Fill and Sign the Pay Judgment Form

Name and Address of Court: ––––– ––––– ––––– ––––– SMALL CLAIMS CASE NO. ––––– PLAINTIFF/DEMANDIANTE (Name, address, and telephone number of each): DEFENDANT/DEMANDADO (Name, address, and telephone number of each): ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– Telephone No.: ––––– Telephone No.: ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– Telephone No.: ––––– Telephone No.: ––––– See attached sheet for additional plaintiffs and defendants. REQUEST TO PAY JUDGMENT IN INSTALLMENTS 1. I request the court to allow me to make installment payments on the judgment entered against me in this case in the amount and manner stated below. 2 My request is based on this declaration, the court records, my completed financial declaration (form EJ-165)— obtain from court clerk) attached to this declaration, and any other evidence that may be presented. NOTE: YOU MUST ATTACH A COMPLETED FINANCIAL DECLARATION WITH THIS REQUEST TO MAKE INSTALLMENT PAYMENTS. 3. Judgment was entered against me in this matter on (date) : ––––– in the amount of (specify) : $ ––––– 4. Payment of the entire amount of the judgment at one time will be a hardship on me because (specify) : ––––– ––––– 5. I can and will make payments toward the judgment in the amount of (specify) : $ ––––– per week month. 6. I request the court to order that I make payments as specified in item 5 and that execution on the judgment be stayed as long as I make payments according to this schedule 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 OF JUDGMENT DEBTOR) NOTICE TO JUDGMENT CREDITOR The judgment debtor has requested the court to allow payment of the judgment installments. Complete the following and return this form to the court within 10 days. You will be notified of the court’s order, or, if a hearing is necessary, the date of the hearing. 1. I am the judgment creditor, and i have read and considered the judgment debtor’s request to make installment payments on the judgment. 2. a. I am willing to accept the payment schedule the judgment debtor has requested. b. I am willing to accept payments in the amount of (specify) : $ ––––– per week month c. I am opposed to accepting installment payments because (specify) : ––––– ––––– 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 OF JUDGMENT CREDITOR) SEE REVERSE FOR HEARIN G DATE, IF ANY. (Continued on reverse) F o r m A p p r o v e d b y t h e J u d i c i a l C o u n c i l o f C a l i f o r n i a S C - 1 0 6 ( N e w J a n u a r y 1 , 1 9 9 2 ) REQUE ST TO PAY JUDG MENT IN INS TALLMENTS (Sm al l Cla i ms ) C o d e o f C i v i l P r o c e d u r e , § 1 1 6 . 6 2 0 ( b ) NOTICE OF MOTION electronic form ã 1996-2000 WWW.LawCA.co m Law Publishers A hearing will be held on this request as follows: HEARING DATE DAY TIME PLACE DATE 1. ––––– –––– ––––– ––––– FECHA 2. ––––– –––– ––––– ––––– DEL 3. ––––– –––– ––––– ––––– JUICIO 4. ––––– –––– ––––– ––––– COURT ORDER 1. The judgment debtor shall pay the full amount of the judgment immediately. 2. The judgment debtor may pay to the judgment as follows: a. (If initial lump sum ordered) Pay $ ––––– on (date) : ––––– b. Pay $ ––––– or more (specify) : ––––– of every (specify) : ––––– until the judgment is fully paid. 3. (Missed payments) On the filing of an affidavit or declaration by the judgment creditor showing that any payment that has not been paid, this order shall be set aside and the clerk may issue a writ of execution immediately, without further order of the court. Date: ––––– (JUDGE OR COMMISSIONER) WARNING: IF YOU MISS A PAYMENT, THE BALANCE OWING ON THE JUDGMENT WILL BECOME DUE IMMEDIATELY. CLERK'S CERTIFICATE OF MAILING – NOTICE TO JUDGMENT CREDITOR I certify that I am not a party to this action. This Notice of Judgment Creditor was mailed first class, postage prepaid, in a sealed envelope to the responding party at the address shown above. The mailing and this certification occurred at (place): ––––– , California, on (date) : ––––– Clerk, by , Deputy CLERK'S CERTIFICATE OF MAILING – NOTICE OF MOTION I certify that I am not a party to this action. This Notice of Motion was mailed first class, postage prepaid, in a sealed envelope to the responding party at the address shown above. The mailing and this certification occurred at (place): ––––– , California, on (date) : ––––– Clerk, by , Deputy CLERK'S CERTIFICATE OF MAILING – COURT ORDER I certify that I am not a party to this action. This Court Order was mailed first class, postage prepaid, in a sealed envelope to the responding party at the address shown above. The mailing and this certification occurred at (place): ––––– , California, on (date) : ––––– Clerk, by , Deputy S C - 1 0 6 ( N e w J a n u a r y 1 , 1 9 9 2 ) REQUE ST TO PAY JUDG MENT IN INS TALLMENTS (Sm al l Cla i ms ) P a g e tw oelectronic form ã 1996-2000 WWW.LawCA.co m Law Publishers