Fill in the court name and street address:
Superior Court of California, County of

SC-222

Order on Request to Make 
Payments  

A request to make payments on a small claims judgment was filed by the 
judgment debtor (name of the person who owes money in this case):

Clerk stamps here when form is filed.

The Request to Make Payments is denied. The person in  
must pay the entire judgment immediately.

The Request to Make Payments is approved, and the court 
orders: 
a.

Payments of $                             ,   on the                              day
of each (month, week, other):   
starting (date): 
until (date of final payment):                                                          , 
amount of final payment: $

Other payment schedule (specify):         

The court orders:

 



b.

c.

d.

e.

The total amount of payments is $                                            , 
which includes interest on the unpaid balance of the judgment. 
The actual amount of that interest may change if the payments 
are made late or early. 

Case Name:

Fill in your case number and case name:
Case Number:

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 judgment, and the judgment will be paid in full. 

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.



Other (specify): 

f.
The court will make orders on this Request after a hearing, which will take place on:

3




Hearing 
Hearing 
Date
Date

Time:

Dept.
:

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 for Request for Accommodations by Persons With 
Disabilities and Response  (Form MC-410). (Civil Code, § 54.8)



Other orders (specify): 

Continued on Attachment 5.

Date:      

Need help?
For free help, contact your county’s small claims advisor:   
[local info here]

Judicial officer                                            

Or go to “County-Specific Court Information” at www.courts.ca.gov/selfhelp-smallclaims.htm

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

Order on Request to Make Payments
(Small Claims)

SC-222