Free Small Claims Declaration - California


File Size: 15.8 kB
Pages: 1
Date: April 20, 2009
File Format: PDF
State: California
Category: Court Forms - Local
Author: parrottr
Word Count: 181 Words, 1,252 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.mendocino.courts.ca.gov/forms/MSC-102.pdf

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Preview Small Claims Declaration
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):

FOR COURT USE ONLY

TELEPHONE NO: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name):

FAX NO. (Optional)

SUPERIOR COURT OF CALIFORNIA, COUNTY OF MENDOCINO
ADDRESS: CITY AND ZIP CODE: BRANCH NAME: CASE NUMBER: PETITIONER/PLAINTIFF: ___________________________________________ RESPONDENT/DEFENDANT: HEARING DATE: TIME: DEPT.:

NOTICED MOTION REQUESTING ENTRY OF JUDGMENT AFTER DEFAULT AND SUPPORTING DECLARATION (Small Claims)

I,

, Plaintiff/Defendant in this action, declare that: (circle)

(date) the parties stipulated that Defendant/Plaintiff perform pursuant to the 1. On terms of the agreement reached in mediation, copy attached. 2. Defendant/Plaintiff, , breached the agreement as follows:

3. On (date), I sent a copy of the document to Defendant/Plaintiff through regular mail to the address listed in the agreement. 4. Plaintiff/Defendant requests that the dismissal of this action be vacated and that the Court enter a judgment granting relief pursuant to the terms of the agreement and the breach as stated above. I declare under penalty of perjury that the foregoing is true and correct.

Date: Signature of Plaintiff/Defendant, declarant
MSC-102-local (new 0109)