SC-103 Fictitious Business Name - Small Claims

SC-103
Case Number:
Fictitious Business Name
Form SC-100
Form SC-120
This form is attached to: OR
If you want to file a small claim and you are doing business under a fictitious name
(“doing business as,” or “dba”) give the following information. (Nonprofits and exempt real
estate investment trusts do not have to file this form.)
Business name of the person suing:
Business address (not a U.S. Postal Service P.O. Box):
The business listed in does business as (check ONLY one):
an individual a corporation
an association a limited liability company
other (specify):a partnership
Name of county where you filed your Fictitious Business Name Statement (dba):
Your Fictitious Business Name Statement number:
Date your Fictitious Business Name Statement expires:
I declare, under penalty of perjur y un der Cal ifor nia Stat e law, that the information above is true and correct.
Date:
Sign your name
Type or print your name and title
SC-103, Page 1 of 1
Judicial Council of California, www.courtinfo.ca.gov
Revised January 1, 2006, Option al Form
Code of Civil Procedure, § 116.430;
Business a nd Professions Code, § 17900 et seq.
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Fictitious Business Name
(Small Claims)
You must follow the laws for fictitious business names. If you have not followed these laws, including filing a
fictitious business name statement in your county and publishing this information in a local newspaper, the court
can dismiss your case.
Only the owner, president, chief executive officer (CEO), or other qualified officer can sign this form.
Need help?
Your county’s Small Claims Advisor can help
for free.
?
Or go to “County-Specific Court Information” at:
www.courtinfo.ca.gov/selfhelp/smallclaims
1
Mailing address (if different):
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