Judicial Council of California Form SC-105, Request for Court Order and Answer (Small Claims) Completed Form Examples and Samples
Find a clear, filled-out example of the Judicial Council of California Form SC-105, Request for Court Order and Answer (Small Claims). This sample demonstrates how to properly complete the form to request a court order, such as a payment plan, after a judgment. Ideal for anyone needing a guide or template.
SC-105 Example: Request to Make Payments on a Small Claims Judgment
How this form was filled:
This is an example of a completed Form SC-105 where the Judgment Debtor (the person who lost the case) is asking the court for an order to pay the judgment amount in monthly installments. The request specifies the proposed payment amount, the start date, and the financial reasons for needing a payment plan.
Information used to fill out the document:
- Plaintiff / Judgment Creditor: Sofia Rossi
- Defendant / Judgment Debtor: David Chen
- Defendant's Address: 456 Oak Ave, Apt 2B, Los Angeles, CA 90013
- Defendant's Phone: (213) 555-0145
- Court Name: Superior Court of California, County of Los Angeles
- Court Address: Stanley Mosk Courthouse, 111 N. Hill Street, Los Angeles, CA 90012
- Case Number: 26SC01234
- Hearing Date: April 10, 2026
- Hearing Time: 9:00 AM
- Hearing Department: 50
- Date of Judgment: January 15, 2026
- Judgment Amount: $2,500.00
- Type of Request: Request to make payments (Item 3a)
- Facts Supporting Request: I am the judgment debtor. I lost my previous job in December 2025. I was recently hired for a new position, but my income is significantly lower than before. I cannot afford to pay the full judgment at once. I can responsibly pay $250 per month.
- Proposed Payment Plan: $250 per month, starting May 1, 2026, payable on the 1st of each month until paid in full.
- Filing Date: March 5, 2026
What this filled form sample shows:
- Correctly identifies the parties as the Judgment Creditor and Judgment Debtor.
- Includes accurate court and case information for proper filing and identification.
- Clearly marks item 3a, Request to Make Payments, as the purpose of the form.
- Provides a concise and clear declaration in item 4, detailing the financial hardship and the proposed payment plan.
- Fills in a specific hearing date, time, and department where the request will be heard by a judge.
Form specifications and details:
| Form Name: | SC-105, Request for Court Order and Answer (Small Claims) |
| Issuing Authority: | Judicial Council of California |
| Use Case: | A judgment debtor requesting an order to pay a small claims judgment in monthly installments. |
Created: February 03, 2026 05:45 AM
