Small Claims Form

This form is for printing only. When completed please send application along
with payment to the address at bottom.



A. My Name: __________________________________________________________________

B.My Address (Street): __________________________________________________________

City, State, Zip Code: ___________________________________________________________

C. My Telephone Numbers -- Daytime: ____________________ Evening: _________________

D. MY CLAIM IS AGAINST (defendant). (NOTE: (a) If you are suing an individual, give his/her full name; (b) If you are suing a business firm, five the firm name and the name of the owner; (c) if you are suing a partnership, you must name the partners; (d) if you are suing a corporation, give its full name; (e) if your suit arises out of an automobile accident, you must name the registered owner, and you should also name the driver as a defendant in the action, if the driver is NOT the owner.)


First Defendant's Name: _________________________________________________________

Address (Street): ______________________________________________________________

City, State, Zip Code: ___________________________________________________________

Second Defendant's Name: _______________________________________________________

Address (Street): ______________________________________________________________

City, State, Zip Code: ___________________________________________________________

E. (Answer only if auto accident) AT THE TIME OF THE ACCIDENT, I WAS THE REGISTERED OWNER OF THE VEHICLE: Yes or No (circle one)






1.Defendant owes me the sum of $________________________________ , not including court costs because

(describe claim and date):





a) ____________ I have asked the defendant to pay this money, but it has not been paid.

b) ____________ I have NOT asked the defendant to pay this money because (explain):




The plantiff must file the claim in the proper court. Below are possible reasons for filing the claim in this court. Insert the proper city and using the list below specify the reason why this is the proper court:

City: _________________________ Venue (Letter from Venue Table below): (A, B, C, D, E, F) (circle one)


Venue Table
This court is the proper court for the trial because:
A. a defendant lives in this judicial district or a defendant corporation or unincorporated association has its principal place of buiness in this judicial district.
B. a person was injured or personal property was damaged in this judicial district.
C. a defendant signed or entered into a contract in this judicial district, a defendant lived in this judicial district when the contract was entered into, a contract or obligation was to be performed in this judicial district, or, if the defendant was a corporation, the contract was breached in this judicial district.
D. the claim is on a retail installment account or contract subject to Civil Code section 1812.10. (Specify facts below.)
E. the claim is on a vehicle finance sale subject to Civil Code section 2984.4. (Specify facts below.)
F. other. (Specify facts below.)


4. I [ _______________] [_______________ ] have not filed more than 12 claims in California, including this claim, during the previous 12 months.

5. I [ _______________] [ _______________ ] have not filed more than one other small claims action anywhere in California during this calendar year in which the amount demanded is more than $2,500.

6. I understand that:

a) I may talk to an attorney about this claim, but I cannot be represented by an attorney at the trial in small claims court.

b) I must appear at the time and date of trial and bring all witnesses, books, receipts, and other papers or things to prove my case.

c) I have no right of appeal on my claim , but I may appeal a claim filed by the defendant in this case.

d) If I cannot afford to pay the fees for filing or service by a sheriff, marshal, or constable, I may ask that these fees by waived.

7. I have received and read the information sheet explaining some important rights of plaintiffs in small claims court.

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 Your Name: ________________________________________________________




INSTRUCTIONS:If you are an individual, you must complete the following declaration.

No defendant named is in the military service so as to be entitled to the benefits of the Soldiers' and Sailors Civil Relief Act of 1940 except (check none if no defendant is in military service)

[ _____________] None [ _____________ ] the following:








a) If you regularly do business in California for profit under a fictitious business name, you must execute, file, and publish a fictitious business name statement. This is sometimes called a "dba" which stands for "doing business as". This requirement applies if you are doing business as an individual, a partnership, a corporation, or an association. The requirement does not apply to nonprofit corporations and associations or certain real estate investment trusts. You must file the fictitious business name statement with the clerk of the county where you have your principal place of business, or in Sacramento County, if you have no place of business within the state.

b) If you do business under a fictitious business name and you also wish to file an action in the small claims court, you must declare under penalty of perjury that you have complied with the fictitious business name laws by filling out the form below.

c) If you have not complied with the fictitious business name laws, the court may dismiss your claim. You may be able to refile your claim when you have fulfilled these requirements.

1. I wish to file a claim in small claims court for a business doing business under the fictitious name of (specify the name and address of the business):

Business Name: ________________________________________________________________

Address (Street): _______________________________________________________________

City, State, Zip Code: ____________________________________________________________


2. The business is doing business as:

[ _______ ] An individual

[ _______ ] A partnership

[ _______ ] A corporation

[ _______ ] An association

[ _______ ] other (specify)



3. The business has complied with the fictitious business name laws by executing, filing, and publishing a fictitious business name statement in the county of (specify):



4. The number of the statement is (specify): ___________________________________________

and the statement expires on (date): _________________________________________________



I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Date: _____________________________

Signature of Declarant: __________________________________________________________


You may submit payment in several ways:

- Click here to complete the Credit Card Submission Form and transmit it to us;

- Call Direct Legal Support, Inc., Inc., Inc. at (213) 483-4900 and provide your credit card information telephonically;

- Print this page and the Credit Card Submission Form, complete both of them, and FAX them, to Direct Legal Support, Inc., Inc., Inc., at (213) 483-7777;

- Or, send your check or money order, along with a completed copy of this form to

1614 W. Temple Street
Los Angeles, Ca. 90026

Direct Legal Support, Inc., Inc. will commence working on your case as soon as your payment has been approved by your credit card company or as soon as your check or money order has cleared. Please call 213.483.4900 or e-mail us if your needs are out of the ordinary and/or if you have any questions.OFFICE HOURS: MONDAY - FRIDAY from 8:30a.m. to 5:00p.m. Pacific Standard Time. Corporate Tax #20-2821265. All pricing throughout this website is subject to change without notice. Pricing is based for clients within California.