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SUPERIOR COURT OF CALIFORNIA OF ORANGE COUNTY SELF-HELP (The Superior Court of California - County of Orange)

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SHC-SC-04 (Rev
. 01/01/2020)
Please visit our Self-Help Portal at: https://selfhelp.occourts.org
LamoreauxJusticeCenter
Room C-190
341TheCityDrive
Orange,CA
HarborJusticeCenter
R
oom107,Self‐HelpWindow
4601JamboreeRoad
NewportBeach,CA
Cen
tralJusticeCenter
RoomG‐100
700CivicCenterDrive
SantaAna,CA
SuperiorCourt
Ser
viceCenter
27573PuertaReal
MissionViejo,CA
NorthJusticeCenter
R
oom355
1275N.BerkeleyAvenue
Fullerton,CA
WestJusticeCenter
1
st
Floor
814113thStreet
Westminster,CA
SUPERIOR COURT OF CALIFORNIA
COUNTY
OF ORANGE
SELF-HELP CENTER
www.occourts.org/self-help
SMALL CLAIMS:
REQUEST TO MAKE PAYMENTS
The Self-Help Center provides a free document review
service. To obtain an appointment to have your documents
reviewed, you must first fully complete the forms.
Pleaseuseblackink.
Self-Help Center Locations:
Read the other side before you fill out this form.
My name is:
On
(date): , the court made the decision (judgment) that:
To
(name of party you must pay):
I am asking for permission to make payments, instead of paying the full
amount all at once, because
(explain):
SC-220, Page 1 of 2
Judicial Council of California, www.courts.ca.gov
Rev. July 1, 2013, Optional Form
Code of Civil Procedure, § 116.620, Cal. Rules of Court, rule 3.2107
SC-220
Request to Make Payments
Request to Make Payments
(Small Claims)
Other payment schedule (specify):
b.
c.
The total amount of payments is $ , which includes interest on the unpaid balance of the judgment.
The actual amount of that interest may be different if the payments are made late or early.
Attach a page that shows how you calculated the interest and write “SC-220, Item 4c” at the top.
e
c
d
f
Clerk stamps here when form is filed.
Case Number:
Fill in your case number and case name:
Fill in the court name and street address:
S
uperior Court of California, County of
Orange
Case Name:
Phone:
I owe (total amount): $
If your answer will not fit in the space below, check this box and attach your
answer on a separate sheet of paper. Write “SC-220, Item 3” at the top.
I ask the court to allow me to make payments on the following terms (check and complete all that apply):
Payments of $ , on the day of each (month, week, other):
a.
d.
The total amount of payments is the same as the judgment. If all payments are made in full and on time, no
interest will be owed on the judgment, and the judgment will be paid in full.
Mailing address:
Starting (date): , until (date of final payment): ; amount of final payment: $
I am asking for permission to pay my small claims judgment in payments.
Phone:
Mailing address:
e.
Other
(specify):
I declare under penalty of perjury under the laws of the State of California that the information above is true and correct.
Date:
Type or print your name Sign here
Warning! If any payment is not made in full and on time, the judgment creditor may notify the court
to cancel the payment plan and the entire unpaid balance will become due and collectible.
General Information
Read this form.
Fill out Form EJ-165, Financial Statement.
The court will mail all other plaintiffs and defendants
in the case copies of your Request to Make Payments
and Financial Statement, and a blank Form SC-221,
Response to Request to Make Payments.
If the court ordered you to pay money, you can ask
the court for permission to make payments. Here’s how:
Fill out Form SC-220, Request to Make Payments.
Fill out one form for each plaintiff or defendant
(judgment creditor) you want to make payments to.
The other parties will have 10 days to file a
Response. Then, the court will mail all plaintiffs and
defendants in the case:
When is the judgment due?
Unless the court orders otherwise, small claims judgments
are due immediately. If the judgment is not paid in full
within 30 days, the judgment creditor (person to whom the
money is owed) can take legal steps to collect any unpaid
amount. (Collection may be postponed if an appeal or a
request to vacate (cancel) or correct the judgment is filed.)
Can the judgment debtor make payments?
A party who was ordered to pay a small claims judgment
(the judgment debtor) can ask the court for permission to
make payments. If the court agrees, the party who is owed
money (the judgment creditor) cannot take any other steps
to collect the money as long as the payments are made
on time.
•
•
•
File your completed forms with the small claims
court clerk.
•
A decision on the Request to Make Payments or
•
A notice to go to a
hearing.
•
Is interest
added after the judgment?
Interest (10 percent per year) is usually added to the
unpaid amount of the judgment from the date the judgment
is entered until it is paid in full. Interest can only be
charged on the unpaid amount of the judgment (the
principal); interest cannot be charged on any unpaid
Read this form and the Request.
If you do not agree with the Request or you want to
be paid interest, file a Response within 10 days
after the court clerk mailed the Request to you.
(This date is on the Clerk’s Certificate of Mailing.) If you
do not do this, the court may allow the person who
owes you money to make payments. And, you may
lose your rights to collect interest on the judgment.
If the court ordered someone to pay you money,
and that person has filed a Request to Make Payments…
If you agree with the Request, you do not need to do
anything.
•
•
•
When the court allows payments, the court often does not
order any interest, as long as all payments are made in full
and on time.
Unless the creditor asks for interest to be
included in the order allowing payments, the creditor may
lose any claims for interest. But, if the debtor does not make
full payments on time, interest on the missed payment or
the entire unpaid balance might become due and collectible.
How do I calculate interest?
If yo
u are proposing a payment schedule that includes
interest, you need to itemize the principal and interest for
each payment. To do this, you can search on the Internet
for “free amortization calculator.” Enter the total amount of
the judgment as the principal, the interest rate of 10
percent per year, the frequency of payments (monthly,
weekly, etc.), and the number or length of payments. Print
the results showing the payment amount and how each
payment is divided between principal and interest. Attach
this to your Request or Response.
Answers to Common Questions
Fill out Form SC-221, Response to Request to Make
Payments.
File your Response and Proof of Service with the small
claims court clerk.
To file your Response:
Have your Response served on all other plaintiffs and
defendants in your case. (See Form SC-112A, Proof of
Service By Mail.)
•
•
•
interest. If a partial payment is received, the money is
applied first to unpaid interest and then to unpaid principal.
Rev. July 1, 2013
SC-220, Page 2 of 2
Need help?
For free help, contact your county’s small claims advisor:
[local info here]
Or go to “County-Specific Court Information” at www.courts.ca.gov/selfhelp-smallclaims.htm
Payments in Small Claims Cases
Request to Make Payments
(Small Claims)
SHORT TITLE:
LEVYING OFFICER FILE NO.
COURT CASE NO.
FINANCIAL STATEMENT
(Wage Garnishment—Enforcement of Judgment
NOTE: If you are married, this form must be signed by your spouse unless you and your spouse are living separate and
apart. If this form is not signed by your spouse, check the applicable box on the reverse in item 9.
1. The following persons other than myself depend, in whole or in part, on me or my spouse for support:
MONTHLY TAKE-HOME
INCOME & SOURCENAME AGE RELATIONSHIP TO ME
a. Spouse
b.
c.
d.
e.
2. My monthly income
a. My gross monthly pay is:.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a. $
b. My payroll deductions are (specify purpose and amount):
(1 ) Federal and state withholding, FICA, and SDI. . . . . . . . .
$
(2)
$
(3)
$
$
(4)
My TOTAL payroll deduction amount is (add (1) through (4)): ................................................
b. $
c. $c. My monthly take-home pay is (a minus b): ..................................................................................
d. Other money I get each month from (specify source):
is .........................
d. $
e. $e. TOTAL MONTHLY INCOME (c plus d) ..................................................................................
3. I, my spouse, and my other dependents own the following property:
a. Cash ..........................................................................................................................................
3a. $
b. Checking, savings, and credit union accounts (list banks):
(1) $
(2) $
(3) b. $$
c. Cars, other vehicles, and boat equity (list make, year of each):
(1)
(2) $
(3) c. $
d. Real estate equity ...................................................................................................................... d. $
e. Other personal property (jewelry, furniture, furs, stocks, bonds, etc.) (list separately):
e. $
Form Adopted by the Judicial Council
of California
WG-007/EJ-165 [Rev. January 1, 2007]
FINANCIAL STATEMENT
(Wage Garnishment—Enforcement of Judgment)
Code of Civil Procedure, §§ 706.124, 703.530
www.courtinfo.ca.gov
$
$
WG-007/EJ-165
Page 1 of 2
4. The monthly expenses for me, my spouse, and my other dependents
a. Rent or house payment and maintenance ................................................................................. 4 a. $
b. Food and household supplies .................................................................................................... b. $
c. Utilities and telephone ............................................................................................................... c. $
d. Clothing ...................................................................................................................................... d. $
e. Medical and dental payments ..................................................................................................... e. $
f. $f. Insurance (life, health, accident, etc.) ........................................................................................
g. School, child care ....................................................................................................................... g. $
h. Child, spousal support (prior marriage) ...................................................................................... h. $
i. $I. Transportation & auto expenses (insurance, gas, repair) (list car payments in item 5) ..............
j. Installment payments (insert total and itemize below in item 5) .................................................. j. $
k. Laundry and cleaning ................................................................................................................. k. $
l. Entertainment ............................................................................................................................. l. $
m. Other (specify):
m. $
n. TOTAL MONTHLY EXPENSES (add a through m): .................................................................... n. $
5. I, my spouse, and my other dependents owe the following debts:
OWED BY
FOR MO. PAYMENTS BALANCE OWED (State person's name)
6. Other facts which support this Claim of Exemption (i.e., unusual medical needs, school tuition, expenses for recent family
emergencies, or other unusual expenses to help your creditor and the judge understand your budget) (describe): (If more space is
needed, attach page labeled Attachment 6.)
An earnings withholding order is now in effect with respect to my earnings or those of my spouse or dependents named in
item 1 (specify each person's name and monthly amount):
7.
A wage assignment for support is now in effect with respect to my earnings or those of my spouse or dependents named in
8.
item 1 (specify each person's name and monthly amount):
My spouse has signed below.9.
I have no spouse.
My spouse and I are living separate and apart.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:
(TYPE OR PRINT NAME)
(SIGNATURE)
(TYPE OR PRINT NAME OF SPOUSE)
(SIGNATURE OF SPOUSE)
FINANCIAL STATEMENT
(Wage Garnishment—Enforcement of Judgment)
WG-007/EJ-165 [Rev. January 1, 2007]
SHORT TITLE:
LEVYING OFFICER FILE NO.
COURT CASE NO.
CREDITOR'S NAME
Page 2 of 2
WG-007/EJ-165
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SUPERIOR COURT OF CALIFORNIA OF ORANGE COUNTY SELF-HELP (The Superior Court of California - County of Orange)

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Completed 8 February 2021

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