Mendocino — MSC-101

Source: https://www.mendocino.courts.ca.gov/system/files/forms-and-filings/msc-101.pdf

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 MENDOCINO

UKIAH Courthouse TEN MILE Branch Court
100 North State Street 700 South Franklin Street
Ukiah, CA 95482 Fort Bragg, CA 95437

PETITIONER/PLAINTIFF:

RESPONDENT/DEFENDANT:

SMALL CLAIMS SETTLEMENT AGREEMENT CASE NUMBER:

This is not a judgment. Pursuant to CCP §664.6 parties stipulate that the Court shall retain personal and subject matter jurisdiction over this matter and that the terms of settlement are as follows: This matter is dismissed without prejudice and the hearing date of is vacated. Defendant(s) shall pay to Plaintiff(s), the amount of $ . That amount is to be paid in monthly weekly installments until paid in full. Each monthly weekly installment is to be in the amount of $ on or before the of each month week, beginning on . Plaintiff(s) shall pay to Defendant(s), the amount of $ . That amount is to be paid in monthly weekly installments until paid in full. Each monthly weekly installment is to be in the amount of $ on or before the of each month week, beginning on . Other terms:

In the event of default as to any of the terms of this stipulated agreement, party(s) may file a Noticed Motion Requesting Entry of Judgment after Default and Supporting Declaration (local form #MSC-102) to request that the Court hear this matter to set aside the dismissal of this action and enter judgment. Judgment shall include the following: 1. Balance due in accordance with the terms of this agreement. 2. The entire amount, less any payments already made, originally asked for in the complaint. 3. Other

Date:

Plaintiff signature Defendant signature

Plaintiff’s Mailing Address: Defendant’s Mailing Address:

MSC-101 (rev 0422)