Judicial Council of California, www.courts.ca.gov
New July 1, 2013, Op ti on al For m
Code of Civil Proce dure, § 116.620
Order on Declaration of Default in
Order on Declaration of Default in Payments
The payment order referred to in (check one):
Clerk stamps here when form is filed.
Fill in your case number and case name:
Fill in the court name and street address:
Superior Court of California, County of
Other orders are stated on Form SC-225A, item .
The court orders:
For free help, contact your county’s small claims advisor:
[local info here]
Or go to www.courts.ca.gov/smallclaims/advisor
A judgment was entered in this case on (date):
against (name of judgment debtor):
On (date): , the court ordered that the judgment
debtor named in
may pay the judgment as follows:
On (date): the judgment creditor (name):
informed the court that the judgment debtor had not made one or more
payments as provided in
and asked the court to order that the
remaining balance of the judgment is due and collectible.
On (date): the judgment debtor filed a
response to the judgment creditor’s request.
is terminated and the balance of the judgment is collectible.
remains in effect, without modification.
is modified as stated on Form SC-225A, item .
The following amounts are owing on the judgment as of (date):
Principal balance of judgment and costs included in judgment (amount): $
Interest (amount): $
Payments of $ , on the day
of each (month, week, other):
until (date of final payment): ,
amount of final payment: $
The payment schedule is stated on Form SC-225A, item .
The court will make orders on the matter after a hearing, which will take place on:
Name and address of court if different than address above:
Request for Accommodations Assistive listening systems, computer-assisted real-time
captioning, or sign language interpreter services are available if you ask at least five days before
the hearing. Contact the clerk’s office or go to www.courts.ca.gov/forms for Request for
Accommodations by Persons With Disabilities and Response (Form MC-410). (Civil Code, § 54.8)
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