Defendant s ClaimCal. Super. - 3rd Dist.September 14, 2018% S O Y ~ ~~ Defendant's Claim and ORDER Gee ae Fi SC-120 to Ge to Small Claims Court Clerk stamps date here when form is filed. ED Notice to the person being sued: SUPERIOR C P g COUNTY OEE. REEIFORNIA « You are being sued by the person you are suing. * You must go to court on the trial date listed below. If you do not go to court, DEC 1 1 2018 you may lose the case. JAKE CHATTERS - If you lose, the court can order that your wages, money, or property be oa VE OFFICER & CLERK taken to pay this claim. * “Waggoner, Deputy - Bring witnesses, receipts, and any evidence you need to prove your case. * Read this form and all pages attached, to understand the claim against Fill in court name and street address: you and to protect your rights. Superior Court of California, County of SUPERIOR COURT OF CALIFORNIA Aviso al demandado: COUNTY OF PLACER 10820 Justice Center Drive ‘ co P.O. B ox 619072 + Tiene que presentarse a la corte en la fecha de su juicio indicada a Roseville, CA 95661-9072 « La persona que ha demandado lo esta demandando a usted. continuacién. Si no se presenta, puede perder el caso. + Si pierde el caso la corte puede ordenar que le quiten de su sueldo, dinero u Pt ee ee ee ae. Case Number: otros bienes para pagar este reclamo. R-Sc-0024 YT) - Lleve testigos, recibos y cualquier otra prueba que necesite para probar Pe Marne: su caso. + Lea este formulario y todas las paginas adjuntas, para entender la demanda Order to Go to Court The people in (4) and (2) must go to court: (Clerk fills out section below.) Trial te ime Department Name and address of court if different from above foal ES- Iq C “OOaM 40) AS STATED ABOVE 2, : 3 \, Date: DEC 1 1 2018 Clerk, by \ GC. Waggoner , Deputy F v en su contra y para proteger sus derechos. Instructions for the person suing: - Before you fill out this form, read Form SC-100-INFO, Jnformation for the Plaintiff, to know your rights. Get SC-100-INFO at any courthouse or county law library, or go to: www.courtinfo.ca. gov/forms + Fill out pages 2 and 3 of this form. Then make copies of all pages of this form. (Make | copy for each party named in this case and an extra copy for yourself.) Take or mail the original and these copies to the court clerk's office and pay the filing fee. The clerk will write the date of your trial in the box above. - You must have someone at least 18-not you or anyone else listed in this case-give each Plaintiff a court-stamp ed copy of all 3 pages of this form and any pages this form tells you to attach. There are special rules for "serving," or delivering, this form to public entities, associations, and some businesses. See Forms SC-104, SC-104B, and SC-104C. » Go to court on your trial date listed above. Bring witnesses, receipts, and any evidence you need to prove yo ur case. facies Counc of Ce enn torn Defendant's Claim and ORDER to Go to SC-120, Page 1 of 3 Code of Civil Procedure, § 116.110 et seq. Small Claims Court => CEB’ Essential (Small Claims) ceb.com | fA Forms Defendant (list names): -~ -~ Case Number: (4) The Plaintiff (t on, business, or public entity that sued first) is: S= Q Name: Phone: OA - e -DS yO Street address: | se c V\ Re . »> ch ; CBr q Street City State Zip Mailing address (if different): 48 Street City State Zip If more than one ie NG list next Plaintiff here: Name: YN IS , . tes Street address: t ‘Ss ‘a Ba lL eV Kd ‘ O OSLVA Q) CH Street City l state Zip Mailing address (if different): Street City State Zip (J Check here if more than 2 Plaintiffs and attach Form SC-120A. (J Check here if any Plaintiff is on active military duty and write his or her name here: 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 (J Check here if more than 2 Defendants and attach Form SC-1204A. () Check here if either Defendant listed above is doing business under a fictitious name. If so, attach Form SC-103. The Defendant claims the Plaintiff owes $ 36 24 30 . (Explain below): a. Why does the Plaintiff owe the Defendant money? WOO b. When did this happen? (Date): _(-4| \26 (+ If no specific date, give the time period: Date started: -________ Through: c. How did 1 calculate the money gwed to you? (Do not include court costs or fees for service.) WOE (eke Ha Woo \ x () Check here if you need more space. Attach one sheet of paper or Form MC-031 and write "SC-120, Item 3" siice, [\Forms: at the top. eee ee Defendant's Claim and ORDER to Go to SC-120, Page 2 of 3 CEB | Essential Small Claims Court > a (Small Claims) Case Number: Defendant (list names): (4) You may ask the Plaintiff (in person, in writing, or by phone) to pay you before you sue. Have you done this? ves L] No Is your claim about an attorney-client fee dispute? [J Yes x No If yes, and if you have had arbitration, fill out Form SC-101, attach it to this form, and check here: (1 (6) Are you suing a public entity? ] Yes = No If yes, you must file a written claim with the public entity first. [| A claim was filed on (date): If the public entity denies your claim or does not answer within the time allowed by law, you can file this form. (7) Have you filed more than 12 other small claims within the last 12 months in California? CL] Yes PLNo If yes, the filing fee for this case will be higher. | understand that by filing a claim in small claims court, | have no right to appeal this claim. (9) If I do not have enough money to pay for filing fees or service, I can ask the court to waive those fees. (10) I have not filed, and understand that I cannot file, more than two small claims cases for more than $2,500 in California during this calendar year. I declare, under penalty of perjury under California State law, that the information above and on any attachments to this form is true and correct. ----- Date: 2 liclzovs “Thamis ob, =. & aa oh Defendant types or prints name here Defendant signs here > Date: Second Defendant types or prints name here Second Defendant signs here = _- Requests for Accommodations 2 Assistive listening systems, computer-assisted, real-time captioning, or sign language interpreter services are available if you ask at least five days before the trial. Contact the clerk’s office or go to www.courtinfo.ca.gov/forms for Request for Accommodations by Persons With Disabilities and Response (form MC-410). (Civil Code, § 54.8.) Need help? Your county’s Small Claims Advisor can help for free. | | | Or go to “County-Specific Court Information” at: www.courtinfo.ca.gov/selfhelp/smallclaims Revised January 1, 2011 Defendant’s Claim and ORDER to Go to SC-120, Page 3 of 3 Small Claims Court (Small Claims)
