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