SC-220 Request to Make Payments

Read the other side before you fill out this form.
My name is:
On
(date): , the court made the decision (judgment) that:
To
(name of party you must pay):
I am asking for permission to make payments, instead of paying the full
amount all at once, because
(explain):
SC-220, Page 1 of 2
Judicial Council of California, www.courts.ca.gov
Rev. July 1, 2013, Optional Form
Code of Civil Procedure, § 116.620, Cal. Rules of Court, rule 3.2107
SC-220
Request to Make Payments
Request to Make Payments
(Small Claims)
Other payment schedule (specify):
b.
c.
The total amount of payments is $ , which includes interest on the unpaid balance of the judgment.
The actual amount of that interest may be different if the payments are made late or early.
Attach a page that shows how you calculated the interest and write “SC-220, Item 4c” at the top.
Clerk stamps here when form is filed.
Case Number:
Fill in your case number and case name:
Fill in the court name and street address:
Superior Court of California, County of
Case Name:
Phone:
I owe (total amount): $
If your answer will not fit in the space below, check this box and attach your
answer on a separate sheet of paper. Write “SC-220, Item 3” at the top.
I ask the court to allow me to make payments on the following terms (check and complete all that apply):
Payments of $ , on the day of each (month, week, other):
a.
d.
The total amount of payments is the same as the judgment. If all payments are made in full and on time, no
interest will be owed on the judgmen t, and the judgment will be paid in full.
Mailing address:
Starting (date): , until ( d at e o f final payme nt ) : ; amount of final payment: $
I am asking for permission to pay my small claims judgment in payments.
Phone:
Mailing address:
e.
Other
(specify):
I declare under penalty of perjury under the laws of the State of California that the information above is true and corre ct.
Date:
Type or print your name Sign here
Warning! If any payment is not made in full and on time, the judgment creditor may notify the court
to cancel the payment plan and the entire unpaid balance will become due and collectible.
To keep other people from
seeing what you entered on
your form, please press the
Clear This Form button at the
end of the form when finished.
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SC-220 Request to Make Payments PDF

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