This form contains 47 fields organized into 17 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name	Type	Description
Case Number and Case Name
Case Number	Text	Enter the court case number for this small claims matter.
Case Name	Text	Enter the case name as it appears on the court records (for example, plaintiff vs. defendant).
Clerk's Certificate of Mailing (Attachment, Mailing Details, Clerk Name)
Certificate of Mailing attached	Checkbox	Check this box if a separate Certificate of Mailing is attached to this form.
Request for Court Order and Answer mailed (first class, postage paid)	Checkbox	Check this box if the clerk mailed the Request for Court Order and Answer by first-class mail, postage paid, to all parties at the addresses listed in item (2).
Clerk's Certificate of Mailing - Mailing Date	Date	Enter the date the clerk mailed the document(s) as stated in the Clerk’s Certificate of Mailing section. Fill only if 'Request for Court Order and Answer mailed (first class, postage paid)' is 'Yes'. Depends on: Request for Court Order and Answer mailed (first class, postage paid)
Clerk's Certificate of Mailing - Mailing City	Text	Enter the city from which the clerk mailed the document(s). Fill only if 'Request for Court Order and Answer mailed (first class, postage paid)' is 'Yes'. Depends on: Request for Court Order and Answer mailed (first class, postage paid)
Clerk's Certificate of Mailing - Clerk Name	Text	Enter the name of the clerk completing and signing the Clerk’s Certificate of Mailing. Fill only if 'Request for Court Order and Answer mailed (first class, postage paid)' is 'Yes'. Depends on: Request for Court Order and Answer mailed (first class, postage paid)
Court and Case Information
Court Name and Street Address	Text	Enter the name of the court and its street address where the case is filed.
Case Number	Text	Enter the court-assigned case number for this small claims case.
Case Name	Text	Enter the case name as it appears on court records (for example, plaintiff v. defendant).
Court Name and Street Address
Court Name and Street Address	Text	Enter the full name of the court and its street address where this form is being filed.
Declaration - Date and Printed Name
Declaration Date	Date	Enter the date you are signing and making this declaration under penalty of perjury.
Printed Name	Text	Type or print your full name as the person making the declaration.
General
For your protection and privacy, please press the Clear This Form button after you have printed the form	Button
Print this form	Button
Save this form	Button
Clear this form	Button
Item 10 - Declaration Date and Printed Name
Item 10 Declaration Date	Date	Enter the date you are signing and making this declaration under penalty of perjury.
Item 10 Printed Name	Text	Type or print your full name as the person making the declaration.
Item 8 - Response to Request (Selections and Explanation)
Item 8a - I agree to the order requested in item 3	Checkbox	Check this box if you agree with the court order the other person requested in item 3.
Item 8 - Explanation for Disagreement	Text	Provide your explanation of why you do not agree to the order requested in item 3 and what you want the court to do instead. Fill only if 'Item 8b - I do not agree to the order requested in item 3' is 'Yes'. Depends on: Item 8b - I do not agree to the order requested in item 3
Item 8b - I do not agree to the order requested in item 3	Checkbox	Check this box if you do not agree with the court order the other person requested in item 3 and you will explain why below.
Item 8 - More space needed (attachment)	Checkbox	Check this box if you need additional space to explain your response and will attach form MC-031 or a separate sheet labeled “SC-105, Item 8.”
Item 8c - I ask the court to have a hearing to decide this matter	Checkbox	Check this box if you want the court to schedule a hearing to decide the request.
Item 9 - Date Copy Mailed to Parties
Item 9 - Date Copy Mailed to Parties	Date	Enter the date you mailed a copy of this form to everyone listed in items 1 and 2.
Notice To - First Person (Name and Address)
Notice To - First Person Name	Text	Enter the full name of the first person or party to receive notice.
Notice To - First Person Address	Text	Enter the complete mailing address for the first person or party to receive notice.
Notice To - More Space Needed
Check here if you need more space	Checkbox	Check this box if you need additional space to list the names and addresses of all other defendants and plaintiffs for item 2 (attach form MC-031 or a plain sheet of paper labeled “SC-105, Item 2”).
Notice To - Second Person (Name and Address)
Notice To - Second Person Name	Text	Enter the full name of the second person who must receive notice of this request.
Notice To - Second Person Address	Text	Enter the complete mailing address for the second person who must receive notice of this request.
Person Filing This Answer (Name, Address, Role)
Person Filing This Answer - Name	Text	Enter the full name of the person filing this Answer.
Person Filing This Answer - Address	Text	Enter the mailing address of the person filing this Answer.
A defendant in this case	Checkbox	Check this box if the person filing this answer is a defendant in this small claims case.
A plaintiff in this case	Checkbox	Check this box if the person filing this answer is a plaintiff in this small claims case.
Person Requesting Order - Identity and Role
Requesting Person Name	Text	Enter the full name of the person asking the court to make the order.
Requesting Person Address	Text	Enter the mailing address of the person asking the court to make the order.
Person requesting order is a defendant in this case	Checkbox	Check this box if the person asking the court to make an order is a defendant in this case.
Person requesting order is a plaintiff in this case	Checkbox	Check this box if the person asking the court to make an order is a plaintiff in this case.
Person requesting order is other (explain)	Checkbox	Check this box if the person asking the court to make an order is neither a plaintiff nor a defendant, and provide an explanation.
Other Role Explanation	Text	If you selected “Other,” describe your role in the case. Fill only if 'Person requesting order is other (explain)' is 'Yes'. Depends on: Person requesting order is other (explain)
Reason for Request (Explain) and More Space
Reason for Request (Explain)	Text	Provide the facts and explanation for why you are asking the court to make this order.
Check here if you need more space (Item 4)	Checkbox	Check this box if you need additional space to explain why you are asking for the order in item 4 and will attach form MC-031 or a separate sheet labeled “SC-105, Item 4.”
Requested Court Order (Specify) and More Space
Requested Court Order (Specify)	Text	Describe the specific court order you are asking the judge to make.
Item 3: More space (requested court order)	Checkbox	Check this box if you need additional space to describe the court order you are asking for in Item 3 and will attach form MC-031 or a plain sheet of paper labeled “SC-105, Item 3.”
Service of Request (Mailed/Delivered and Date)
Mailed	Checkbox	Check this box if you served (sent) a copy of this form to everyone listed in item 2 by mail.
Delivered in person	Checkbox	Check this box if you served (gave) a copy of this form to everyone listed in item 2 by personal delivery (in person).
Service Date (Mailed/Delivered)	Date	Enter the date on which you mailed or delivered in person a copy of this form to everyone listed in item 2. Fill only if 'Mailed', 'Delivered in person' is 'Yes' (any). Depends on: Mailed, Delivered in person

Judicial Council of California Form SC-105, Request for Court Order and Answer (Small Claims) Instructions