Plaintiff s Claim 5001 to 10000Cal. Super. - 6th Dist.May 20, 2020SC-1 00 Plaintiffs Claim aHd ORDER Clerkstamps date here when fonnis filed. to Go to Small Claims Court Notice to the person being sued: Aviso al Demandado: San Jose, CA 951 13 Electronically Filed 3y Superior Court of CA, lounty of Santa Clara, m 5/20/2020 10:04 AM Reviewed By: D. Pinheiro Ease #ZOSC083368 Envelope: 4355593 You are the defendant if your name is listed in® on page 2 0f this form. The person suing you is the plaintiff, listed in® on page 2. You and the plaintiff must go t0 court on the trial date listed below. Ifyou do not go to court, you may lose the case. Ifyou lose, the court can order that your wages, money, or property be taken to pay this claim. Bring witnesses, receipts, and any evidence you need t0 prove your‘case. F”, ,-,, com name and street address; Read this form and all pages attached to understand the claim against you SUPerior court 0f california’ county 0f ' Santa Clara t t t .and o pro ect your Ugh S 191 North 1st Street Usted es el Demandado si su nombre figura en® de la pégina 2 de este formulario. La persona que lo demanda es e] Demandante, la que figura en <1) de 1a pégina 2' Court fills in case number when form is filed. Usted y el Demandante tienen que presentarse en la corte en la fecha del Case Number: juicio indicada a continuacién. Si no se presenta, puede perder e1 caso. 208C083368 Si pierde el caso la corte podria ordenar que le quiten de su sueldo, dinero u Case Name: 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 péginas adjuntas para entender 1a demanda en su contra y para proteger sus derechos. Order to Go to Court The people in CD and ® must go t0 court: (Clerkfills out section below.) Trial ~> Date Time Department Name and address of court, if different from above Date 1- ' I Slgned: 8/20/2020 01:09 PM 2. 3. 4 \i Date: 5/28/2020 Clerk, by D. Pinheiro a 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-lOO-INFO, Informationfor the Plaintzfl, to know your rights. Get SC-lOO- INFO at any courthouse or county law library, or go to www.courts.ca.g0v/smallclaims/forms. Fill out pages 2 and 3 of this form. Then make copies 0f all pages of this form. (Make one 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 ofyour trial in the box above. You must have someone at least 18-n0t you or anyone else listed in this case-give each defendant a court-stamped copy of all five 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. G0 to court on your trial date listed above. Bring witnesses, receipts, and any evidence you need to prove your case. JudicialCouncilofCanfomia,wwwoouns.ca.gov P|aintifrs Claim and ORDER SC-100, Page1 of5 Revised January 1, 2020. Mandatory Form _ CodeofCivilProcedure,§§116.110etseq., to Go to Sma" ClaIms Court 9 116.220(c), 1 16.340(g) (Small Claims) 20SC083368 Plaintiff (list names): Case Number: Lisa Altera ® The plaintiff (the person, business, or public entity that is suing) is: Name: Lisa Altera Phone: (650)714-7343 Street address: 188 Paul Avenue Mountain View CA 94041 Street City State Zip Mailing address (zfdifferent): Street City State Zip If more than one plaintiff, list next plaintiff here: Name: Phone: Street address: Street City State Zip Mailing address (zfdifferem): Street City State Zip D Check here ifmore than two plainnfis and attachform SC-I 00A. D Check here ifeitherplaintifllz‘sted above is doing business under aficfitious name. Ifso, attachform SC-I 03. D Check here ifanyplaintz'fi’is a “licensee ” 0r ”deferred deposit originator” (payday lender) under Financial Code sections 23000 et seq. ' ® The defendant (the person, business, or public entity being sued) is: Name: Lun-Cheng Chu Phone: Street address: 726 Georgia Avenue Sunnyvale CA 94086 Street City State Zip Mailing address (zfdifferent): Street City State Zip If the defendant is a corporation, limited liability company, or public entity, list the person or agent authorized for service of process here: Name: Job title, ifknown: Address : Street City State Zip D Check here ifyour case is against more than one defendant, and attachform SC-I00A. D Check here ifany defendant is 0n active military duty, and write his 0r her name here: @ The plaintiff claims the defendant owes $ 10,000 . (Explain below).- a. Why does the defendant owe the plaintiff money? On 5/22/1 8, Len-Cheng Chu violated his duty of care as the 3rd car to run a red light. His negligence damaged my car and forced me to undergo months ofphysical therapy, resulting in lost wages/pain&suffering. When did this happen? (Date): May 22, 201 8 b. Ifno specific date, give the time period: Date started: Through: c. How did you calculate the money owed to you? (Do not include court costs orfeesfor service.) Medical bills, invoices t0 my client, time spent going to physical therapy appointments, and time spent performing exercises assigned by my physical therapists. m/Check here ifyou need more space. Attach one sheet ofpaper orform MC-03I and write “SC-I 00, Item 3 ” at the top. ReViSEWamam’mz" Plaintiff’s Claim and ORDER to Go to Small Claims Court 304°", Page 2 0‘5 (Small Claims) ‘9 20SC083368 Plaintiff (list names): Case Number: Lisa Altera G) You must ask the defendant (in person, in writing, or by phone) to pay you before you sue. If your claim is for possession of property, you must ask the defendant to give you the property. Have you done this? Yes D No If no, explain why not: I have sent a demand letter on this claim to Allstate Insurance, who insures Lun-Cheng Chu. ® Why are you filing your claim at this courthouse? This courthouse covers the area (check the one that applies): a. (1) Where the defendant lives or does business. (4) Where a contract (written or spoken) was made, (2) Where the plaintiff’s propexty was damaged. signed, performed, or broken by the defendant 0r (3) Where the plaintiffwas injured. where the defendant lived or did business when the defendant made the contract. b. CI Where the buyer or lessee signed the contract, lives now, or lived when the contract was made, ifthis claim, is about an offer or contract for personal, family, or household goods, services, or loans. (Code Civ. Proa, § 395(b).) 'c. E] 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. D Where the buyer signed the contract, lives now, 0r lived when the contract was made, or where the vehicle is permanently garaged, ifthis claim is about a vehicle finance sale. (Civ Code, § 2984.4.) e. D Other (specifiz): @ List the zip code of the place checked in (5) above (zfyou know): 94041 ® ls your claim about an attorney-client fee dispute? D Yes E No Ifyes, and ifyou have had arbitration, fill ourform SC-I 01, attach it t0 thisform, and check here: D Are you suing a public entity? D Yes No Ifyes, you mustfile a written claim with the entigzfirst. D A claim was filed on (date): Ifthe public entity denies your claim 0r does not answer within the time allowed by law, you canfile thisform. Have you filed more than 12 other small claims within the last 12 months in California? [:1 Yes E N0 Ifyes, thefilingfeefor this case will be higher. ls your claim for more than $2,500? Yes D No Ifyes, I have notfiled, and understand that I cannotfile, more than two small claims casesfor more than $2,500 in California during this calendar year. l understand that by filing a claim in small claims court, l have no right to appeal this claim. I declare, under penalty of peljury under California State law, that the infonnation above and on any attachments to this form xs true and correct. DatezMay 19, 2020 Lisa Altera . r ‘VA‘iwmb Plainfifltypes orprim‘s name here ‘ Plaintiffsigns here Date: ’ Secondplaz'ntifltypes 0r prints name here Secondplaintz'flsigm here Requests for Accommodations Assistive listening systems, computer-assisted real-time captioning, or sign language interpreter services are available ifyou ask at least five days before the trial. Contact the clerk’s office for form MC-410, Requestfor Accommodations by Persons With Disabilities and Response. (Civ. Code, § 54.8.) RevisedJan”a‘Y"2°2" Plaintiff’s Claim and ORDER to Go to Small Claims Court 39-100: P3963 °f5 (Small Claims) '9 SC-1 00 Informacién para el demandado (la persona demandada) La “Corte de reclamos menores” es una corte especial donde se deciden casos por $1 0,000 o menos. Los individuos, o sea Ias “personas fisicas” y Ios propietarios por cuenta propia, pueden reclamar hasta $10,000. Las corporaciones, asociaciones, entidades pfiblicas y otras empresas solo pueden reclamar hasta $5,000. (Vea abajo para Ias excepciones.*) El proceso es répido y barato. Las reglas son sencillas e informales. Usted es el Demandado-la persona que se esté demandando. La persona que lo esté demandando es el Demandante. gNecesito un abogado? Puede hablar con un abogado antes o después del caso. Pero no puede tener a un abogado que Io represente ante la corte (a menos que se trate de una apelacién de un case de reclamos menores). gCémo me prepare para ir a la corte? No tiene que presenter ningunos papeles antes del juicio, a menos que piense que ésta es Ia corte equivocada para su caso. Pero Ileve al juicio cualquier testigos, recibos y pruebas que apoyan su caso. Y lea “Esté preparado para su juicio" en www.courts.ca.govlreclamosmenoreslpreparese. ¢Qué hago si necesito una adaptacién? Si tiene una discapacidad o tiene impedimentos de audicién, Ilene el formulario M0410, Request for Accomodations. Entregue e1 formulario al secretario de la corte o al Coordinador de Acceso/ADA de su corte. aQué pasa si no hablo bien inglés? Solicite un intérprete al secretario de Ia corte Io més pronto posibie. Puede usar el formulario lNT-300 o un formulario de su corte local. Si no esté disponible un intérprete de la corte para su juicio, es posible que se tenga que cambiar la fecha de su juicio. N‘o 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 Ia regla 2.893 de las Reglas de la Corte de California, y el formulario lNT-140.) gDénde puedo obtener Ios formularios de la corte que necesito? Vaya a cualquier edificio de la corte, la biblioteca legal de su condado, o imprima Ios formularios en www.courts.ca.gov/ smallclaimslforms (pégina esté en inglés) gQué pasa en el juicio? El juez escucharé a ambas partes. El juez puede tomar su decisién durante Ia audiencia o enviérsela por correo después. éQué pasa si pierdo el caso? Si pierde, puede apelar. Tendré 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 apelacién (Notice of Appeal). Tiene que presentarlo dentro de 30 dias después de que e} secretario Ie entregue o envie Ia decisién (fallo) del juez en el formulario 80-200 o SC-1 30, Aviso de publicacio’n del fallo (Notice of Entry of Judgment). . Si no estuvo en e| juicio, llene y presente el formulario SC~1 35, Aviso de peticién para anular eI faIIo y Declaracién para pedirle al juez que anule el fallo (decisién). Si la corte no Ie otorga un nuevo juicio, tiene 10 dias para apelar la decisién. Presente el formulario SC-140. Para obtener més informacién sobre Ias apelaciones, vea www. courts.ca.gov/reclamosmenores/apelaciones. éTengo otras opciones? Si. Si Io estén 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 e! formulario ClV-1 10, SoIicitud de desestimacién (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 reciamo.Tiene que entregar (dar) una copia de su carta (por correo o en persona) a todas Ias partes. (Su carta a la corte tiene que decir que hizo la entrega.) . Ir al juicio y tratar de ganar el caso. Lleve testigos, recibos y cualquier prueba que necesite para probar su caso. Si desea que Ia corte emita una orden de comparecencia para que Ios testigos vayan al juicio. Hene el formulario SC-1 07, Citaton'o de reclamos menores (Small Claims Subpoena) y entrégueselo legalmente al testigo. . Demandar a la persona que lo demandé. 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-1 20, Reclamo del demandado (Defendant’s Claim) y presentarlo en este mismo caso. Si su reclamo excede el limite permitido en la corte de reclamos menores, puede igualmente presentarlo en Ia corte de reclamos menores si esté dispuesto a limitar su reclamo al méximo permitido, o puede presentar un reclamo por el monto total en Ia corte apropiada. Si su reclamo excede el limite pennitido en la corte de reclamos menores y esté relacionado con e1 mismo contrato, transaccién, asunto o acontecimiento que el reclamo del Demandante, puede presentar su reclamo en Ia corte apropiada y presentar una mocién para transferir el reclamo del Demandante a dicha corte, para poder resolver los dos reclamos juntos. Puede ver una descripcién de Ios montos permitidos en el pérrafo anterior tituiado “Cone 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 Ios pagos. . No ir al juicio y aceptar el fallo por falta de comparecencia. Si no Ilega a un acuerdo con eI Demandante y no va al juicio (fallo por falta de comparecencia), el juez le puede otorgar al Demandante Io que esté reclamando més Ios costos de la corte. En ese caso, el Demandante legalmente puede tomar su dinero, su sueldo o sus bienes para cobrar el fallo. ¢Qué hago si necesito més tiempo? Puede cambiar la fecha del juicio si: - No puede ir a la corte en Ia fecha programada (tendré que pagar una cuota para aplazar el juicio), o ~ No le entregaron Ios documentos legalmente (no recibié Ia orden para ir a Ia corte) por lo menos 1 5 dias antes del juicio (6 20 dias si vive fuera del condado), o - Necesita més tiempo para conseguir intérprete. (Se perrnite un solo aplazamiento sin tener que pagar cuota para aplazar el juicio). Pregfintele al secretario de reclamos menores sobre Ias reglas y las cuotas para aplazar un juicio. O llene el formulario SC-1 50 (o escriba una carta) y envielo antes det plazo a la corte y a todas Ias otras personas que figuran en sus papeles de la corte. Adjunte un cheque para pagar Ios costos de la corte, a menos que le hayan dado una exencién. gNecesita ayuda? El Asesor de Reclamos Menores de su condado le puede ayudar sin cargo. WWIEIms Advhur JL_ [411m muzmu, {muonsam O visite www.courts.ca.gov/reclamosmenores/asesores. ‘ Excepciones: Existen diferemes limites en un reclamo contra un garante. (Vea el Cédigo de Prooedimiento CiviL seocién 116220 (c).) Revised January 1, 2020 Reclamo del Demandante y ORDEN 86-100, Page 5 of 5 Para Ir a la Corte de Reclamos Menores (Reclamos Menores) SC-1 00 Information for the defendant (the person being sued) "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. D0 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 I 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/smallclaims/prepare. What if l 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 l don’t speak English well? Ask the court clerk as soon as possible for a court-provided interpreter. You may use form lNT-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 necessaty 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 I 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 wiu listen to both sides. The judge may make a decision at your trial or mail the decision to you tater. What if I lose the case?” you lose, you may appeal. You’ll have to pay a fee. (Plaintiffs cannot appeal their own claims.) . If you were at the trial, file form SC-140, Notice ofAppeal. 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 ofEntry of Judgment. . If you were not at the trial, fill out and file form 80-135, 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 1O days to appeal the decision. File form SC-140. For more information on appeals, see www.courts.ca.gov/ smallclaims/appeals. Do I have options? Yes. If you are being sued, you can: ’ Settle your case before the trial. Ifyou and the plaintiff agree on how to settle the case, the piaintiff must file form ClV-1 10, Request for Dismissal, with the clerk. Ask the Small Claims Advisor for help. ' 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. Ifyou 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 plaintiff‘s '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 I 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. j _l l- HWdI-Clalms Advhur [411mmam {muonsz B} L Or go to www. couris.ca.gov/smallclaims/advisor. * Exceptions: Different limits apply in an action against a defendant who is a guarantor. (See Code Civ. Proc., § 116.220(c).) Revised January 1, 2020 Plaintiff’s Claim and ORDER to Go to Small Claims Court (Small Claims) SC-1 00, Page 4 of 5 .9 20SC083368 Transaction Totals by Date Report Page 4 of 4 , r-Ay v . m.._ ‘ w-fi ‘ 1, ’ (a A n J" vaI/g / k‘ i ' J f Y z w/ 104 97110-PR THERAPEUTIC EXERCISES EA 15 MIN Isley, Roisin Mary, OTR... 02/04/2019 220.00 (Match Pmt) 112 9900000243MT INSURANCE 02/13/2019 o‘oo (Match Adj) 138 esoooooo-ADJ BAD DEBT W/o 05/07/2019 220.00 105 97140-PR MANUAL THERAPY TECH 1+ REGS E,.. Isley, Roisin Mary, OTR... 02/04/2019 103.00 (Match Pmt) 112 99000002-PMT INSURANCE 02/13/2019 0,00 (Match Adj) 139 geocoooo-ADJ BAD DEBT WIo 06/07/2019 103.00 106 97035-PR ULTRASOUND THERAPY EA 15 MIN Isley, Roisin Mary, OTR... 02/04/2019 50.00 (Match Pmt) 112 aaoooooz-PMT INSURANCE 02/13/2019 0.00 (Match Adj) 14o eeoooooo-ADJ BAD DEBT WIo 06/07/2019 50.00 108 971 10-PR THERAPEUTIC EXERCISES EA 15 MIN Isley, Roisin Mary, OTR... 02/1 1/2019 220.00 . (Match Pm‘) 116 99000002»PMT INSURANCE 02/21/2019 0.00 (Match Adj) 141 geocoooo-ADJ BAD DEBT Wlo 05/07/201 9 220.00 109 97140-PR MANUAL THERAPY TECH 1+ REGS E... lsley, Roisin Mary, OTR... 02/1 1/2019 103.00 (Match Pmt) 116 99000002-PMT INSURANCE 02/21/2019 0.00 7 V (Match Adj) 142 ¥ r igaoooooorADJ BAD DEBT W/o 06/07/2019 103.00 110 97035-PR ULTRASOUND THERAPY EA 15 MiN Isley. Roisin Mary, OTR... 02/1 1/2019 50.00 (Match Prm) 116 99000002_PMT INSURANCE 02/21/2019 0.00 (Match Adg) 143 saoooooo-ADJ BAD DEBT Wlo 06/07/201 9 50.00 113 971 10-PR THERAPEUTIC EXERCISES EA 15 MIN Isley, Roisin Mary, OTR... 02/19/2019 220.00 (Match Pmt) 120 seawooz-PMT INSURANCE 02/27/2019 0.00 (Match Adj) 144 ssoaoooo-ADJ BAD DEBT Wlo 06/07/201 9 220.00 114 97140-PR MANUAL THERAPY TECH 1+ REGS E... lsley, Roisin Mary, OTR... 02/19/2019 103.00 (Match Pmt) 120 9eoooooz-PMT INSURANCE 02/27/2019 0.00 (Match Adj) 145 saoooooo-ADJ BAD DEBT Wlo 06/07/201 9 103.00 115 97035-PR ULTRASOUND THERAPY EA 15 MIN Isley, Roisin Mary, OTR... 02/19/2019 50.00 (Match Pmt) 120 geocoooz-PMT INSURANCE 02/27/2019 0.00 (Match Adj) 146 ssoooooo-ADJ BAD DEBT W/o 06/07/2019 5000 117 97110-PR THERAPEUTIC EXERCISES EA 15 MIN lsfey, Roisin Mary, OTR... 02/25/2019 220.06 (Match Prat) 121 99000002-PMT INSURANCE 03/06/2019 0.00 (Match Ad» 147 98000000_ADJ BAD DEBT W/o 06/07/2019 220.00 118 97140-PR MANUAL THERAPY TECH 1+ REGS E... Isley, Roisin Mary, CTR”. 02/25/2019 103.00 2- 03/06/2019 0.00 :5 ceronzme 103.00 119 97035-PR ULTRASOUND THERAPY EA 15 MIN Isley, Roisin Mary, OTR... 02/25/2019 50.00 (Match Pm‘) 121 990000024=MT :NSL'RMCE 03/06/2019 o‘oo (Match Adj) 149 98000000_ADJ BAD DEBT WIo 06/07/2019 50.00 Payments Matched to charges 306.85 Adjustments Matched to charges 7,408.15 Note: This report contains only those payments and adjustments which are matched to the charges listed in the Charges section.
