If more than two plaintiffs (person, business, or entity suing), list their information below:
If more than one defendant (person, business, or entity being sued), list their information
below:
Judicial Council of California, www.courts.ca.gov
Revised January 1, 2017, Mandatory Form
Code of Civil Procedure, § 116.110 et seq.
Other Plaintiffs or Defendants
(Attachment to Plaintiff's Claim and ORDER
to Go to Small Claims Court)
Is this plaintiff doing business under a fictitious name? If yes, attach form SC-103.
Is this plaintiff doing business under a fictitious name? If yes, attach form SC-103.
Mailing address (if different):
Zip:
State: Zip:
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.
I understand that by filing a claim in small claims court, I have no right to appeal this
claim.
If yes, 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.
SC-100A, Page __ of __
1
2
3
4
Other plaintiff’s name:
Street address:
City:
Yes No
Yes No
Check here if more than 4 plaintiffs and fill out and attach another form SC-100A.
Check here if your case is against more than two defendants, and fill out and attach another form SC-100A.
Date:
Type or print your name
Date:
Type or print your name
State:
City:
Street address:
City: State: Zip:
Mailing address (if different):
Zip:State:City:
Other defendant’s name:
Street address:
Zip:State:City:
Mailing address (if different):
Zip:State:City:
Name:
Address:
Zip:State:
City:
Other plaintiff’s name:
SC-100A
Other Plaintiffs or Defendants
Case Number:
This form is attached to form SC-100, item 1 or 2.
Sign your name
Sign your name
Phone:
Phone:
Phone:
Job title, if known:
If this defendant is a corporation, limited liability company, or public entity, list the person or agent authorized for
service of process:
Is your claim for more than $2,500?
No
Yes
For your protection and privacy, please press the Clear
This Form button after you have printed the form.
