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MAIL TO THE JUDGMENT CREDITOR DO NOT FILE WITH THE COURT JUDGMENT CREDITOR (the person or business who won the case) (name): JUDGMENT DEBTOR (the person or business who lost the case and owes money) (name): NOTICE TO JUDGMENT DEBTOR: You must (1) pay the judgment or (2) appeal or (3) file a motion to vacate. If you fail to pay or take one of the other two actions, you must complete and mail this form to the judgment creditor. If you do not, you may have to go to court to answer questions and may have penalties imposed on you by the court. SMALL CLAIMS CASE NO.: SCA 33 "ISO AL DEUDOR POR FALLO JUDICIAL: Usted debe (1) pagar el monto del fallo judicial, o (2) presentar un recurso de apelacion o (3) presentar un recurso de nulidad. Si usted no paga el fallo o presenta uno de estos dos recursos, debera Ilenar y enviar por correo este formulario a su acreedor por fallo judicial. Si no to hate, es posible que deba presentarse ante la Corte para contestar preguntas y pagar las multas que la torte le pueda imponer. INSTRUCTIONS The small claims court has ruled that you owe money to the judgment creditor. 1. You may appeal a judgment against you only on the other party's claim. You may not appeal a judgment against you on your claim. a. If you appeared at the trial and you want to appeal, you must file a Notice of Appeal (form SC-140) within 30 days after the date the Notice of Entry of Judgment (form SC-1 30 or SC-200) was mailed or handed to you by the clerk. b. If you did not appear at the trial, before you can appeal, you must first file a Notice of Motion to Vacate Judgment and Declaration (form SC-135) and pay the required fee within 30 days after the date the Notice of Entry of Judgment was mailed or handed to you. The judgment cannot be collected until the motion is decided. If your motion is denied, you then have 10 days after the date the notice of denial was mailed to file your appeal. 2. Unless you pay the judgment or appeal the judgment or file a motion to vacate, you must fill out this form and mail it to the person who won the case within 30 days after the Notice of Entry of Judgment was mailed or handed to you by the clerk. Mailing this completed form does not stay enforcement of the judgment. 3. If you lose your appeal or motion to vacate, you must pay the judgment, including postjudgment costs and interest. As soon as the small claims court denies your motion to vacate and the denial is not appealed, or receives the dismissal of your appeal or judgment from the superior court after appeal, the judgment is no longer suspended and may be immediately enforced against you by the judgment creditor. 4. Unless you have paid the judgment, complete and mail this form to the judgment creditor within 30 days after the date the clerk mails or delivers to you (a) the denial of your motion to vacate, or (b) the dismissal of your appeal, or (c) the judgment against you on your appeal. If you were sued as an individual, skip this box and begin with item 1 below. Otherwise, check the applicable box, attach the docu- ments indicated, and complete item 15 on the reverse. a. (Corporation or partnership) Attached to this form is a statement describing the nature, value, and exact location of all assets of the corporation or the partners, and a statement showing that the person signing this form is authorized to submit this form on behalf of the corporation or partnership. b. (Governmental agency) Attached to this form is the statement of an authorized representative of the agency stating when the agency will pay the judgment and any reasons for its failure to do so. JUDGMENT DEBTOR'S STATEMENT OF ASSETS EMPLOYMENT 1. What are your sources of income and occupation? (Provide job title and name of division or office in which you work.) 2. a. Name and address of your business or employer (include address of your payroll or human resources department, if different): b. If not employed, names and addresses of all sources of income (specify): 3. How often are you paid? 0 daily 0 every two weeks 0 monthly 0 weekly 0 twice a month 0 other (explain): 4. What is your gross pay each pay period? $ 5. What is your take-home pay each pay period? $ 6. If your spouse earns any income, give the name of your spouse, the name and address of the business or employer, job title, and division or office (specify): Page 1 of 2 Form Adopted for Mandatory Use JUDGMENT DEBTOR'S STATEMENT OF ASSETS Code of Civil Procedure, Judicial Council of California §§ 116.620(a), 116.830 SC-133 [Rev. January 1, 20111 (Small Claims) www.courts.co.gov