NAME AND ADDRESS OF COURT:

SMALL CLAIMS CASE NO.:

SC-134

FOR COURT USE ONLY

PLAINTIFF/DEMANDANTE (name, address, and telephone number of each):

Telephone No.:

DEFENDANT/DEMANDADO (name, address, and telephone number of each):

Telephone No.:

See attached sheet for additional plaintiffs and defendants.

ORDER TO PRODUCE STATEMENT OF ASSETS 
AND TO APPEAR FOR EXAMINATION

1.
2.

TO JUDGMENT DEBTOR (name):
YOU ARE ORDERED
a.

to pay the judgment and file proof of payment (a canceled check or money order or cash receipt, and a written declaration that 
shows full payment of the judgment, including postjudgment costs and interest) with the court before the hearing date shown in 
the box below, OR
to (1) personally appear in this court on the date and time shown below, and  
    (2) bring with you a completed Judgment Debtor's Statement of Assets (form SC-133). 

b.

At the hearing you will be required to 
l answer questions about your income and assets; and 
l explain why you did not complete and mail form SC-133 to judgment creditor in a timely manner. (You should have sent it 

within 30 days after the Notice of  Entry of Judgment (form SC-130) was mailed or handed to you by the clerk.) 

Name and address of court if different from above:

 

Hearing 
Date

g

Date:

Dept.:

Time:

Room:

If you fail to appear and have not paid the judgment, 
including postjudgment costs and interest, a bench warrant  
may be issued for your arrest, you may be held in contempt 
of court, and you may be ordered to pay penalties.

Si usted no se presenta y no ha pagado el monto del fallo 
judicial, inclusive las costas e intereses posterlores al fallo, 
la corte puede expedir una orden de detencion contra usted, 
declararle en desacato y ordenar clue pague multas.

3.

This order may be served by a sheriff, marshal, or registered process server.

Date:

APPLICATION FOR THIS ORDER
(See Instructions on reverse)

(SIGNATURE OF JUDGE)

A.

B.

applies for an order requiring

Judgment creditor (the person who won the case) (name):
judgment debtor (the person or business who lost the case and owes money) (name):
to (1) pay the judgment or (2) personally appear in this court with a completed Judgment Debtor's Statement of Assets (form 
SC-133), explain why judgment debtor did not pay the judgment or complete and mail form SC-133 to judgment creditor within 30 
days after the Notice of Entry of Judgment was mailed or handed to judgment debtor, and answer questions about judgment 
debtor's income and assets.
I, judgment creditor, state the following:
(1)
(2)
(3)
(4)
(5)
(6)

Judgment debtor has not paid the judgment.
Judgment debtor either did not file an appeal or the appeal has been dismissed or judgment debtor lost the appeal.
Judgment debtor either did not file a motion to vacate or the motion to vacate has been denied.
More than 30 days have passed since the Notice of Entry of Judgment was mailed or delivered to judgment debtor. 
I have not received a completed Judgment Debtor's Statement of Assets from judgment debtor.
The person to be examined resides or has a place of business in this county or within 150 miles of the place of examination.

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:

(TYPE OR PRINT NAME)

(DECLARANT)

Form Adopted for Mandatory Use 
Judicial Council of California 
SC-134 [Rev. January 1, 2017]

– The county provides small claims advisor services free of charge –

APPLICATION AND ORDER TO PRODUCE STATEMENT 
OF ASSETS AND TO APPEAR FOR EXAMINATION 
(Small Claims)

Page 1 of 2

Code of Civil Procedure, §§ 116.820, 
116.830, 708.170 
www.courts.ca.gov

1.

2.

3.

4.

INSTRUCTIONS FOR APPLICANT

SC-134

This form is intended to be an easy tool to enforce your right to receive a completed Judgment Debtor's Statement of Assets (form 
SC-133). This form is not intended to replace the Application and Order for Appearance and Examination (form EJ-125), often 
called an "Order for Examination." The Application and Order for Appearance and Examination should still be used to enforce a 
small claims judgment if you are not seeking at the same time to make the debtor complete a Judgment Debtor's Statement of 
Assets.

To set a hearing on an Application and Order to Produce Statement of Assets and to Appear for Examination, you must complete 
this form, present it to the court clerk, and pay the fee for an initial hearing date or a reset hearing date.

After you file this form, the clerk will set a hearing date, note the hearing date on the form, and return two copies or an original and 
one copy of the form to you.

If you want to be able to ask the court to enforce the order on the judgment debtor (the person or business who lost the case), you 
must have a copy of this form and a blank copy of the Judgment Debtor's Statement of Assets (form SC-133) personally served on 
the judgment debtor by a sheriff, marshal, or registered process server at least 10 calendar days before the date of the hearing, and 
have a proof of service filed with the court. The law provides for a new fee if you reset the hearing.

5.

If the judgment is paid, including all postjudgment costs and interest, you must immediately complete the Acknowledgment of 
Satisfaction of Judgment on the reverse of the Notice of Entry of Judgment (form SC-130) and file a copy with the court.

6.

You must attend the hearing unless the judgment has been paid.

Request for Accommodations. Assistive listening systems, computer-assisted real-time captioning, or sign 
language interpreter services are available if you ask at least 5 days before your hearing. Contact the clerk’s 
office for Request for Accommodation (form MC-410). (Civil Code, § 54.8.)

SC-134 [Rev. January 1, 2017]

Page 2 of 2

APPLICATION AND ORDER TO PRODUCE STATEMENT 
OF ASSETS AND TO APPEAR FOR EXAMINATION 
(Small Claims)