Preview
Plaintiff's Claim and ORDER Clerk stamps date here when form is fed.
Same Y to Go to Small Claims Court
Notice to the person being sued: SMALL CLAIMS
* You are the Defendant if your name is listed in @ on page 2 of this sip of California
form. The person suing you is the Plaintiff, listed in on page 2. on of Go Branco
+ You and the Plaintiff must go to court on the trial date listed below. If you NOY 02 2020
do not go to court, you may lose the case. CLE = COURT
+ Ifyou lose, the court can order that your wages, money, or property be By:
taken to pay this claim. - epuiy Sierk
+ Bring witnesses, receipts, and any evidence you need to prove your case, Fill in court name and street adaress:
+ Read this form and all pages attached to understand the claim against ‘Superior Court of California, County of
you and to protect your rights. SMALL CLAI MS
Aviso al Demandado: SUPERIOR COURT
: 400 McALLISTER, ROOM 103
* Usted es el Demandado si su nombre figura en@)de la pagina 2 SAN FRANCISCO, CALIFORNIA 94102
de este formulario. La persona que lo demanda es el Demandante, la que
figura en@) de la pagina 2. Clerk fills in case number and case name:
Case Number:
* Usted y el Demandante tienen que presentarse en la corte en la fecha del “Csi 02 0 =8 637 97
juicio indicada a continuacién. Si no se presenta, puede perder el caso. Ca: : .
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,
ehreltaCRCr ROMO a
The people in @ and @ must go to Court: (Clerk fills out section below.)
Name:
* Si pierde el caso la corte podria ordenar que le quiten de su sueldo, dinero u N ON A K vs, K dA
J
Tria) }> Date Time Department Name and address of court if different from above
Dato) FEB 25 202 |Za S0® STH Eloo le
2.
Lo
3.
Date: WOV 9 2020 Clerk, by VERLINDA JONES H , 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 law library, or go to: www.courts, ca, gov/smaliclaims/forms.
Fill out pages 2 and 3 of this form. Then make copies of alll pages of this form. (Make 1 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 ofall 5 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,
HGH Coal a Cll, wnicoutaoa gor Plaintiff's Claim and ORDER 80-100, Page Tots
Cafe cul Prceauer ag tena to Go to Small Claims Court
196 220fc), 116 340(g) (Smail Claims)Plaintiff (list names):
Case Number:
CSM = 20-863 797
@) The Plaintiff (the person, Pusingss, or public entity that is suing) is:
rele Ovalk
Name:_(5 @
Phone: (4/5) 997 = YES P |
State
Street address: {3 273 Ulelor Sk att BRB San Tren aren CA UC/ (pe
Zp
Mailing address (if different): Some
Street
City
City State Zip
lf more than one Plaintiff, list next Plaintiff here:
Name: WO Phone:(__)
Street address:
Steet Oily State Zip
Mailing address (if different):
Street City State Zip
0) Check here if more than 2 Plaintiffs and attach Form SC-100A.
Ol Check here if either Plaintiff listed above is doing business under a fictitious name. Af so, attach Form SC-103.
The Defendant (the person, busi ess, or public entity being sued) is:
ti af e ay
Name:_ ‘4
lan Lanye-
Phone: 444 202~ q ( Os-
Street address: 1260 44 ave .t 2 Ss Preise
Mailing address (if different):
CA 44122
State Zip
‘Street Cily State Zp
If more than one Defendant, list next Defendant here:
Name: Phone: ( )
Street address:
Street City State Zip
Mailing address (if different):
‘Street iy State Zip
OD Check here ifmore than 2 Defendants and attach Form SC-100A.
0) Check here if any Defendant is on active military duty, and write his or her name here:
(3) The Plaintiff claims the Defendant owes $ [ 6 ! Y 6 § . (Explain below): “to J
{
a. Why does the Defendant owe the Plaintiff money? Aaiwti t£
se_iunfovmatio y +o
ed av accifout . Proy
hev hsurann. t+ have Proof, Mow (Usuvang
0 u(~_offe red SAS, hos Sufficitut fo £ik um
CAN.
b. When did this happen? (Date): 6[2020
If no specific date, give the time period: Date started: @ Zp ™
¢. How did you calculate the money owed to you? (Do not include court costs or ‘fees for service.)
a
Through:
Coy parry gst mate
KJ Check here ifyou need more space. Attach one sheet of ‘Paper or Form MC-031 and write “SC-100, Item 3” at
the top.
Rovised January 1, 2012
Plaintiff's Claim and ORDER
to Go to Small Claims Court
(Smail Claims)
SC-100, Page 2 of 5
>SC-100, ITEM 3 .
GSM ° 20-863 797
Fulton is a Large, 4-lane street. In the San Francisco Richmond District. 7
Two lanes are going west, and two lanes are going east. See picture 1
attached. The speed limit there is 30 mph
It was rush-hour, 5 pm, quite a bit of traffic.
| was driving west on the left lane About 25 miles an hour.
Some traffic was behind me. Traffic going in the opposite direction was moving also.
Suddenly, unsafely and quite close to me, a car (Ms. Kay) shot out of
11th Ave. right in front of my car. There is no stop sign or traffic light for Fulton at that
intersection.
She had a STOP SIGN on 11th Ave., and she was supposed to stop there until it was safe
to enter Fulton for her left turn. But she didn’t stop and wait, she Unsafely entered the
intersection and caused the accident.
This is how the accident happened:
| was approaching a 25 miles an hour and stepping on the brakes when she came
shooting out of 11th Ave. unexpectedly.
She applied her brakes and brought her car to stop right in front of my car.
Because she saw that there were also cars coming on the oncoming
lanes, both lanes, that are going from west to east, she didn’t want to get hit by the
oncoming traffic and selected to stop right in front of my car. This is how the collision
happened.
In other words, Jillian Kay Decided to fully apply her brakes in front of my car and get
hit by me instead of going across and getting hit with the oncoming
traffic.
She violated vehicle code 21802 CBC which provides a stop at intersections and yield to
motorists already at the intersection. | am not a law enforcement officer, she may have
violated additional vehicle codes.
I took several pictures which | will bring to court.
Instead of telling her STATE FARM insurance the truth, she lied to them and said that |
ran a red light. There is no traffic light on Fulton and 11th Ave.! There’s only a stop sign
for her to observe.
| spoke with my insurance, Hartford, and submitted evidence. They quickly saw that |
was 100% at fault, that Jillian Kay had entirely caused the accident. They are not paying
for her damages, and they are not raising my insurance rate. | am attaching a transcript
that came from my assessor at Hartford insurance. Where it is clear that Jillian Kay lied
to her insurance, State Farm.
! cannot get my car fixed for $494.14, that is all that State Farm offered. The estimate is
$1614.81. | talked to State Farm several times, but they are not listening to me and
adjusting the payment. Therefore, | need to take this irresponsible drive her to court.Plaintiff (list names): Case Number:
GS 20- 863797
@) 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?
Ye If lain why not: ~ ane
© She Ted to te eR uanc Chet willing be
cChoanugo yey Lie t
@) Why are you filing your claim at this courthouse? ©
This courthouse covers the area (check the one that applies):
a. Bk (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. CJ 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. LC] 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. C1 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 (ifyou know): 74 (2.2.
@ Is your claim about an attorney-client fee dispute? [] Yes $4No
Ifyes, and if you have had arbitration, fill out form SC-101, attach it to this form, and check here: (]
(8) Are you suing a public entity? [1] Yes No
If yes, you must file a written claim with the entity first. [] A claim was filed on (date):
If the public entity denies your claim or does not answer within the time allowed by law, you can file this form.
(3) Have you filed more than 12 other small claims within the last 12 months in California?
OO Yes PANo If yes, the filing fee for this case will be higher.
Is your claim for more than $2,500? [1 Yes €-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 and on any attachments to this
form is true [2 correct.
Date: {[ 2, [2020 6abo Kel C Lowa > ~e— A
Plaintiff types or prints name here Plaintiff 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, 2020 Plaintiff's Claim and ORDER to Go to Small Claims Court SC-100, Page 3 of 5
(Small Claims) >°20- 863797
GSM
Informacion para el dermandado (la persona Se manciags)
La “Corte de reclamos menores” es una corte especial donde se
deciden casos por $10,000 o 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 reclamar 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.
éNecesito un abogado? Puede hablar con un abogado antes 0
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).
Como me preparo para ir a 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 lleve 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 adaptacién? Si tiene una discapacidad
0 tiene impedimentos de audicién, llene el formulario MC-410,
Request for Accomodations. Entregue el formulario al secretario de la
corte o al Coordinador de Acceso/ADA de su corte.
éQué pasa si no hablo bien inglés? Solicite un intérprete al
secretario de la corte lo mas pronto posible. Puede usar el formulario
INT-300 0 un formulario de su corte local. Si no esta disponible un
intérprete de la corte para su juicio, es posible que se tenga que
cambiar la fecha de su juicio. No puede llevar su propio intérprete
para el juicio a menos que el intérprete haya sido aprobado por la
corte como un intérprete certificado, registrado, o provisionalmente
calificado. (Vea la regla 2.893 de las Reglas de la Corte de California,
y el formulario INT-140.)
eDonde puedo obtener los formularios de la corte que necesito?
Vaya a cualquier edificio de la corte, la biblioteca legal de su condado,
o imprima los formularios en www.courts.ca.gov/ smallclaims/forms.
(pagina esta en inglés).
&Qué pasa en el juicio? El juez escuchara a ambas partes, El juez
puede tomar su decision durante la audiencia o enviarsela por correo
después. .
zQué pasa si pierdo el caso? Si pierde, puede apelar. Tendra 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
apelaci6n (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 de! fallo (Notice of Entry of Judgment).
Si no estuvo en el juicio, llene y presente el formulario SC-135,
Aviso de peticién para anular el fallo y Declaracién para pedirle al
juez que anule el fallo (decisién). Sila corte no le otorga un nuevo
juicio, tiene 10 dias para apelar la decisién. Presente el formulario
SC-140.
Para obtener mas informacion sobre las apelaciones, vea www.
courts.ca.gov/reclamosmenores/apelaciones,
éTengo otras opciones? Si. Silo 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 desestimacion
(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 0 en persona) a
todas las partes. (Su carta ala corte tiene que decir que hizo la
entrega.)
« ral juicio 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, Ilene el formulario SC-107, Citatorio de reclamos
menores (Small Claims Subpoena) y entrégueselo legalmente al
testigo.
Demandar a la persona que Io demand6. Si tiene un reclamo
contra el Demandante, y el reclamo se puede presentar en la
corte de reclamos menores, tal como se describe en este
formulario, puede presentar el formulario SC-120, Reclamo de!
demandado (Defendant's Claim) y presentarlo en este mismo
caso. Si su reclamo excede el limite permitido en la corte de
reclamos meniores, puede igualmente presentarlo en !a corte de
reclamos 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 el limite
permitido en la corte de reclamos menores y esta relacionado con
el mismo contrato, transaccién, asunto o acontecimiento que el
reclamo del Demandante, puede presentar su reclamo en la corte
apropiada y presentar una moci6n para transferir el reclamo del
Demandante a dicha corte, para poder resolver los dos reclamos
juntos. Puede ver una descripcién de los montos permitidos en el
parrafo anterior titulado “Corte de reclamos menores”.
. Aeptar el reclamo del Demandante y pagar el dinero. O, si no
puede pagar en ese momento, vaya al juicio y diga que quiere
hacer los pagos. .
+ Noir al juicio y aceptar el fallo 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
Dernandante lo que esta reclamando mas los costos de Ia corte.
En ese caso, el Demandante legalmente puede tomar su dinero,
su sueldo 0 sus bienes para cobrar el fallo.
eQué hago si necesito mas tiempo? Puede cambiar la fecha del
Juicio si:
+ No puede ira la corte en la fecha programada (tendraé que pagar
una cuota para aplazar el juicio), o .
» No le entregaron los documentos legalmente (no recibié 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 aplazamiento sin tener que pagar cuota para aplazar ef
juicio).
Preguntele al secretario de reclamos menores sobre las reglas y las
cuotas para aplazar un juicio. O Ilene ef formulario SC-150 (0 escriba
una carta) y envielo antes del plazo 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.
zNecesita ayuda? El Asesor de Reclamos Menores de su
condado le puede ayudar sin cargo.
_l
O visite www.courts.ca.gov/reclamosmenores/asesores.
* Excepelones: Existen diferentes limites en un reclame contra un garants. (Vea cl Cédigo de Procedimiento Civil, saccién 116.220 (c).)
Revised January 1, 2020
Reclamo del Demandante y ORDEN
SC-100, Page 5 of 5
Para Ir ala Corte de Reclamos Menores
(Reclamos Menores)
For your protection and privacy, please press the Clear
This Form button after you have printed the form.
[ Save this form |GSM 20-863797
Information for the defendant (the person being suéd)
“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 I 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
Trial” 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 form to your court clerk or the ADA/
Access Coordinator.
What if I don’t speak English well? Ask the court clerk
as soon as possible for a court-provided interpreter. You may use
form INT-300 or local court form to request an interpreter. If a
court interpreter is not available at the time of your trial, it may be
necessary to reschedule your trial. You cannot bring your own
interpreter for the trial unless the interpreter has been approved
by the court as a certified, registered, or provisionally qualified
interpreter. (See Cal. Rules of Court, rule 2.893, and form
INT-140.)
Where can | get the court forms I need? Go to any
courthouse or your county law library, or print forms at www.
courts.ca.gov/smallclaims/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 I lose the case?!f you lose, you may appeal. You'il
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 (judgment) on form SC-200 or form SC-130,
Notice of Entry of Judgment.
If you were not at the trial, fill 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 I 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.
* Exceptions: Different limits apply in an action against a defendant
* 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 plaintiffs 's claim to that court to resolve
both matters together. You can see a description of the amounts
allowed in the paragraph above titled “Small Claims Court.”
Agree with the plaintiff's 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 plus 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:
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.
[ “|
L
Or go to www.courts.ca.gov/smaliclaims/advisor.
who is a guarantor. (See Code Civ. Proc., § 116.220(c).)
Revised January 1, 2020
(Small
Plaintiff's Claim and ORDER to Go to Small Claims Court
SC-100, Page 4 of 5
Claims)
Preview
Plaintiff's Claim and ORDER Clerk stamps date here when form is fed. Same Y to Go to Small Claims Court Notice to the person being sued: SMALL CLAIMS * You are the Defendant if your name is listed in @ on page 2 of this sip of California form. The person suing you is the Plaintiff, listed in on page 2. on of Go Branco + You and the Plaintiff must go to court on the trial date listed below. If you NOY 02 2020 do not go to court, you may lose the case. CLE = COURT + Ifyou lose, the court can order that your wages, money, or property be By: taken to pay this claim. - epuiy Sierk + Bring witnesses, receipts, and any evidence you need to prove your case, Fill in court name and street adaress: + Read this form and all pages attached to understand the claim against ‘Superior Court of California, County of you and to protect your rights. SMALL CLAI MS Aviso al Demandado: SUPERIOR COURT : 400 McALLISTER, ROOM 103 * Usted es el Demandado si su nombre figura en@)de la pagina 2 SAN FRANCISCO, CALIFORNIA 94102 de este formulario. La persona que lo demanda es el Demandante, la que figura en@) de la pagina 2. Clerk fills in case number and case name: Case Number: * Usted y el Demandante tienen que presentarse en la corte en la fecha del “Csi 02 0 =8 637 97 juicio indicada a continuacién. Si no se presenta, puede perder el caso. Ca: : . 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, ehreltaCRCr ROMO a The people in @ and @ must go to Court: (Clerk fills out section below.) Name: * Si pierde el caso la corte podria ordenar que le quiten de su sueldo, dinero u N ON A K vs, K dA J Tria) }> Date Time Department Name and address of court if different from above Dato) FEB 25 202 |Za S0® STH Eloo le 2. Lo 3. Date: WOV 9 2020 Clerk, by VERLINDA JONES H , 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 law library, or go to: www.courts, ca, gov/smaliclaims/forms. Fill out pages 2 and 3 of this form. Then make copies of alll pages of this form. (Make 1 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 ofall 5 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, HGH Coal a Cll, wnicoutaoa gor Plaintiff's Claim and ORDER 80-100, Page Tots Cafe cul Prceauer ag tena to Go to Small Claims Court 196 220fc), 116 340(g) (Smail Claims)Plaintiff (list names): Case Number: CSM = 20-863 797 @) The Plaintiff (the person, Pusingss, or public entity that is suing) is: rele Ovalk Name:_(5 @ Phone: (4/5) 997 = YES P | State Street address: {3 273 Ulelor Sk att BRB San Tren aren CA UC/ (pe Zp Mailing address (if different): Some Street City City State Zip lf more than one Plaintiff, list next Plaintiff here: Name: WO Phone:(__) Street address: Steet Oily State Zip Mailing address (if different): Street City State Zip 0) Check here if more than 2 Plaintiffs and attach Form SC-100A. Ol Check here if either Plaintiff listed above is doing business under a fictitious name. Af so, attach Form SC-103. The Defendant (the person, busi ess, or public entity being sued) is: ti af e ay Name:_ ‘4 lan Lanye- Phone: 444 202~ q ( Os- Street address: 1260 44 ave .t 2 Ss Preise Mailing address (if different): CA 44122 State Zip ‘Street Cily State Zp If more than one Defendant, list next Defendant here: Name: Phone: ( ) Street address: Street City State Zip Mailing address (if different): ‘Street iy State Zip OD Check here ifmore than 2 Defendants and attach Form SC-100A. 0) Check here if any Defendant is on active military duty, and write his or her name here: (3) The Plaintiff claims the Defendant owes $ [ 6 ! Y 6 § . (Explain below): “to J { a. Why does the Defendant owe the Plaintiff money? Aaiwti t£ se_iunfovmatio y +o ed av accifout . Proy hev hsurann. t+ have Proof, Mow (Usuvang 0 u(~_offe red SAS, hos Sufficitut fo £ik um CAN. b. When did this happen? (Date): 6[2020 If no specific date, give the time period: Date started: @ Zp ™ ¢. How did you calculate the money owed to you? (Do not include court costs or ‘fees for service.) a Through: Coy parry gst mate KJ Check here ifyou need more space. Attach one sheet of ‘Paper or Form MC-031 and write “SC-100, Item 3” at the top. Rovised January 1, 2012 Plaintiff's Claim and ORDER to Go to Small Claims Court (Smail Claims) SC-100, Page 2 of 5 >SC-100, ITEM 3 . GSM ° 20-863 797 Fulton is a Large, 4-lane street. In the San Francisco Richmond District. 7 Two lanes are going west, and two lanes are going east. See picture 1 attached. The speed limit there is 30 mph It was rush-hour, 5 pm, quite a bit of traffic. | was driving west on the left lane About 25 miles an hour. Some traffic was behind me. Traffic going in the opposite direction was moving also. Suddenly, unsafely and quite close to me, a car (Ms. Kay) shot out of 11th Ave. right in front of my car. There is no stop sign or traffic light for Fulton at that intersection. She had a STOP SIGN on 11th Ave., and she was supposed to stop there until it was safe to enter Fulton for her left turn. But she didn’t stop and wait, she Unsafely entered the intersection and caused the accident. This is how the accident happened: | was approaching a 25 miles an hour and stepping on the brakes when she came shooting out of 11th Ave. unexpectedly. She applied her brakes and brought her car to stop right in front of my car. Because she saw that there were also cars coming on the oncoming lanes, both lanes, that are going from west to east, she didn’t want to get hit by the oncoming traffic and selected to stop right in front of my car. This is how the collision happened. In other words, Jillian Kay Decided to fully apply her brakes in front of my car and get hit by me instead of going across and getting hit with the oncoming traffic. She violated vehicle code 21802 CBC which provides a stop at intersections and yield to motorists already at the intersection. | am not a law enforcement officer, she may have violated additional vehicle codes. I took several pictures which | will bring to court. Instead of telling her STATE FARM insurance the truth, she lied to them and said that | ran a red light. There is no traffic light on Fulton and 11th Ave.! There’s only a stop sign for her to observe. | spoke with my insurance, Hartford, and submitted evidence. They quickly saw that | was 100% at fault, that Jillian Kay had entirely caused the accident. They are not paying for her damages, and they are not raising my insurance rate. | am attaching a transcript that came from my assessor at Hartford insurance. Where it is clear that Jillian Kay lied to her insurance, State Farm. ! cannot get my car fixed for $494.14, that is all that State Farm offered. The estimate is $1614.81. | talked to State Farm several times, but they are not listening to me and adjusting the payment. Therefore, | need to take this irresponsible drive her to court.Plaintiff (list names): Case Number: GS 20- 863797 @) 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? Ye If lain why not: ~ ane © She Ted to te eR uanc Chet willing be cChoanugo yey Lie t @) Why are you filing your claim at this courthouse? © This courthouse covers the area (check the one that applies): a. Bk (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. CJ 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. LC] 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. C1 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 (ifyou know): 74 (2.2. @ Is your claim about an attorney-client fee dispute? [] Yes $4No Ifyes, and if you have had arbitration, fill out form SC-101, attach it to this form, and check here: (] (8) Are you suing a public entity? [1] Yes No If yes, you must file a written claim with the entity first. [] A claim was filed on (date): If the public entity denies your claim or does not answer within the time allowed by law, you can file this form. (3) Have you filed more than 12 other small claims within the last 12 months in California? OO Yes PANo If yes, the filing fee for this case will be higher. Is your claim for more than $2,500? [1 Yes €-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 and on any attachments to this form is true [2 correct. Date: {[ 2, [2020 6abo Kel C Lowa > ~e— A Plaintiff types or prints name here Plaintiff 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, 2020 Plaintiff's Claim and ORDER to Go to Small Claims Court SC-100, Page 3 of 5 (Small Claims) >°20- 863797 GSM Informacion para el dermandado (la persona Se manciags) La “Corte de reclamos menores” es una corte especial donde se deciden casos por $10,000 o 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 reclamar 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. éNecesito un abogado? Puede hablar con un abogado antes 0 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). Como me preparo para ir a 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 lleve 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 adaptacién? Si tiene una discapacidad 0 tiene impedimentos de audicién, llene el formulario MC-410, Request for Accomodations. Entregue el formulario al secretario de la corte o al Coordinador de Acceso/ADA de su corte. éQué pasa si no hablo bien inglés? Solicite un intérprete al secretario de la corte lo mas pronto posible. Puede usar el formulario INT-300 0 un formulario de su corte local. Si no esta disponible un intérprete de la corte para su juicio, es posible que se tenga que cambiar la fecha de su juicio. No puede llevar su propio intérprete para el juicio a menos que el intérprete haya sido aprobado por la corte como un intérprete certificado, registrado, o provisionalmente calificado. (Vea la regla 2.893 de las Reglas de la Corte de California, y el formulario INT-140.) eDonde puedo obtener los formularios de la corte que necesito? Vaya a cualquier edificio de la corte, la biblioteca legal de su condado, o imprima los formularios en www.courts.ca.gov/ smallclaims/forms. (pagina esta en inglés). &Qué pasa en el juicio? El juez escuchara a ambas partes, El juez puede tomar su decision durante la audiencia o enviarsela por correo después. . zQué pasa si pierdo el caso? Si pierde, puede apelar. Tendra 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 apelaci6n (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 de! fallo (Notice of Entry of Judgment). Si no estuvo en el juicio, llene y presente el formulario SC-135, Aviso de peticién para anular el fallo y Declaracién para pedirle al juez que anule el fallo (decisién). Sila corte no le otorga un nuevo juicio, tiene 10 dias para apelar la decisién. Presente el formulario SC-140. Para obtener mas informacion sobre las apelaciones, vea www. courts.ca.gov/reclamosmenores/apelaciones, éTengo otras opciones? Si. Silo 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 desestimacion (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 0 en persona) a todas las partes. (Su carta ala corte tiene que decir que hizo la entrega.) « ral juicio 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, Ilene el formulario SC-107, Citatorio de reclamos menores (Small Claims Subpoena) y entrégueselo legalmente al testigo. Demandar a la persona que Io demand6. Si tiene un reclamo contra el Demandante, y el reclamo se puede presentar en la corte de reclamos menores, tal como se describe en este formulario, puede presentar el formulario SC-120, Reclamo de! demandado (Defendant's Claim) y presentarlo en este mismo caso. Si su reclamo excede el limite permitido en la corte de reclamos meniores, puede igualmente presentarlo en !a corte de reclamos 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 el limite permitido en la corte de reclamos menores y esta relacionado con el mismo contrato, transaccién, asunto o acontecimiento que el reclamo del Demandante, puede presentar su reclamo en la corte apropiada y presentar una moci6n para transferir el reclamo del Demandante a dicha corte, para poder resolver los dos reclamos juntos. Puede ver una descripcién de los montos permitidos en el parrafo anterior titulado “Corte de reclamos menores”. . Aeptar el reclamo del Demandante y pagar el dinero. O, si no puede pagar en ese momento, vaya al juicio y diga que quiere hacer los pagos. . + Noir al juicio y aceptar el fallo 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 Dernandante lo que esta reclamando mas los costos de Ia corte. En ese caso, el Demandante legalmente puede tomar su dinero, su sueldo 0 sus bienes para cobrar el fallo. eQué hago si necesito mas tiempo? Puede cambiar la fecha del Juicio si: + No puede ira la corte en la fecha programada (tendraé que pagar una cuota para aplazar el juicio), o . » No le entregaron los documentos legalmente (no recibié 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 aplazamiento sin tener que pagar cuota para aplazar ef juicio). Preguntele al secretario de reclamos menores sobre las reglas y las cuotas para aplazar un juicio. O Ilene ef formulario SC-150 (0 escriba una carta) y envielo antes del plazo 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. zNecesita ayuda? El Asesor de Reclamos Menores de su condado le puede ayudar sin cargo. _l O visite www.courts.ca.gov/reclamosmenores/asesores. * Excepelones: Existen diferentes limites en un reclame contra un garants. (Vea cl Cédigo de Procedimiento Civil, saccién 116.220 (c).) Revised January 1, 2020 Reclamo del Demandante y ORDEN SC-100, Page 5 of 5 Para Ir ala Corte de Reclamos Menores (Reclamos Menores) For your protection and privacy, please press the Clear This Form button after you have printed the form. [ Save this form |GSM 20-863797 Information for the defendant (the person being suéd) “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 I 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 Trial” 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 form to your court clerk or the ADA/ Access Coordinator. What if I don’t speak English well? Ask the court clerk as soon as possible for a court-provided interpreter. You may use form INT-300 or local court form to request an interpreter. If a court interpreter is not available at the time of your trial, it may be necessary to reschedule your trial. You cannot bring your own interpreter for the trial unless the interpreter has been approved by the court as a certified, registered, or provisionally qualified interpreter. (See Cal. Rules of Court, rule 2.893, and form INT-140.) Where can | get the court forms I need? Go to any courthouse or your county law library, or print forms at www. courts.ca.gov/smallclaims/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 I lose the case?!f you lose, you may appeal. You'il 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 (judgment) on form SC-200 or form SC-130, Notice of Entry of Judgment. If you were not at the trial, fill 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 I 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. * Exceptions: Different limits apply in an action against a defendant * 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 plaintiffs 's claim to that court to resolve both matters together. You can see a description of the amounts allowed in the paragraph above titled “Small Claims Court.” Agree with the plaintiff's 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 plus 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: 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. [ “| L Or go to www.courts.ca.gov/smaliclaims/advisor. who is a guarantor. (See Code Civ. Proc., § 116.220(c).) Revised January 1, 2020 (Small Plaintiff's Claim and ORDER to Go to Small Claims Court SC-100, Page 4 of 5 Claims)