Fresno — SHP-41 E06-22 Small Claims COVID-related Rent Packet

Source: https://www.fresno.courts.ca.gov/system/files/shp-41-e06-22-small-claims-covid-related-rent-packet-web.pdf

FRESNO COUNTY SUPERIOR COURT • STATE OF CALIFORNIA

PLAINTIFF’S PACKET

SMALL CLAIMS DEPARTMENT Civil Division – Fresno 1130 "O" Street, Fresno, CA 93724 559-457-1900

SHP-15 R06-22

SMALL CLAIMS COVID-19 RENTAL DEBT PACKET

PURSUANT TO THE CALFORNIA COVID-19 TENANT RELIEF ACT OF 2020 AND CODE OF CIVIL PROCEDURE (CCP) 116.223, THIS PACKET SHOULD BE UTILIZED FOR SMALL CLAIMS ACTIONS INVOLVING RENTAL DEBT WHICH OCCURRED BETWEEN March 1, 2020 AND September 30, 2021.

Please note: The law allowing COVID-19 rent to be recovered in Small Claims is in effect until October 1, 2025.

If your Small Claims action does not involve COVID-19 period rent, as described above, you may utilize the alternate small claims packet posted on the Fresno Superior Court Website.

FILING A SMALL CLAIMS ACTION

Filing the Plaintiffs Claim If the damages claimed are $1,500 or less the filing fee is $30. If the damages claimed are more than $1,500 but less than or equal to $5,000 the filing fee is $50. If the damages claimed are more than $5,000 but less than or equal to $10,000 the filing fee is $75. If you have filed more than 12 claims during the past 12 months, the filing fee is $100.00. If you are filing a claim to recover COVID-19 rent for over $10,000.00, the filing fee is $75.00.

You need to: Electronic Filing is available via https://www.fresno.courts.ca.gov/forms-filing/local-forms/online- document-help Click on Civil then Small Claims to start a claim online. File the original claim and one copy with the Clerk’s Office. No extra copy is needed if using E-File. Check Local Rule 2.8.6 for the proper venue. Claim is a six-page document. Make two copies of your claim for each named defendant. Make one copy to keep for yourself. Serving the Plaintiff’s Claim You must serve every defendant you sue by one of the following methods: Certified mail by the court. Personal service using Sheriff’s Department representatives. Using private process servers. Having a disinterested party serve the claim. (A disinterested party is anyone over the age of 18 years who is not a party to the claim.)

If you want the court to serve the defendant(s) by certified mail, you will be charged $15.00 for each defendant to be served. You must contact the court two weeks prior to the hearing date to find out if the service was successful.

If you are unable to serve the defendant(s), you must reschedule the hearing date and attempt to have the defendant(s) served in one of the other ways listed above.

If you choose to have the defendant(s) personally served, you must file a properly completed Proof of Service form with the court at least 5 days before the hearing date.

After Judgment

Suggested number of forms to copy: Writ of Execution: Original plus 4 copies Application and Order for Examination: Original plus 3 copies Abstract of Judgment: Original plus 1 copy Note: Verify that all pages of forms are copied.

Settling the Case

If your claim is settled before trial, please complete a Request for Dismissal form and file it with the court.

FSC-14 R06-22

Services) Claims remove amount Mediation Small to Small be BBB the by on than order could unless (Created or other (i.e. advice as: been 10/28/21 telephone such court person a has Revised via provides in businesses).** Fresno Advisor $10,000.00, issues, that Recovery.** for another St., PM (SCA) sued, than County. ‘O’ remotely Rental Claims dispute been 4:00 a more against etc.).

dispute been 4:00 a more against etc.).

dispute been 4:00 a more against etc.). Advisor 1130 Claims Advisor Fresno charges. ($5,000.00 AM–File Small with in have or order fence,
a 8:00 provided COVID-19 Claims Conflicts involving criminal Claims for sue, waived courtYou person court Small common Disputes to is a Courthouse, Small Help? any remove with dispute Do? and Claims want a want to Small Sisk currently Assist… WeAfter exception assist is B.F. We County who court. with www.fresnosmallclaimsadvisor.org who order dealing the Small anor

www.fresnosmallclaimsadvisor.org who order dealing the Small anor $10,000.00 Monday–Friday: 559-457-2174 Can can Checks info@fresnosmallclaimsadvisor.org in is Do procedures tree, Fresno Landlord/Tenant Bad Consumer/Merchant SCA Cannot People Claims People over People a People email. What The court • • • Whom The brought We • • • • Contact Phone: Location: Hours: Website: Email: Assistance and **ThereBefore

Available

it take for If it Inc. or do. andAre own not through to decide. of before scheduled to Foundation, your agreement, will you County be confidential what money, in needs out judge California is you and a dispute guide end the often 93711Services Fresno work mediator CA Central your will in can tell time for
of can The meets doesn’t mediation or “no.” court saves Services Fresno, you that in sides Bureau® Services resolve it say 559-228-6518No-Cost

559-228-6518No-Cost

559-228-6518No-Cost mediator mediation you businesses done take claims Lane, where the mediation Fax. Business mediator. or or not unfair, works, help If Courts. agree, is settlement small Mediation Shaw Better (English/Español) a said can does to W. the meeting skilled Instead, otherwise. offer a a BBB residents Mediation case County parties of do. mediation 2600 of Information to

https://www.bbb.org/local-bbb/bbb-serving-central- stressful. the agree project the to the 559-256-6300 a reaching Advisor Services help mediator is cost Everything less When BBB Fresno for take Claims arranging the what settlement

arranging the what settlement lot No in When days. parties The
a a by Services few still Contact Phone: Website: california-and-inland-empire-counties Location: you We? with a the Mediation? filed Mediation process involved. tell Free. Fast. Private. Fair. think Smart. can Services/Small court usually Mediation Are or Try BBB to It’s cases It’s within It’s unless It’s you It’s is you BBB Mediation proven Who The goes settlement sides a everyone Why • • • • • The BBB

sea con no Services) de orden la que de una Mediation que por casos persona de BBB corte árbol). by negocios).** en corte un ejemplo Menores la otra menos (Created para remota a en al (por Menores legales cualquier COVID-19 a remover 10/28/21 de llevar forma Revised persona para Reclamos de consejos asistir demandas $10,000.00, ($5,000.00Archive PM alquiler como: puede de Fresno da sido de otra orden de

Fresno da sido de otra orden de

Fresno da sido de otra orden de se fondos puede o St., 4:00 de… han más una Reclamos casos aQue contra Legal ‘O’ o de renunciada en tener AM proporciona civil, de Menores seaDe no Fresno 1130 se orden Casos de archivada 8:00 recuperación por Asesor una orden criminales. en demandar pequeñas. de la demandas consejos sido el Legal y para Reclamos Nosotros? cerca, casos electrónico. ha $10,000.00 de condado Asistir quieren una a www.fresnosmallclaimsadvisor.org la queDespués tienen quieren con Courthouse, Viernes asistencia demandas con cancelados del que Sisk que sobre queo pequeñas Ayudamos? menores. de 559-457-2174 correo
y Asesor Legal B.F. Lunes Web: info@fresnosmallclaimsadvisor.org excepción Hacemos

59-457-2174 correo y Asesor Legal B.F. Lunes Web: info@fresnosmallclaimsadvisor.org excepción Hacemos corte remover una Propietario/inquilinos Cheques Consumidor/comerciante Quien demanda Podemos Personas la Personas cantidad Personas de Personas Asesor consejeroAntes ¿Que El demandas • • • ¿A El una demandas No • • • • Comuníquese Teléfono: Lugar: Horas: Página Email: Actualmente, teléfono Hay renateros. Disponibles un con a Inc. y dice tiempo para del al nomás lesEstán El corte. mediación corte Página no utilizar lleguen la la a Foundation, conflictos y a hace Mediación conflictos ahorrar en confidencial injusto, que sus no corte. le de 93711 es y es California la de lados, durante demanda CAAlguno a para comerciantes acuerdo días. o resolver

comerciantes acuerdo días. o resolver

comerciantes acuerdo días.
o resolver Central Si la
a 559-228-6518
of archivados caso hablar toma manera. neutral acuerdo funciona, de unos su no Servicios el Fresno, mediación proceso llevar estánCobro Mediación otra es Fax. Bureau® la el están ayudar partidos. residentes entre el de que puedan llevar BBB lados, Lane, estresante. decide,Sin de guía Mediación? los que Business cita de el cree mediación

cita de el cree mediación

cita de el cree mediación pueden que puede no partidos
la hecho ambos toma le Shaw Better una De para o (English/Español) casos menos del antes para no usted W. convengan es para todavía con ambos Si mediador para 559-256-6300 hacer dicho cobro

Information Cuando o mediador proyecto el Servicios 2600 ProcesoServicios un hay Nosotros? Mediación https://www.bbb.org/local-bbb/bbb-serving- es Advisor personas El usted. mediador Todo partidos mediador Cuando puede acuerdo, de satisfecho Claims No Fresno las El se un los decida. por usualmente El cambio, BBB a de sea Usar de y Comuníquese Teléfono: Web: central-california-and-inland-empire-counties Lugar: Mediación Somos

por usualmente El cambio, BBB a de sea Usar de y Comuníquese Teléfono: Web: central-california-and-inland-empire-counties Lugar: Mediación Somos acuerdo. En que algún juez de cita “no.” el Services/Small Servicios un que Que Gratis. Rápido. Privado. Justo. Conveniente. hay a dinero, Servicios hacer. Es condado Es mediación, Es menos Es decisiones diga Es y no que Mediation BBB asistencia BBB ¿Quienes El la mediador llegar que acuerdo ¿Para • • • • • El BBB

TIPS FOR SMALL CLAIMS LITIGANTS

CONDUCT IN THE COURTROOM

• No food, drinks or gum are allowed in the courtroom. • Be prepared and on time. You must be present when your case is called. • Do not ask the court staff for legal advice. The staff is not allowed to give legal advice.

TRIAL PREPARATION

• The scheduled date with which you are provided is the date set for your trial. You must come to court prepared to present your case. • Bring all the exhibits you might want the court to see and consider, such as written contracts, repair estimates, photos, receipts, etc. You will be required to allow the opposing party to see and read your exhibits before your case is heard. If you have exhibits that will take time to read, you should make copies and give them to the opposing party either before the trial date or on the trial date, as soon as both parties have arrived in court. • If you have any witnesses whose testimony you need to prove your case, they should come to court on your trial date. You are solely responsible for arranging the appearance of any witnesses at your trial. Remember that this is your case, and you must present the evidence for the court to consider. • As the plaintiff in the case, you are the one requesting judgment. Be ready to answer questions the judge may ask, such as: How did you arrive at the amount of the claim? • The court may keep the exhibits you present. If you need copies of your records to retain, you should make those copies before you come to court. • If you require an Interpreter for court, submit form INT-300 Request for Interpreter Civil. This is available on the Court’s website under California State Forms.

DAY OF TRIAL

• If your name is on the calendar, when the courtroom is unlocked please take a seat in the courtroom and remain in the courtroom until roll is taken and the oath has been administered. • When roll is taken, if you are representing someone else, please advise the clerk taking the roll of that fact, and give him or her your name and correct spelling. Be sure to notify the clerk of any change of address. • If you are assigned to a courtroom where a temporary judge will be sitting, you will be asked to stipulate, on the record, that he or she may decide your case. A temporary judge is an attorney who sits by assignment of the Fresno Superior Court, has been as attorney for at least five years, and has attended a small claims judicial officer training course. Once you stipulate, any judgment issued by the temporary judge is the same as a judgment issued by an appointed judge.

FSC-24 R06-22

• After roll is taken, if you have not already done so, give the opposing party copies of your exhibits or let the opposing party see the exhibits you plan to present to the court. The opposing party must have a chance to read the exhibits before the judge sees them. You will delay the time of your trial if you do not give these copies to the opposing party ahead of time. Keep your original exhibits until your case is called. • Cases may not be called in the order listed on the posted calendar. • Mediation is highly regarded as an excellent alternative to a trial. A Better Business Bureau representative (mediator) will be at court on the day and time of your hearing to help you resolve your case. • The mediator is specially trained and impartial, he or she does not give legal advice or make decisions. The parties involved in the dispute make the decisions and the mediator and the parties work together to identify the issues that are most important for each side and then to find practical resolutions. If a settlement cannot be reached the case goes to trial that same day and a judge will decide the outcome.

AFTER TRIAL

• Once a judgment is rendered, the time to appeal the court’s decision extends for thirty (30) days. The judgment will become final after the 30-day appeal period, if an appeal is not filed. • Original exhibits may be picked up from the Small Claims Department of the Sisk Civil Courthouse at 1130 "O" Street after the judgment becomes final. A notice will be mailed by the clerk’s office with a number to call and set an appointment to pick up exhibits. • Once a judgment is issued in your case, a notice of that judgment will be mailed to you. • If your matter was taken under advisement by the temporary judge or judge hearing your case, you will be notified of his or her decision by mail. The court can take up to ninety (90) days to issue a ruling when a case is taken under advisement. Please do not call the court.

PLEASE KEEP THE COURT ADVISED IF YOUR ADDRESS CHANGES.

OTHER RESOURCES

Guide & File Form Preparation Interviews Link – Choose Civil, then Small Claims https://www.fresno.courts.ca.gov/forms-filing/local-forms/online-document-help

Small Claims Advisors 1130 O Street, Fresno, CA 93724 (559) 457-2174 Open Mon-Fri 8:00-4:00 www.fresnosmallclaimsadvisor.org Fresno, CA 93711 1221 Van Ness Ave.

FSC-24 R06-22

SC-500-INFO COVID-19 Rental Debt in Small Claims Court

Beginning November 1, 2021, a landlord has the option to How does a tenant respond? bring an action in small claims court to recover COVID-19 A tenant does not need to file any papers before the trial rental debt that is more than the normal limits for small date. Tenants should go to court on the day of trial with claims actions. The purpose of bringing these claims in evidence about the amount of COVID-19 rental debt owed, small claims court is to resolve disputes about COVID-19 if any. rental debt. The small claims court cannot determine possession of residential property or evict a tenant from What should tenant take to small claims court property. for a COVID-19 rental debt case? What is COVID-19 rental debt? Both the landlord and the tenant in a small claims action COVID-19 rental debt means any unpaid rent or any other for COVID-19 rental debt can present arguments and money owed under a residential lease or residential rental evidence about how much money they believe is owed, agreement (for example, parking fees or utility payments) how much has already been paid, and other factors that can that came due between March 1, 2020, and September affect the amount of COVID-19 rental debt that must be 30, 2021. paid. What is small claims court? The parties should bring the rental agreement, any rental Small claims court is a special court where disputes are receipts, and any other receipts or other documents that resolved quickly and inexpensively. The rules are simple show the following: and informal. You may ask a lawyer for advice before you • The amounts of COVID-19 rental debt owed go to court, but you cannot have a lawyer in court. and the dates on which each amount came due. Remember that COVID-19 rental debt means Who are the parties in a small claims case? rent and other financial obligations that came • The person who sues is the plaintiff, the landlord in due between March 1, 2020, and September these cases. If the landlord is a business, an 30, 2021. employee such as a property manager may go to a • Any amounts that the tenant paid toward small claims trial for the landlord (use form the rent or other financial obligations and the SC-109, Authorization to Appear). dates of payment. • Any other amounts of rent or other obligations • The person who is sued is the defendant, the tenant that were paid through rental assistance in these cases. There may be more than one tenant programs or other third parties on behalf of the paying rent for a single residence. The landlord may tenant. want to name all tenants as defendants. • Any evidence of conditions affecting the How does a COVID-19 rental debt case start in residence, such as items needing repair. the small claims court? • Any evidence to support arguments made to The landlord must: determine the amount of money owed. • Complete and file form SC-500, Plaintiff's Claim and Page 2 of this information sheet provides a list of some of ORDER to Go to Small Claims Court (COVID-19 the arguments that landlords and tenants can make to help Rental Debt); the court determine the amount of COVID-19 rental debt • Attach documentation showing the landlord's good- that is owed. faith efforts to seek rental assistance (examples of documentation include emails, texts, and notes from Can you bring a witness to small claims phone calls); and court? • Serve the form on the tenants (see form Both the landlord and the tenant may bring witnesses to SC-100-INFO, Information for the Plaintiff). the trial who can tell the court what they know about the COVID-19 rental debt, the condition of the home, and agreements between the landlord and the tenant about the need for repairs and payment for repairs.

Judicial Council of California, www.courts.ca.gov SC-500-INFO, Page 1 of 3New October 15, 2021, Optional Form COVID-19 Rental Debt in Small Claims Court Code of Civil Procedure, §§ 116.110 et seq., 116.223, 871.10, 1161.2.5, 1179.02; Health & Safety Code, § 50897.3

SC-500-INFO COVID-19 Rental Debt in Small Claims Court

What arguments can you make? The landlord and tenant may disagree about the amount of rent that is owed for various reasons. Read more about these reasons in the California Department of Real Estate's guide at landlordtenant.dre.ca.gov/resources/guidebook/index.html, in the "Living in the Rental Unit" and "Dealing with Problems" sections. Below are questions that can help you identify the issues that may exist in the case and may affect the amount of rent owed. Please note: This list does not include every possible argument. Other laws, including local ordinances, may affect the rights of landlords and tenants in COVID-19 rental debt cases. • Did landlord make a good-faith effort to: • Investigate whether governmental rental assistance is available to the tenant; • Seek governmental rental assistance for the tenant; or • Cooperate with the tenant's efforts to obtain rental assistance from any governmental entity or other third party under Civil Code section 1947.3(a)(3)? • Is there any pending application for rental assistance or other financial compensation from any other source corresponding to the amount claimed? • Did landlord receive rental assistance or other financial compensation from any other source corresponding to the amount claimed? • Did landlord improperly apply payments to past-due rent without the tenant's written agreement? • Does the amount claimed include service fees that were increased or not previously charged? • Does the amount claimed include late fees on rent or other financial obligations? • Did landlord improperly raise the rent? • Did tenant or a third party offer a rental payment that landlord would not accept? • If the lease or rental agreement was terminated, was the security deposit returned? Read more about the rules for security deposits at www.courts.ca.gov/selfhelp-eviction-security-deposits.htm. • Did tenant make needed repairs and properly deduct the cost from the rent? If so, did landlord gave proper credit? • Did landlord fail to provide habitable premises? This means that if the housing did not meet certain standards, the amount owed may be reduced. Note: It is illegal for a landlord to retaliate against a tenant for raising any of the above issues or any of the defenses listed on form UD-105, Answer—Unlawful Detainer. Can a tenant file a claim in the landlord's case? A tenant who is a defendant in a COVID-19 rental debt case may bring a claim against the landlord in the same case using form SC-120, Defendant’s Claim and ORDER to Go to Small Claims Court. What if you disagree with the court's decision? If you are a tenant, you may appeal the decision on a claim filed against you. More information about appeals is available in the information at the end of Plaintiff's Claim and ORDER to Go to Small Claims Court (COVID-19 Rental Debt) (form SC-500) and at www.courts.ca.gov/smallclaims/appeals. If you are the landlord, you cannot appeal a small claims decision on a claim you filed. (Note that a landlord has the option of filing a COVID-19 rental debt recovery case in general civil court [use form Complaint—Recovery of COVID -19 Rental Debt (form PLD-C-500)]. In general civil court, all parties may appeal the court's decision and all parties may be represented by lawyers.)

How much does it cost to file a case in small claims court? The amount the court charges a landlord to file a case in small claims court depends on the amount demanded and how many cases are brought by the landlord in a single year. The filing fees for small claims cases are listed on the Statewide Civil Fee Schedule, available at www.courts.ca.gov/7646.htm. There is no fee for the tenant to go to the hearing.

New October 15, 2021 COVID-19 Rental Debt in Small Claims Court SC-500-INFO, Page 2 of 3

SC-500-INFO COVID-19 Rental Debt in Small Claims Court

What if you cannot afford the filing fee? What help is available when you go to court? If you want to sue someone in small claims court and • Accommodations for disability. If you have a cannot afford to pay court fees and costs, you may not have disability and need an accommodation while you are at to pay. The court may waive all or part of those fees if you: court: Are getting public benefits; or • You can use form MC-410, Disability • Are a person with very low income; or Accommodation Request , to tell the court about • Do not haveho enough income to pay for your your needs. • household's basic needs and your court fees. • For more information about making a disability To ask the court to waive your fees in small claims court, accommodation request, see form MC-410-INFO, complete form FW-001, Request to Waive Court Fees. How to Request a Disability Accommodation for File your request with the court. Court. • Remember to submit your request to the ADA Where can you get help with a small claims Coordinator or designated person in your court. case? • Visit your court's website to find the ADA Coordinator or designated person. For help• Small Claims Advisors. Every county has a Small finding your court, go to www.courts.ca.gov/ Claims Advisor who is available to help you with your find-my-court.htm. small claims case. These services are free. To find the • Interpreters. If you do not speak English well: Small Claims Advisor in your county, go to • Ask the court clerk as soon as possible for a court- www.courts.ca.gov/selfhelp-advisors.htm. provided interpreter. • Forms and online help. You can find small claims forms • You may use form INT-300, Request for Interpreter and more information about small claims court at the (Civil), or a local court form to request an California Courts Online Self-Help Center interpreter. www.courts.ca.gov/smallclaims . You can also get forms • If no court interpreter is available at the time of your and help at your county law library or the courthouse trial, it may be necessary to reschedule your trial. nearest you. • Local court websites. Your local court may have • You cannot bring your own interpreter for the additional information and help for your small claims trial unless the interpreter has been approved by the matter. Visit your court's website for current information court as a certified, registered, or provisionally on small claims hearing procedures. For help finding your qualified interpreter. See Cal. Rules of Court, rule court, visit www.courts.ca.gov/find-my-court.htm. 2.893, and form INT-140, Temporary Use of a Noncertified or Nonregistered Spoken Language • Legal services organizations. Local organizations may Interpreter. be able to assist parties in preparing for court. Parties may Who can look at your case file? be able to find a legal service organization that serves their area at http://lawhelpca.org/. If you are sued in small claims court for nonpayment of COVID-19 rental debt, only the following people may see • Lawyers. Both parties may ask a lawyer about the case, the case file: but a lawyer may not represent either party in court at the • The parties (landlords and tenants). small claims trial. Generally, after judgment and on • A person who gives the court clerk the name of at appeal, both parties may be represented by lawyers. least one landlord and one tenant. • A person who lives in the residence for which COVID-19 rental debt is owed who shows proof of residency and gives the clerk the case number or the name of one of the parties. • A person who gets an order from the court after showing that they have good cause to see the case file.

New October 15, 2021 COVID-19 Rental Debt in Small Claims Court SC-500-INFO, Page 3 of 3

Print this form Save this form

SC-500 Plaintiff's Claim and ORDER to Go to Clerk stamps date here when form is filed. Small Claims Court (COVID-19 Rental Debt) THIS IS AN ACTION TO RECOVER COVID-19 RENTAL DEBT AS DEFINED UNDER CODE OF CIVIL PROCEDURE, § 1179.02. ACCESS TO RECORDS IN THIS CASE IS LIMITED UNDER CODE OF CIVIL PROCEDURE, § 1161.2.5. Notice to the person being sued: • You are the defendant if your name is listed in 2 of this form or on form SC-500A. The person suing you is the plaintiff, listed in 1 . • You and the plaintiff must go to court on the trial date listed below. If you do Fill in court name and street address: not go to court, you may lose the case. If you lose, the court can order that your wages, money, or property be taken to pay this claim. (Note: This Superior Court of California, County of small claims case cannot result in your eviction.) Bring witnesses, receipts, and any other 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, and read SC-500-INFO, COVID-19 Rental Debt in Small Claims Court for more information, at www.courts.ca.gov/forms. Aviso al Demandado: Court fills in case number when form is filed. Case Number:• Usted es el Demandado si su nombre figura en 2 de la página 2 de este formulario, o en el formulario SC-500A. La persona que lo demanda es el Demandante, la que figura en 1 de la página 2. Case Name: • Usted y el Demandante tienen que presentarse en la corte en la fecha del juicio indicada a continuación. Si no se presenta, puede perder el caso. Si pierde el caso, la corte podría ordenar que le quiten de su sueldo, dinero u otros bienes para pagar este reclamo. (Nota: Este caso de reclamos menores no puede resultar en un desalojo.) Lleve testigos, recibos y cualquier otra prueba que necesite para probar su caso. • Lea este formulario y todas las páginas adjuntas para entender la demanda en su contra y para proteger sus derechos, y lea SC-500-INFO, La deuda de alquiler del COVID-19 en la corte de reclamos menores para más información, en www.courts.ca.gov/forms. Order to Go to Court The people in 1 and 2 must go to court: (Clerk fills out section below.)

Date Time Department Name and address of court, if different from above Trial
1. Date
2.

3. Date: Clerk, by , 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 forms SC-500-INFO and SC-100-INFO to know your rights. Get the forms at any courthouse or county law library, or go to www.courts.ca.gov/forms. • 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’s 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. See forms SC-104 and SC-104B. • 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, www.courts.ca.gov Plaintiff's Claim and ORDER SC-500, Page 1 of 6 New November 1, 2021, Mandatory Form Code of Civil Procedure, §§ 116.110 et seq., to Go to Small Claims Court 116.223, 1161.2.5, 1179.02 (COVID-19 Rental Debt)

Plaintiff (list names): Case Number:

1 The plaintiff (the person, business, or public entity that is suing) is: Name: Phone:

Street address:
Street City State Zip
Mailing address (if different):
Street City State Zip
Email address (if available):

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):
Check here if more than two plaintiffs and attach form SC-500A.
Check here if either plaintiff listed above is doing business under a fictitious name and attach form SC-103.

2 The defendant (the person being sued) is: Name: Phone:

Street address:
Street City State Zip
Mailing address (if different):
Street City State Zip

If more than one defendant, list next defendant here:

Name: Phone:

Street address:
Street City State Zip
Mailing address (if different):
Street City State Zip

Check here if more than two defendants and attach form SC-500A.
Check here if any defendant is on active military duty and write defendant's name here:

New November 1, 2021 Plaintiff’s Claim and ORDER to Go to Small Claims Court SC-500, Page 2 of 6 (COVID-19 Rental Debt)

Plaintiff (list names): Case Number:

3 The plaintiff claims the defendant owes $ for COVID-19 rental debt (unpaid rent or other financial obligations of a tenant that came due in the period from March 1, 2020, to September 30, 2021). (Code Civ. Proc., § 1179.02.) (Explain amount below.) a. Rent. List all rent you claim defendant owes that came due in the period from March 1, 2020, to September 30, 2021. For each month you claim rent is due, include each amount due and the date it came due.

b. Other amounts of COVID-19 rental debt. List all unpaid financial obligations under the lease or rental agreement (other than rent) that you claim defendant owes and that came due during the period in (a) above. For each month you claim other financial obligations are due, include each amount, the date it came due, and what it was for (for example, parking fees or utilities included as part of the rental agreement).

Check here if you need more space. Attach one sheet of paper or form MC-031, and write “SC-500, Item 3” at the top.

4 Amounts paid or offsets. List any amounts you received from defendant, rental assistance programs, and other third parties that you have already credited, and any other amounts you have offset or credited, for rent or other financial obligations due between March 1, 2020, and September 30, 2021, that you are not claiming in item 3 above. Include each amount, when it was paid or credited, and what it was for.

Check here if you need more space. Attach one sheet of paper or form MC-031, and write “SC-500, Item 4” at the top.

5 You must ask the defendant (in person, in writing, or by phone) to pay you before you sue. Have you done this? Yes No If no, explain why not:

New November 1, 2021 Plaintiff’s Claim and ORDER to Go to Small Claims Court SC-500, Page 3 of 6 (COVID-19 Rental Debt)

Plaintiff (list names): Case Number:

6 Why are you filing your claim at this courthouse? This courthouse covers the area (check one that applies): a. Where the defendant lives or does business. b. Where the rental agreement, lease, or contract (written or spoken) was made, signed, performed, or broken by the defendant or where the defendant lived or did business when the defendant made the contract. c. Other (specify): 7 List the zip code of the place checked in 6 above (if you know it):

8 Have you filed more than 12 other small claims within the last 12 months in California? Yes No If yes, the filing fee for this case will be higher. 9 Plaintiff must make a good-faith effort to help defendant obtain rental assistance before filing this case. Check all that apply below. You must also attach documentation of those efforts or, if you do not have documentation, describe your effort below. Plaintiff made a good-faith effort to help defendant obtain rental assistance before filing this case, as required under Code of Civil Procedure section 871.10(a), by: a. Investigating whether governmental rental assistance is available to the tenant; b. Seeking governmental rental assistance for the tenant; or c. Cooperating with the tenant's efforts to obtain rental assistance from any governmental entity or other third party. Check here if documentation is attached. If not attached, describe your efforts below.

10 I understand that the court cannot issue a judgment for me if I have received rental assistance for the amounts I am claiming from defendant. (Both statements must be true.) a. I have not received rental assistance or other financial compensation from any other source corresponding to any of the amount claimed in item 3 above; and b. I do not have any application pending for rental assistance or other financial compensation from any other source corresponding to any of the amount claimed in item 3 above.

11 I understand that by filing a claim in small claims court, I have no right to appeal this claim. I 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. Date: 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. For these and other accommodations, contact the clerk’s office for Disability Accommodation Request (form MC-410). (Civ. Code, § 54.8.)

New November 1, 2021 Plaintiff’s Claim and ORDER to Go to Small Claims Court SC-500, Page 4 of 6 (COVID-19 Rental Debt)

SC-500 Information for the defendant (the person being sued)

"Small claims court" is a special court where generally only • Prove this is the wrong court. Send a letter to the court claims for $10,000 or less are decided. This limitation has been before your trial explaining why you think this is the wrong court. lifted for cases for recovery of COVID-19 rental debt.* The process Ask the court to dismiss the claim. You must serve (give) a copy is quick and cheap. The rules are simple and informal. You are the of your letter (by mail or in person) to all parties. (Your letter to defendant—the person being sued. The person who is suing you the court must say you have done so.) is the plaintiff. • Go to the trial and try to win your case. Bring Do I need a lawyer? You may talk to a lawyer before or after witnesses, receipts, and any evidence you need to prove your the case. But you may not have a lawyer represent you in court case. To have the court order a witness to go to the trial, fill out (unless this is an appeal from a small claims case). form SC-107, Small Claims Subpoena and Declaration and have it served on the witness.How do I get ready for court? Read form SC-500-INFO, COVID-19 Rental Debt in Small Claims Court. You don’t have to • Sue the person who is suing you. If you have a claim file any papers before your trial, unless you think this is the wrong against the plaintiff, and the claim is for $10,000 or less, you court for your case. But bring to your trial any witnesses, receipts, may file Defendant's Claim and ORDER to Go to Small Claims and evidence that support your case. And read “Be Prepared for Court (form SC-120 ) and bring the claim in this action. If your Your Trial” at www.courts.ca.gov/smallclaims/prepare. 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 Where can I get the court forms I need? Go to any small claims value amount, or you may file a claim for the full courthouse or your county law library, or get forms at value of the claim in the appropriate court. If your claim is for www.courts.ca.gov/forms. more than allowed in small claims court and relates to the same What if I need an accommodation? If you have a contract, transaction, matter, or event that is the subject of the disability or are hearing impaired, fill out form MC-410, Disability plaintiff's claim, you may file your claim in the appropriate court Accommodation Request. Give the form to your court clerk or the and file a motion to transfer the plaintiff's claim to that court to ADA/Access Coordinator. resolve both matters together. You can see a description of the What if I don’t speak English well? Ask the court clerk amounts allowed in the paragraph above, titled “Small Claims Court.”as soon as possible for a court-provided interpreter. You may use form INT-300, Request for Interpreter (Civil) , or a local court form • Agree with the plaintiff's claim and pay the to request an interpreter. If a court interpreter is unavailable for money. Or, if you can’t pay the money now, go to your trial your trial, it may be necessary to reschedule your trial. You cannot and say you want to make payments. bring your own interpreter for the trial unless the interpreter has been approved by the court as a certified, registered, or • Let the case "default." If you don’t settle and do not go to provisionally qualified interpreter. (See Cal. Rules of Court, rule the trial (default), the judge may give the plaintiff what he or she 2.893, and form INT-140.) is asking for plus court costs. If this happens, the plaintiff can legally take your money, wages, and property to pay theWhat happens at the trial? The judge will listen to both judgment. (But not your rental unit; this is not an eviction case.) sides. The judge may make a decision at your trial or mail the decision to you later. What if I need more time? What if I lose the case? If you lose, you may appeal. You’ll You can change the trial date if: have to pay a fee. (Plaintiffs cannot appeal their own claims.) • You cannot go to court on the scheduled date (you will have to pay a fee to postpone the trial), or• 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 • 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 judge's decision (judgment) on form SC-200 or form SC-130, county). Notice of Entry of Judgment. Ask the Small Claims Clerk about the rules and fees for• 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 postponing a trial. Or fill out form SC-150 (or write a letter) and

y of Judgment. Ask the Small Claims Clerk about the rules and fees for• 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 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 cancel the judgment (decision). If the judge does not give you a papers before the deadline. Enclose a check for your court fees, new trial, you have 10 days to appeal the decision. File form unless a fee waiver was granted. SC-140. For more information on appeals, see www.courts.ca.gov/ Need help? smallclaims/appeals. Your county’s Small Claims Advisor can help for free. ? 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 before the trial, the plaintiff must file form CIV-110, Request for Dismissal or a written and signed settlement agreement with the clerk. Ask the Small Claims Advisor for help. Or go to www.courts.ca.gov/smallclaims/advisor.

*Limits do not apply in an action to recover COVID-19 rental debt, which is unpaid rent or other financial obligations of a tenant that are due between March 1, 2020, and Sept. 30, 2021. (See Code Civ. Proc., §§ 116.223 & 1179.02.) Read SC-500-INFO, COVID-19 Rental Debt in Small Claims Court. New November 1, 2021 Plaintiff’s Claim and ORDER to Go to Small Claims Court SC-500, Page 5 of 6 (COVID-19 Rental Debt)

SC-500 Información para el demandado (la persona demandada)

La “Corte de reclamos menores” es una corte especial donde • Probar que es la corte equivocada. Envíe una carta a la corte generalmente se deciden casos por $10,000 o menos. Se suspendió antes del juicio explicando por qué cree que es la corte este límite para acciones para reclamar una deuda de alquiler del equivocada. Pídale a la corte que despida el reclamo.Tiene que COVID-19.* El proceso es rápido y económico. Las reglas son entregar (dar) una copia de su carta (por correo o en persona) a sencillas e informales. Usted es el Demandado—la persona que se todas las partes. (Su carta a la corte tiene que decir que hizo la está demandando. La persona que lo está demandando es el entrega.) Demandante. • Ir al juicio y tratar de ganar el caso. Lleve testigos, recibos y ¿Necesito un abogado? Puede hablar con un abogado antes o cualquier prueba que necesite para probar su caso. Si desea que después del caso. Pero no puede tener a un abogado que lo la corte emita una orden de comparecencia para que los testigos represente ante la corte (a menos que se trate de una apelación de un vayan al juicio, llene el formulario SC-107, Citatorio de reclamos caso de reclamos menores). menores (Small Claims Subpoena) y entrégueselo legalmente al ¿Cómo me preparo para ir a la corte? Lea el formulario SC-500- testigo. INFO, La deuda de alquiler del COVID-19 en la corte de reclamos • Demandar a la persona que lo demandó. Si tiene un reclamo menores. No tiene que presentar ningún documento antes del juicio, a contra el Demandante, y el reclamo se puede presentar en la menos que piense que ésta es la corte equivocada para su caso. Pero corte de reclamos menores, tal como se describe en este lleve al juicio los testigos, recibos y pruebas que apoyan su caso. Y formulario, puede presentar el formulario SC-120, Reclamo del lea “Esté preparado para su juicio” en www.courts.ca.gov/ demandado (Defendant’s Claim) y presentarlo en este mismo reclamosmenores/preparese. caso. Si su reclamo excede el límite permitido en la corte de reclamos menores, puede igualmente presentarlo en la corte de¿Dónde puedo obtener los formularios de la corte que necesito? reclamos menores si está dispuesto a limitar su reclamo alVaya a cualquier edificio de la corte, la biblioteca legal de su condado, máximo permitido, o puede presentar un reclamo por el montoo imprima los formularios en www.courts.ca.gov/smallclaims/forms total en la corte apropiada. Si su reclamo excede el límite(página está en inglés). permitido en la corte de reclamos menores y está relacionado con ¿Qué hago si necesito una modificación? Si tiene una el mismo contrato, transacción, asunto o acontecimiento que el discapacidad o tiene impedimentos de audición, puede llenar el reclamo del Demandante, puede presentar su reclamo en la corte formulario MC-410, Solicitud de modificaciones para discapacidad. apropiada y presentar una moción para transferir el reclamo del Entregue el formulario al secretario de la corte o al Coordinador de Demandante a dicha corte, para poder resolver los dos reclamos Acceso/ADA de su corte. juntos. Puede ver una descripción de los montos permitidos en el ¿Qué pasa si no hablo bien inglés? Solicite un intérprete al párrafo anterior titulado “Corte de reclamos menores”. secretario de la corte lo más pronto posible. Puede usar el formulario • Aceptar el reclamo del Demandante y pagar el dinero. O, si no INT-300 o un formulario de su corte local. Si no está disponible un puede pagar en ese momento, vaya al juicio y diga que quiere intérprete de la corte para su juicio, es posible que se tenga que hacer los pagos a plazos. cambiar la fecha de su juicio. No puede llevar su propio intérprete • No ir al juicio y aceptar el fallo por falta de comparecencia. Sipara el juicio a menos que el intérprete haya sido aprobado por la no llega a un acuerdo con el Demandante y no va al juicio (fallo corte como un intérprete certificado, registrado, o provisionalmente por falta de comparecencia), el juez le puede otorgar al calificado. (Vea la regla 2.893 de las Reglas de la Corte de California, Demandante lo que está reclamando más los costos de la corte. y el formulario INT-140.) En ese caso, el Demandante legalmente puede tomar su dinero, ¿Qué pasa en el juicio? El juez escuchará a ambas partes. El juez su suel

a regla 2.893 de las Reglas de la Corte de California, Demandante lo que está reclamando más los costos de la corte. y el formulario INT-140.) En ese caso, el Demandante legalmente puede tomar su dinero, ¿Qué pasa en el juicio? El juez escuchará a ambas partes. El juez su sueldo o sus bienes para cobrar el fallo. (Pero no su hogar puede tomar su decisión durante la audiencia o enviársela por correo alquilado; esto no es un caso de desalojo.) después. ¿Qué hago si necesito más tiempo? Puede cambiar la fecha del ¿Qué pasa si pierdo el caso? Si pierde, puede apelar. Tendrá que juicio si: pagar una cuota. (El Demandante no puede apelar su propio reclamo.) • No puede ir a la corte en la fecha programada (tendrá que pagar • Si estuvo presente en el juicio, llene el formulario SC-140, Aviso de una cuota para aplazar el juicio), o apelación (Notice of Appeal). Tiene que presentarlo dentro de 30 • No le entregaron los documentos legalmente (no recibió la orden días después de que el secretario le entregue o envíe la decisión para ir a la corte) por lo menos 15 días antes del juicio (o 20 días (fallo) del juez en el formulario SC-200 o SC-130, Aviso de si vive fuera del condado). publicación del fallo (Notice of Entry of Judgment). Pregúntele al secretario de reclamos menores sobre las reglas y las • Si no estuvo en el juicio, llene y presente el formulario SC-135, cuotas para aplazar un juicio. O llene el formulario SC-150 (o escriba Aviso de petición para anular el fallo y Declaración para pedirle al una carta) y envíelo antes del plazo a la corte y a todas las otras juez que anule el fallo (decisión). Si la corte no le otorga un nuevo personas que figuran en sus papeles de la corte. Adjunte un cheque juicio, tiene 10 días para apelar la decisión. Presente el formulario para pagar los costos de la corte, a menos que le hayan dado una SC-140. exención. Para obtener más información sobre las apelaciones, vea ? ¿Necesitacondado le ayuda?puede ayudarEl Asesorsin cargo.de Reclamos Menores de suwww.courts.ca.gov/reclamosmenores/apelaciones. ¿Tengo otras opciones? Sí. Si lo están demandando, puede: • Resolver su caso antes del juicio. Si usted y el Demandante se ponen de acuerdo en cómo resolver el caso antes del juicio, el Demandante tiene que presentar el formulario CIV-110 Solicitud de desestimación (Request for Dismissal) o un acuerdo de resolución O visite www.courts.ca.gov/reclamosmenores/asesores. escrito y firmado al secretario de la corte. Pídale al Asesor de Reclamos Menores que lo ayude. *Los límites no se aplican a las acciones para reclamar una deuda de alquiler del COVID-19, que se define como alquiler u otras obligaciones financieras impagas de un inquilino que vencieron entre el 1 de marzo de 2020 y el 30 de septiembre de 2021. (Vea el Código de Procedimiento Civil, secciones 116.223 y 1179.02.) Lea el formulario SC-500-INFO, La deuda de alquiler del COVID-19 en la corte de reclamos menores. New November 1, 2021 Reclamo del Demandante y ORDEN Para Ir a la Corte de SC-500, Page 6 of 6 Reclamos Menores (COVID-19 Rental Debt)

For your protection and privacy, please press the Clear This Form button after you have printed the form. Print this form Save this form Clear this form

Other Plaintiffs or Defendants Case Number: SC-500A (COVID-19 Rental Debt)

This form is attached to form SC-500, item 1 or 2.

1 If more than two plaintiffs (person, business, or entity suing), list their information below: Other plaintiff’s name: Phone: Street address: Street City State Zip Mailing address (if different): Street City State Zip Email address (if available): Is this plaintiff doing business under a fictitious name? Yes No If yes, attach form SC-103. Other plaintiff’s name: Phone: Street address: Street City State Zip Mailing address (if different): Street City State Zip Email address (if available): Is this plaintiff doing business under a fictitious name? Yes No If yes, attach form SC-103. Check here if more than four plaintiffs and fill out and attach another form SC-500A.

2 If more than two defendants (person being sued), list their information below: Other defendant’s name: Phone: Street address: Street City State Zip Mailing address (if different): Street City State Zip

Other defendant’s name: Phone:
Street address:
Street City State Zip
Mailing address (if different):
Street City State Zip
Check here if your case is against more than four defendants and fill out and attach another form SC-500A.

3 I understand that by filing a claim in small claims court, I have no right to appeal this claim.

I 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.

Date:

Type or print your name Sign your name

Date:

Type or print your name Sign your name

Judicial Council of California, www.courts.ca.gov Other Plaintiffs or Defendants SC-500A, Page ofAdopted November 1, 2021, Mandatory Form Code of Civil Procedure, § 116.223 et seq. (COVID-19 Rental Debt)

For your protection and privacy, please press the Clear This Form button after you have printed the form. Print this form Save this form Clear this form

SC-103 Fictitious Business Name Case Number:

This form is attached to: Form SC-100 Form SC-120 Form SC-500

1 If you want to file a small claim and you are doing business under a fictitious name (“doing business as,” or “dba”) give the following information. (Nonprofits and exempt real estate investment trusts do not have to file this form.) Business name of the person suing: Business address (not a U.S. Postal Service P.O. Box): Mailing address (if different):

2 The business listed in 1 does business as (check ONLY one): an individual a corporation an association a limited liability company a partnership other (specify): You must follow the laws for fictitious business names. If you have not followed these laws, including filing a fictitious business name statement in your county and publishing this information in a local newspaper, the court can dismiss your case.

3 Name of county where you filed your Fictitious Business Name Statement (dba):

4 Your Fictitious Business Name Statement number:

5 Date your Fictitious Business Name Statement expires:

6 I declare under penalty of perjury under the laws of the State of California that the information above is true and correct. Only the owner, president, chief executive officer (CEO), or other qualified officer can sign this form.

Date:

Type or print your name and title Sign your name

Need help? ? Your county’s Small Claims Advisor can help for free.

Or go to “County-Specific Court Information” at
www.courts.ca.gov/selfhelp-smallclaims

Judicial Council of California, www.courts.ca.gov Rev. November 1, 2021, Optional Form Fictitious Business Name SC-103, Page 1 of 1 Code of Civil Procedure, § 116.430 Business and Professions Code, § 17900 et seq. (Small Claims) For your protection and privacy, please press the Clear This Form button after you have printed the form. Print this form Save this form Clear this form

CIV-110 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY

TELEPHONE NO.: FAX NO. (Optional):

E-MAIL ADDRESS (Optional):

ATTORNEY FOR (Name):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF

STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PLAINTIFF/PETITIONER:

DEFENDANT/RESPONDENT:

REQUEST FOR DISMISSAL CASE NUMBER:

A conformed copy will not be returned by the clerk unless a method of return is provided with the document.

This form may not be used for dismissal of a derivative action or a class action or of any party or cause of action in a class action. (Cal. Rules of Court, rules 3.760 and 3.770.)

1. TO THE CLERK: Please dismiss this action as follows: a. (1) With prejudice (2) Without prejudice b. (1) Complaint (2) Petition (3) Cross-complaint filed by (name): on (date): (4) Cross-complaint filed by (name): on (date): (5) Entire action of all parties and all causes of action (6) Other (specify):*

2. (Complete in all cases except family law cases.) The court did did not waive court fees and costs for a party in this case. (This information may be obtained from the clerk. If court fees and costs were waived, the declaration on the back of this form must be completed). Date: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (TYPE OR PRINT NAME OF ATTORNEY PARTY WITHOUT ATTORNEY) (SIGNATURE) *If dismissal requested is of specified parties only of specified causes of action Attorney or party without attorney for: only, or of specified cross-complaints only, so state and identify the parties, Plaintiff/Petitioner Defendant/Respondentcauses of action, or cross-complaints to be dismissed. Cross Complainant

3. TO THE CLERK: Consent to the above dismissal is hereby given.** Date:

(TYPE OR PRINT NAME OF ATTORNEY PARTY WITHOUT ATTORNEY) (SIGNATURE)

** If a cross-complaint – or Response (Family Law) seeking affirmative Attorney or party without attorney for: relief – is on file, the attorney for cross-complainant (respondent) must sign this consent if required by Code of Civil Procedure section 581 (i) Plaintiff/Petitioner Defendant/Respondent or (j). Cross Complainant

(To be completed by clerk) 4. Dismissal entered as requested on (date):

5 Dismissal entered on (date): as to only (name):

6. Dismissal not entered as requested for the following reasons (specify):

7. a. Attorney or party without attorney notified on (date): b. Attorney or party without attorney not notified. Filing party failed to provide a copy to be conformed means to return conformed copy Clerk, by , Deputy Date:

Form Adopted for Mandatory Use Code of Civil Procedure, § 581 et seq.; Judicial Council of California REQUEST FOR DISMISSAL Gov. Code, § 68637(c); Cal. Rules of Court, rule 3.1390 CIV-110 [Rev. Jan. 1, 2013] www.courts.ca.gov

CIV-110 PLAINTIFF/PETITIONER: CASE NUMBER: DEFENDANT/RESPONDENT:

COURT'S RECOVERY OF WAIVED COURT FEES AND COSTS If a party whose court fees and costs were initially waived has recovered or will recover $10,000 or

more in value by way of settlement, compromise, arbitration award, mediation settlement, or other means, the court has a statutory lien on that recovery. The court may refuse to dismiss the case until the lien is satisfied. (Gov. Code, § 68637.)

Declaration Concerning Waived Court Fees

1. The court waived court fees and costs in this action for (name):

2. The person named in item 1 is (check one below): a. not recovering anything of value by this action. b. recovering less than $10,000 in value by this action. c. recovering $10,000 or more in value by this action. (If item 2c is checked, item 3 must be completed.)

3. All court fees and court costs that were waived in this action have been paid to the court (check one): Yes No

I declare under penalty of perjury under the laws of the State of California that the information above is true and correct.

Date:

(TYPE OR PRINT NAME OF ATTORNEY PARTY MAKING DECLARATION) (SIGNATURE)

CIV-110 [Rev. January 1, 2013] REQUEST FOR DISMISSAL Page 2 of 2

SC-104B What Is “Proof of Service”? What is “service”? How is personal service done? “Service” or “serving” is when someone—not you or Ask someone who is at least 18 and not listed in this anyone else listed in this case—gives a copy of your case to personally “serve” (give) a copy of your court court papers to the person, business, or public entity you papers to the person or the agent authorized to accept are suing. Service lets the other party know: court papers for the person, business, or public entity listed on form SC-104.• What you are asking for; • When and where the trial will be; and Give the server a separate Proof of Service form for each • What the party can choose to do. person, business, or public entity you are suing. And tell the server to: There are strict rules for serving court papers. This form • Walk up to the person to be served. explains how to serve these forms: • Say, “These are court papers.” • Form SC-100, Plaintiff’s Claim • Give the person copies of all papers checked on • Form SC-120, Defendant’s Claim form SC-104, Proof of Service. If the person won’t• Form SC-500, Plaintiff's Claim (COVID-19 Rental Debt) take the papers, just leave them near the person. How is service done? It doesn’t matter if the person tears them up. This form tells you how to serve by personal service or • Fill out and sign page 2 of form SC-104, Proof of substituted service. Service. Personal service means someone gives the papers How is substituted service done? directly to the person being sued or to the agent If you don’t want to use personal service or can’t find authorized to accept service (business or public entity). the person to be served, ask someone who is at least 18 and not listed in this case to serve the court papers.Substituted service means someone gives the papers to Give the server a separate Proof of Service form for eachan adult where the person lives, works, or receives mail person, business, or public entity you are suing. Tell the(including a private post office box, but not a U.S. Postal server to give the papers to:Service P.O. Box). • A competent adult (at least 18) at the home of and What if the court papers do not get served? living with the person to be served or The judge cannot hear your case unless the court papers • An adult who seems to be in charge where the person were served correctly. to be served usually works or • An adult who seems to be in charge where the personCan the court serve the papers for me? receives mail (including a private mailbox, but not a Yes. You can pay the court to mail your claim to the U.S. Postal Service P.O. Box). Note: This is only for person you are suing. But if the person you are suing or cases where the physical address of the person to be the person’s agent for service doesn’t sign the U.S. served is not known. Postal Service mail receipt with his or her complete Then do the following: name, or if someone else signs the receipt, you will have to serve again using personal or substituted service. • Write down that person’s name and say, “Please give these court papers to [name of person to be served].” Who can serve? If the person does not want to give his or her name, You can ask a friend, a process server, or the sheriff. describe the person you served. The server must be at least 18 and not listed in the case. • Give that person copies of all papers checked on form A “process server” is someone you pay to deliver court SC-104, Proof of Service. If the person won’t take the forms. Look in the Yellow Pages under “Process papers, just leave them near the person. Serving.” The sheriff (or marshal if your county has • Mail another copy of the papers (by first-class mail) one) can also deliver court forms. Ask the court clerk to the person being sued at the same address where how to contact the sheriff. Or look in the county section you left the papers. of your phone book under “Sheriff.” You must pay the • Fill out and sign page 2 of form SC-104, Proof of server, unless you qualify for a fee waiver. Service.

Judicial Council of California, www.courts.ca.gov What Is “Proof of Service”? SC-104B, Page 1 of 2 1, 2021Rev. November (Small Claims)

SC-104B What Is “Proof of Service”?

What does the server do with the original For personal or substituted service, subtract 5 days from Proof of Service form? the trial date. That’s the deadline for serving your small claims forms if you were served at least 11 days before theIf a process server or sheriff served the papers, he or she trial. If you were served 10 days or less before the trialcan file form SC-104, Proof of Service, with the clerk. date, you must serve at least 1 day before the trial. But youIf the server used a different Proof of Service form, ask can serve the forms before the deadline.him or her to list each paper served on the form. Also make sure that the registered server will file the original What if I can’t get the court papers served directly with the court and will mail you a copy of the before the trial? filed form. Take it with you when you go to court. If you were not able to serve your claim (form SC-100, If a friend served the papers, tell him or her to give the SC-120, or SC-500) before the deadline for service, talk to completed form back to you. Keep a copy for your records your Small Claims Clerk. Each county has its own rules. and take the copy with you when you go to court. If you already served your claim on some parties but not everyone you are suing, you may need to fill out and fileYou need to file the original completed Proof of Service form 5 days before your trial. form SC-150, Request to Postpone Trial, at least 10 days before the trial date (or explain why you couldn't meet the When do the court forms have to be served? 10-day deadline). Then give or mail a copy of this form to • If you are serving form SC-100, Plaintiff’s Claim, all other plaintiffs and defendants listed on your court or form SC-500, Plaintiff’s Claim (COVID-19 papers. Rental Debt), look at the trial date on page 1. Then, The court may postpone your trial for 15 days or more. look at a calendar. For personal service, subtract 15 days from the trial date Who do I have to serve? (or 20 days if the person, business, or public If you are suing a person (or people)—not a business or entity is located outside the county). That’s the public entity—serve each person you are suing. For deadline for serving your small claims forms. But example, if you were in a car accident and you are suing you can serve the forms before the deadline. the owner and the driver of the car, you must list the names of the owner and the driver on your claim and The people in 1 and 2 must go to court serve both people. Examples: Date Time Trial If the owner and driver are the same person: Date 1. Lee Smith, owner and driver If the owner and driver are not the same person: Lee Smith, owner and driver Bob Smith, owner For substituted service, subtract 25 days from the date If you are suing a business, an association, or a public the server mailed a copy of the court papers served (or entity, read form SC-104C, How to Serve a Business. 30 days if the person, business, or public entity is located outside the county). That’s the deadline for Need help? serving your small claims forms. But you can serve the ? forms before the deadline. Your county’s Small Claims Advisor can help for free. If the person, business, or public entity to be served is outside California or if you are serving a different form, ask the Small Claims Advisor for more information. • If you are serving form SC-120, Defendant’s Claim, Or go to “County-Specific Court Information” at look at the trial date on page 1. Then look at a calendar. www.courts.ca.gov/selfhelp-smallclaims.htm

Rev. November 1, 2021 What Is “Proof of Service”? SC-104B, Page 2 of 2 (Small Claims) For your protection and privacy, please press the Clear This Form button after you have printed the form. Print this form Save this form Clear this form

To serve a public entity, see page 2. SC-104C How to Serve a Business or Public Entity (Small Claims)

You must serve the right person and write the exact name of the business and the person to be served. Use this form to make sure you serve correctly, and follow the instructions on Proof of Service, form SC-104.

Business Type: Sole Partnership Landlord Corporation, Limited Liability Company (LLC), Unknown Proprietorship Association Limited Liability Partnership (LLP), Business Type (Only 1 owner) Limited Partnership (LP) Serve: The owner If you are suing a The property owner or Agent for service listed with Agent for service listed with Someone who partnership, serve one manager (Read Civil Secretary of State or any Secretary of State seems to be in of the partners. Code sections 1962– corporate officer (president, charge of the 1962.7.) vice-president, secretary, To serve a limited partnership, you business during If you are suing a treasurer), chief executive can also serve the general partner. normal business partnership and the officer (CEO), controller, chief hours partners, serve each financial officer, or general partner. manager

Write on your • Business name • Partnership name • Business name (if • Corporation name • Company or partnership name • Business name,
Proof of • Owner's name and • Name of partner, there is one) • Name of corporate officer • Name of agent or partner for form unknown
Service form: job title general manager, or • Owner's name or agent for service and job service and job title • Owner's name
agent for service and and job title title and job title (if
job title you know it)

Check that you • County Clerk–Recorder's or County Tax County Tax Collector Search under Corporation, LP and LLC at the California Secretary Try the other have the exact Assessor's Office (Ask to see the fictitious of State website: businesssearch.sos.ca.gov/ resources listed on names of the business name statement.) Your county's Or call:1-916-657-5448 this page to see if owner and Web site may have this information. OR they know more business with: Check: www.csac.counties.org. County Clerk–Recorder's Office: (Ask to see the fictitious business about the name statement.) Your county's website may have this information. business's • City Clerk's Office (Ask to see the OR organization type, business license.) Your city's website may City Clerk's Office: (Ask to see the business license.) Your city's like corporation or have this information. website may have this information. sole proprietorship.

Need help? For free help, contact your county’s Small Claims Advisor:? [space for local info here]

Or, go to "County-Specific Court Information" at: www.courts.ca.gov/selfhelp/smallclaims

Judicial Council of California, www.courts.ca.gov How to Serve a Business or Public Entity SC-104C, Page 1 of 2Revised July 1, 2017 (Small Claims)

To serve a business, see page 1. SC-104C How to Serve a Business or Public Entity (Small Claims)

You must serve the right person and write the exact name of the public agency and the person to be served. Use this form to make sure you serve correctly, and follow the instructions on Proof of Service, form SC-104.

City, County, or Public Entity State of California, Federal Agency
State Agency

Serve: City or county clerk, chief officer or director of public agency, Use this general address for service: You cannot sue a federal agency
or agent authorized to accept service Office of the Attorney General in small claims court.
1300 I Street
Sacramento, CA 95814

Exception: if your claim involves California Department of
Transportation (Caltrans), serve it at:
California Department of Transportation
1120 N Street
Sacramento, CA 95814
Important! Note:
Before you sue, you must first file a claim with the public Before you sue, you must first file a claim with the state or
entity. Contact it and ask for the claim procedures. the state agency. To file a claim, see:
www.dgs.ca.gov/orim/Programs/
GovernmentClaims.aspx or call: 1-800-955-0045
Write on your • Name of city, county, or public entity • Name of the agency you are suing
Proof of • Name of city clerk, county clerk, chief officer, or agent for • Name of agent for service
Service form: service and job title

Check that you Call the city or county clerk. See the government pages of Call the agency to confirm the name and address for have the exact your phone book. service. Use the State Directory: names of the 1-800-807-6755 owner and Or search under the California Roster at the California Or search: cold.ca.gov under "agency information" business with: Secretary of State website: www.sos.ca.gov/administration/california-roster/

Need help? For free help, contact your county’s Small Claims Advisor:? [space for local info here]

Or, go to "County-Specific Court Information" at: www.courts.ca.gov/selfhelp/smallclaims

Revised July 1, 2017 How to Serve a Business or Public Entity SC-104C, Page 2 of 2 (Small Claims)

For your protection and privacy, please press the Clear
This Form button after you have printed the form. Print this form Save this form Clear this form

SC-104 Proof of Service Clerk stamps date here when form is filed. Use this form to serve a person, a business, or a public entity. To learn more about proof of service, read What Is "Proof of Service"?, Form SC-104B. To learn more about how to serve a business or entity, read How to Serve a Business or Public Entity, Form SC-104C. To serve a business, you must serve one of the following people: • Owner (for a sole proprietorship) • Partner (for a partnership) or general partner (for a limited partnership) • Any officer or general manager (corporation or association) • Any person authorized for service by the business (corporation, association, general partnership, limited partnership) Fill in court name and street address: • Any person authorized for service with the Secretary of State (corporation, Superior Court of California, County of association, limited liability company [LLC], limited liability partnership [LLP], limited partnership) To serve a public entity, you must first file a claim with that entity, then serve one of the following people: • Clerk (of a city or county) • Chief officer or director (of a public agency) Fill in case number, case name, hearing date, day, time, and department below: • Any person authorized for service by the entity Case Number: 1 a. If you are serving a person, write the person’s name below:

Case Name:

b. If you are serving a business or entity, write the name of the business or entity, the person authorized for service, and that person’s job title:

Hearing Date:

Business or Agency Name

Time: Dept.: Person Authorized for Service Job Title 2 Instructions to Server: You must be at least 18 years old and not be named in this case. Follow these steps: • Give a copy of all the documents checked in 3 to the person in 1 , or • Give a copy of all the documents checked in 3 to one of the following people: a. A competent adult (at least 18) living with, and at the home of the person in 1 , or b. An adult (at least 18) who seems to be in charge at the usual workplace of the person in 1 , or c. An adult (at least 18) who seems to be in charge where the person in 1 usually receives mail (but not a U.S. Post Office box), if there is no known physical address for the person in 1 . and mail a copy of the documents left with one of the adults in a, b, or c above to the person in 1 . THEN • Complete and sign this form, and • Give or mail your completed form to the person who asked you to serve these court papers, in time for the form to be filed with the court at least 5 days before the hearing. 3 I served the person in 1 a copy of the documents checked below: a. SC-100, Plaintiff’s Claim and ORDER to Go to Small Claims Court b. SC-120, Defendant’s Claim and ORDER to Go to Small Claims Court c. Order for examination (This form must be personally served. Check the form that was served): Note: The court can issue a civil arrest warrant if the served party does not come to court only if the order for examination was personally served by a registered process server, sheriff, marshal, or someone appointed by the court. (1) SC-134, Application and Order to Produce Statement of Assets and to Appear for Examination (2) AT-138/EJ-125, Application and Order for Appearance and Examination d. Other (specify):

Judicial Council of California, www.courtinfo.ca.gov Revised January 1, 2009, Optional Form Proof of Service SC-104, Page 1 of 2 Code of Civil Procedure, §§ 116.340, 415.10, 415.20 (Small Claims)

Case Number:

Case name:

4 Fill out “a” or “b” below: a. Personal Service: I personally gave copies of the documents checked in 3 to the person in 1 : On (date): At (time): a.m. p.m. At this address: City: State: Zip: b. Substituted Service: I personally gave copies of the documents checked in 3 (a, b, or d) to (check one): A competent adult (at least 18) at the home of, and living with the person in 1 , or An adult who seems to be in charge where the person in 1 usually works, or An adult who seems to be in charge where the person in 1 usually receives mail, or has a private post office box (not a U.S. Post Office box), if there is no known physical address for the person in 1 . I told that adult, "Please give these court papers to (name of person in 1 )." I did this on (date): At (time): a.m. p.m. At this address: City: State: Zip: Name or description of the person I gave the papers to:

After serving the court papers, I put copies of the documents listed in 3 in an envelope, sealed the envelope,
and put first-class prepaid postage on it. I addressed the envelope to the person in 1 at the address where I
left the copies.
I mailed the envelope on (date): from (city, state):
by leaving it (check one):
a. At a U.S. Postal Service mail drop, or
b. At an office or business mail drop where I know the mail is picked up every day and deposited with the
U.S. Postal Service, or
c. With someone else I asked to mail the documents to the person in 1 , and I have attached that person’s
completed Form SC-104A.

5 Server’s Information Name: Phone: Address: City: State: Zip: Fee for service: $ If you are a registered process server: County of registration: Registration number:

6 I declare under penalty of perjury under California state law that I am at least 18 years old and not named in this case and that the information above is true and correct. Date:

Type or print server’s name Server signs here after serving

Revised January 1, 2009 Proof of Service SC-104, Page 2 of 2 (Small Claims)