Mendocino — SC-103

Source: http://www.courts.ca.gov/documents/sc103.pdf

SC-103 Fictitious Business Name Case Number:

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

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 selfhelp.courts.ca.gov/small-claims-advisor

Judicial Council of California, courts.ca.gov SC-103, Page 1 of 1Rev. January 1, 2026, Optional Form Fictitious Business Name Code Civ. Proc., § 116.430 Bus. & Prof. Code, § 17900 et seq. (Small Claims) For your protection and privacy, please press the Clear button after you have printed the form. Print Save Clear