, recibos y persona que se esta demandando. La persona que lo esta cualquier prueba que necesite para probar su caso. Si desea que demandando es el Demandante. la corte emita una orden de comparecencia para que los testigos 2Necesito un abogado? Puede hablar con un abogado antes 0 vayan al juicio, Ilene el formulario SC-107, Citatorio de reclamos después del caso. Pero no puede tener a un abogado que lo menores (Small Claims Subpoena) y entrégueselo legalmente al tepresente ante la corte (a menos que se trate de una apelacién de un testigo. caso de.reclamos menores). Demandar a la persona que lo demand6, Si tiene un reclamo zCémo me preparo para ir ala corte? No tiene que presentar contra el Demandante, y el reclamo se puede presentar en la ningun documento antes del juicio, a menos que piense que ésta es la corte de reclamos menores, tal como se describe en este corte equivocada para su caso. Pero lleve al juicio cualquier testigos, formulario, puede presentar el formulario SC-120, Reclamo del recibos y pruebas que apoyan su caso. Y lea “Esté preparado para su demandado (Defendant's Claim) y presentarlo en este mismo. caso. Si su reclamo excede el limite permitido en la corte de juicio” en www.courts.ca.gov/reclamosmenores/preparese. éQué hago si necesito una modificacién? Si tiene una reclamos menores, puede igualmente presentarlo en la corte de reclamos menores si esta dispuesto a limitar su reclamo al discapacidad 0 tiene impedimentos de audicién, liene e! formulario MC-410, Solicitud de modificaciones para discapacidad. Entregue el maximo permitido, o puede presentar un reclama por el monto formulario al secretario de la corte o al Coordinador de Acceso/ADA total en la corte apropiada. Si su reclamo excede el limite de su corte, permitido en la corte de reclamos menores y esta relacionado con el mismo contrato, transaccién, asunto 0 acontecimiento que el zQué pasa si no hablo bien inglés? Solicite un intérprete al reclamo del Demandante, puede presentar su reclamo en la corte secretario de la corte lo mas pronto posible. Puede usar el formulario apropiada y presentar una mocidn para transferir el reclamo det INT-300 6 un formulario de su corte local. Si no esta disponible un Demandante a dicha corte, para poder resolver los dos reclamos intérprete’de la corte para su juicio, es posible que se tenga que juntos. Puede ver una descripcién de los montos permitidos en el cambiar la fecha de'su juicio. No puede llevar su propio intérprete parrafo anterior titulado “Corte de reclamos menores’ para el juicio a menos que el intérprete haya sido aprobado por la corte como un intérprete certificado, registrado, o provisionalmente Aceptar el reclamo del Demandante y pagar el dinero. O, sino calificado.:(Vea la regia 2.893 de las Reglas de la Corte de California, puede pagar en ese momento, vaya al juicio y diga que quiere y el formulario INT-140.) hacer los pagos a plazos. zD6nde puedo obtener los formularios de fa corte que necesito? No ir al juicio y aceptar el fallo por falta de comparecencia. Si Vaya a cualquier edificio de la corte, la biblioteca. fegal de su condado, no llega a un acuerdo con el Demandante y no va al juicio (fallo 0 imprima los formularios en www.courts.ca. govismaliclaims/forms por falta de comparecencia), el juez le puede otorgar al (pagina esta en inglés). Demandante lo que esta reclamando més los costos de la corte. En ese caso, el Demandante legalmente puede tomar su dinero, zQué pasa en el juicio? El juez escuchara a ambas partes. El juez su sueldo o sus blenes para cobrar el fallo. puede tomar su decision durante la audiencia o enviarsela por correo después, ~Qué hago si necesito mas tiempo? Puede cambiar la fecha del juicio si: eQué pasa si plerdo el caso? Si pierde, puede apelar. Tendra que + No puede ir a la corte en la fecha programada (tendra que pagar pagar una cuota. (El Demandante no puede apelar su propio reclamo.) una cuota para aplazar el juicio), 0 . Si estuvo presente en el juicio, llene el formulario SC-140, Aviso de + No le entregaron los documentos legalmente (no recibio la orden apelacién (Notice of Appeal). Tiene que presentarlo dentro de 30 para ir a la corte) por lo menos 15 dias antes del juicio (6 20 dias dias después de que el secretario le entregue o envie la decision si vive fuera de! condado). (fallo) del juez en el formulario SC-200 o SC-130, Aviso de Preguntele al secretario de reclamos menores sobre las reglas y las publicacién del fallo (Notice of Entry of Judgment). cuotas para aplazar un juicio. O Ilene el formulario SC-150 (0 escriba Si no estuvo en el juicio, llene y presente el formulario SC-135, una carta) y envielo antes del plazo a la corte y a todas las otras Aviso de peticién para anular el fallo y Declaraci6n para pedirle al personas que figuran en sus papeles de la corte. Adjunte un cheque que anule el fallo (decision). Si la corte no le otorga un nuevo para pagar los costos de Ia corte, a menos que le hayan dado una juicio, tiene 10 dias para apelarla decisi6n. Presente el formulario exencién, SC-140. 2Necesita ayuda? El Asesor de Reclamos Menores de su Para obtener mas informacién sobre las apelaciones, vea www.courts.ca. gov/reclamosmenores/apelaciones. condada le puede ayudar sin cargo. 4 eTengo 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 antes del juicio, el Demandante tiene que presentar el formutario ClV-110 Solicitud de O visite www.courts.ca.gov/reclamosmenores/asesores. desestimacién (Request for Dismissal) o un acuerdo de resolucién escrito y firmado al secretario de la corte. Pidale al Asesar de * Excepelones: Existen diferentes limites en un raciama contra un garante. (Vea al Cédigo da Reclamos Menores que lo ayude. Pracedimiento Civ, seccién 116,220 (c),) Los limites na se aptican a tas acciones para reclamar una deuda de alquller del COVID-19. (Vea ef Cédiga de Pracedimlento Civil, secciones 116.223, 1179.02: y el formulario SC-500.) Rev. January 1, 2024 SC-100, Page 6 of 6 Reclamo del Demandante y ORDEN Para Ir a la Corte de Reclamos Menores : For your protection and privacy, please press thie Clear — This Form button after you have printed the form. int: Hs | [ Save this form | re af a