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Here is the text we could read:

MAIL TO THE JUDGMENT CREDITOR
DO NOT FILE WITH THE COURT

SC-133

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.:

AVISO AL DEUDOR POR FALLO JUDICIAL: Usted debe (1)
pagar el monto del fallo judicial, o (2) presentar un recurso
de apelación o (3) presentar un recurso de nulidad. Si usted
no paga el fallo o presenta uno de estos dos recursos, deberá
llenar y enviar por correo este formulario a su acreedor por fallo
judicial. Si no lo hace, es posible que deba presentarse ante la
corte para contestar preguntas y pagar las multas que la corte 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-130 or SC-200) was mailed or handed to you by the clerk.
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.
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.

(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.
(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.

EMPLOYMENT
1. What are your sources of income and occupation? (Provide job title and name of division or office in which you work.)

JUDGMENT DEBTOR'S STATEMENT OF ASSETS

a. Name and address of your business or employer (include address of your payroll or human resources department, if different):

If not employed, names and addresses of all sources of income (specify):

3. How often are you paid?

daily
weekly

every two weeks
twice a month

monthly
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):

Form Adopted for Mandatory Use
Judicial Council of California
SC-133 [Rev. January 1, 2011]

JUDGMENT DEBTOR'S STATEMENT OF ASSETS
(Small Claims)

Page 1 of 2

Code of Civil Procedure,
§§ 116.620(a), 116.830
www.courts.ca.gov

$
$
$
$

CASH, BANK DEPOSITS
7. How much money do you have in cash? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8. How much other money do you have in banks, savings and loans, credit unions, and other financial

institutions either in your own name or jointly (list):

Name and address of financial institution

Account number

Individual or joint?

Balance

a.
b.
c.
d.

PROPERTY
9. List all automobiles, other vehicles, and boats owned in your name or jointly:

Make and year

License and vehicle identification (VIN) numbers

Value

Legal owner if different
from registered owner

Amount owed

10. List all real estate owned in your name or jointly:

Address of real estate

Fair market value

Amount owed

OTHER PERSONAL PROPERTY (Do not list household furniture and furnishings, appliances, or clothing.)
11. List anything of value not listed above owned in your name or jointly (continue on attached sheet if necessary):

Description

Value

Address where property is located

$
$
$
$

12.

Is anyone holding assets for you?
Yes
person or entity holding each asset (specify):

If yes, describe the assets and give the name and address of the

13. Have you disposed of or transferred any asset within the last 60 days?
address of each person or entity who received any asset and describe each asset (specify):

Yes

If yes, give the name and

14. If you are not able to pay the judgment in one lump sum, you may be able to make payment arrangements with the person or

business who won the case (the judgment creditor). State the amount that you can pay each month: $
on (date):
make installment payments by filing a Request to Make Payments (form SC-220).

. If you are unable to agree, you may also ask the court for permission to

, beginning

15. 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)

(SIGNATURE)

Mail or deliver this completed form to the judgment creditor at the address shown on the Notice of Entry of Judgment form.

SC-133 [Rev. January 1, 2011]

Page 2 of 2

JUDGMENT DEBTOR'S STATEMENT OF ASSETS
(Small Claims)

Judgment Debtor's Statement of Assets (Small Claims)

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the California state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from selfhelp.courts.ca.gov (2023-03)
Page(s): 2
Fields(s): 77
Average fields per page: 38
Reading Level: Grade 9
LIST Grouping(s): CO-07-00-00-00, CO-00-00-00-00.

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

c_page_title_field__1 was SC-133[0].Page1[0].Title[0].Field1[0] (0.54 conf)
c_page_title_field__2 was SC-133[0].Page1[0].Title[0].Field2[0] (0.37 conf)
c_page_title_field__3 was SC-133[0].Page1[0].Title[0].Field3[0] (0.37 conf)
c_page_instructions_list was SC-133[0].Page1[0].Instructions[0].List4[0].Lia[0].Checkbox[0] (0.38 conf)
c_page_instructions_lib was SC-133[0].Page1[0].Instructions[0].List4[0].Lib[0].Checkbox[0] (0.38 conf)
c_page_employment_item_field__1 was SC-133[0].Page1[0].Employment[0].Li1[0].item1[0].Field6[0] (0.39 conf)
c_page_employment_li_lia_field was SC-133[0].Page1[0].Employment[0].Li2[0].Lia[0].Field7[0] (0.38 conf)
c_page_employment_li_lib_field was SC-133[0].Page1[0].Employment[0].Li2[0].Lib[0].Field8[0] (0.38 conf)
c_page_employment_li_box_ch__1 was SC-133[0].Page1[0].Employment[0].Li3[0].Box1[0].Ch1[0] (0.38 conf)
c_page_employment_li_box_ch__2 was SC-133[0].Page1[0].Employment[0].Li3[0].Box2[0].Ch2[0] (0.38 conf)
c_page_employment_li_box_ch__3 was SC-133[0].Page1[0].Employment[0].Li3[0].Box3[0].Ch3[0] (0.38 conf)
c_page_employment_li_box_ch__4 was SC-133[0].Page1[0].Employment[0].Li3[0].Box4[0].Ch4[0] (0.38 conf)
c_page_employment_li_box_ch__5 was SC-133[0].Page1[0].Employment[0].Li3[0].Box5[0].Ch5[0] (0.38 conf)
c_page_employment_li_box_ch__6 was SC-133[0].Page1[0].Employment[0].Li3[0].Box6[0].Ch6[0] (0.38 conf)
c_page_employment_li_box_field was SC-133[0].Page1[0].Employment[0].Li3[0].Box6[0].Field9[0] (0.38 conf)
c_page_employment_item_field__2 was SC-133[0].Page1[0].Employment[0].Li4[0].item4[0].Field11[0] (0.39 conf)
c_page_employment_item_field__3 was SC-133[0].Page1[0].Employment[0].Li5[0].item5[0].Field12[0] (0.39 conf)
c_page_employment_item_field__4 was SC-133[0].Page1[0].Employment[0].Li6[0].item6[0].Field15[0] (0.39 conf)
c_page_employment_item_field__5 was SC-133[0].Page1[0].Employment[0].Li6[0].item6[0].Field16[0] (0.39 conf)
c_page_cash_li_item_field was SC-133[0].Page2[0].Cash[0].Li7[0].item7[0].Field18[0] (0.39 conf)
c_page_cash_li_lia_field__1 was SC-133[0].Page2[0].Cash[0].Li8[0].Lia[0].Field20[0] (0.38 conf)
c_page_cash_li_lia_field__2 was SC-133[0].Page2[0].Cash[0].Li8[0].Lia[0].Field21[0] (0.38 conf)
c_page_cash_li_lia_field__3 was SC-133[0].Page2[0].Cash[0].Li8[0].Lia[0].Field22[0] (0.38 conf)
c_page_cash_li_lia_field__4 was SC-133[0].Page2[0].Cash[0].Li8[0].Lia[0].Field23[0] (0.38 conf)
c_page_cash_li_lib_field__1 was SC-133[0].Page2[0].Cash[0].Li8[0].Lib[0].Field24[0] (0.38 conf)
c_page_cash_li_lib_field__2 was SC-133[0].Page2[0].Cash[0].Li8[0].Lib[0].Field25[0] (0.38 conf)
c_page_cash_li_lib_field__3 was SC-133[0].Page2[0].Cash[0].Li8[0].Lib[0].Field26[0] (0.38 conf)
c_page_cash_li_lib_field__4 was SC-133[0].Page2[0].Cash[0].Li8[0].Lib[0].Field27[0] (0.38 conf)
c_page_cash_li_lic_field__1 was SC-133[0].Page2[0].Cash[0].Li8[0].Lic[0].Field28[0] (0.38 conf)
c_page_cash_li_lic_field__2 was SC-133[0].Page2[0].Cash[0].Li8[0].Lic[0].Field29[0] (0.38 conf)
c_page_cash_li_lic_field__3 was SC-133[0].Page2[0].Cash[0].Li8[0].Lic[0].Field30[0] (0.38 conf)
c_page_cash_li_lic_field__4 was SC-133[0].Page2[0].Cash[0].Li8[0].Lic[0].Field31[0] (0.38 conf)
c_page_property_li_lia_field__1 was SC-133[0].Page2[0].Property[0].Li9[0].Lia[0].Field35[0] (0.38 conf)
c_page_property_li_lia_field__2 was SC-133[0].Page2[0].Property[0].Li9[0].Lia[0].Field36[0] (0.38 conf)
c_page_property_li_lia_field__3 was SC-133[0].Page2[0].Property[0].Li9[0].Lia[0].Field37[0] (0.38 conf)
c_page_property_li_lia_field__4 was SC-133[0].Page2[0].Property[0].Li9[0].Lia[0].Field38[0] (0.38 conf)
c_page_property_li_lia_field__5 was SC-133[0].Page2[0].Property[0].Li9[0].Lia[0].Field39[0] (0.38 conf)
c_page_property_li_lib_field__1 was SC-133[0].Page2[0].Property[0].Li9[0].Lib[0].Field40[0] (0.38 conf)
c_page_property_li_lib_field__2 was SC-133[0].Page2[0].Property[0].Li9[0].Lib[0].Field41[0] (0.38 conf)
c_page_property_li_lib_field__3 was SC-133[0].Page2[0].Property[0].Li9[0].Lib[0].Field42[0] (0.38 conf)
c_page_property_li_lib_field__4 was SC-133[0].Page2[0].Property[0].Li9[0].Lib[0].Field43[0] (0.38 conf)
c_page_property_li_lib_field__5 was SC-133[0].Page2[0].Property[0].Li9[0].Lib[0].Field44[0] (0.38 conf)
c_page_property_li_lic_field__1 was SC-133[0].Page2[0].Property[0].Li9[0].Lic[0].Field45[0] (0.38 conf)
c_page_property_li_lic_field__2 was SC-133[0].Page2[0].Property[0].Li9[0].Lic[0].Field46[0] (0.38 conf)
c_page_property_li_lic_field__3 was SC-133[0].Page2[0].Property[0].Li9[0].Lic[0].Field47[0] (0.38 conf)
c_page_property_li_lic_field__4 was SC-133[0].Page2[0].Property[0].Li9[0].Lic[0].Field48[0] (0.38 conf)
c_page_property_li_lic_field__5 was SC-133[0].Page2[0].Property[0].Li9[0].Lic[0].Field49[0] (0.38 conf)
c_page_property_li_lid_field__1 was SC-133[0].Page2[0].Property[0].Li9[0].Lid[0].Field50[0] (0.38 conf)
c_page_property_li_lid_field__2 was SC-133[0].Page2[0].Property[0].Li9[0].Lid[0].Field51[0] (0.38 conf)
c_page_property_li_lid_field__3 was SC-133[0].Page2[0].Property[0].Li9[0].Lid[0].Field52[0] (0.38 conf)
c_page_property_li_lid_field__4 was SC-133[0].Page2[0].Property[0].Li9[0].Lid[0].Field53[0] (0.38 conf)
c_page_property_li_lid_field__5 was SC-133[0].Page2[0].Property[0].Li9[0].Lid[0].Field54[0] (0.38 conf)
c_page_property_li_lia_field__6 was SC-133[0].Page2[0].Property[0].Li10[0].Lia[0].Field55[0] (0.38 conf)
c_page_property_li_lia_field__7 was SC-133[0].Page2[0].Property[0].Li10[0].Lia[0].Field56[0] (0.38 conf)
c_page_property_li_lia_field__8 was SC-133[0].Page2[0].Property[0].Li10[0].Lia[0].Field57[0] (0.38 conf)
c_page_property_li_lib_field__6 was SC-133[0].Page2[0].Property[0].Li10[0].Lib[0].Field58[0] (0.38 conf)
c_page_property_li_lib_field__7 was SC-133[0].Page2[0].Property[0].Li10[0].Lib[0].Field59[0] (0.38 conf)
c_page_property_li_lib_field__8 was SC-133[0].Page2[0].Property[0].Li10[0].Lib[0].Field60[0] (0.38 conf)
c_page_li_lia_field__1 was SC-133[0].Page2[0].Other[0].Li11[0].Lia[0].Field61[0] (0.38 conf)
c_page_li_lia_field__2 was SC-133[0].Page2[0].Other[0].Li11[0].Lia[0].Field62[0] (0.38 conf)
c_page_li_lia_field__3 was SC-133[0].Page2[0].Other[0].Li11[0].Lia[0].Field63[0] (0.38 conf)
c_page_li_lib_field__1 was SC-133[0].Page2[0].Other[0].Li11[0].Lib[0].Field64[0] (0.38 conf)
c_page_li_lib_field__2 was SC-133[0].Page2[0].Other[0].Li11[0].Lib[0].Field65[0] (0.38 conf)
c_page_li_lib_field__3 was SC-133[0].Page2[0].Other[0].Li11[0].Lib[0].Field66[0] (0.38 conf)
c_page_li_lic_field__1 was SC-133[0].Page2[0].Other[0].Li11[0].Lic[0].Field67[0] (0.38 conf)
c_page_li_lic_field__2 was SC-133[0].Page2[0].Other[0].Li11[0].Lic[0].Field68[0] (0.38 conf)
c_page_li_lic_field__3 was SC-133[0].Page2[0].Other[0].Li11[0].Lic[0].Field69[0] (0.38 conf)
c_page_li_item_ch__1 was SC-133[0].Page2[0].Other[0].Li12[0].item12[0].ch1[0] (0.37 conf)
c_page_li_item_ch__2 was SC-133[0].Page2[0].Other[0].Li12[0].item12[0].ch1[1] (0.37 conf)
c_page_li_item_field__1 was SC-133[0].Page2[0].Other[0].Li12[0].item12[0].Field70[0] (0.39 conf)
c_page_li_item_ch__3 was SC-133[0].Page2[0].Other[0].Li13[0].item13[0].ch12[0] (0.37 conf)
c_page_li_item_ch__4 was SC-133[0].Page2[0].Other[0].Li13[0].item13[0].ch12[1] (0.37 conf)
c_page_li_item_field__2 was SC-133[0].Page2[0].Other[0].Li13[0].item13[0].Field72[0] (0.39 conf)
c_page_li_item_field__3 was SC-133[0].Page2[0].Other[0].Li14[0].item14[0].Field75[0] (0.39 conf)
c_page_li_item_field__4 was SC-133[0].Page2[0].Other[0].Li14[0].item14[0].Field76[0] (0.39 conf)
c_page_sign_date was SC-133[0].Page2[0].Sign[0].Date1[0] (0.37 conf)
c_page_sign_print_name was SC-133[0].Page2[0].Sign[0].PrintName1[0] (0.41 conf)

We've done our best to group similar variables togther to avoid overwhelming the user.

Suggested Screen 0:

c_page_instructions_list
c_page_instructions_lib
c_page_employment_li_lib_field
c_page_cash_li_lib_field__1
c_page_cash_li_lib_field__2
c_page_cash_li_lib_field__3
c_page_cash_li_lib_field__4
c_page_property_li_lia_field__1
c_page_property_li_lia_field__2
c_page_property_li_lia_field__3
c_page_property_li_lia_field__4
c_page_property_li_lia_field__5
c_page_property_li_lib_field__1
c_page_property_li_lib_field__2
c_page_property_li_lib_field__3
c_page_property_li_lib_field__4
c_page_property_li_lib_field__5
c_page_property_li_lid_field__1
c_page_property_li_lid_field__2
c_page_property_li_lid_field__3
c_page_property_li_lid_field__4
c_page_property_li_lid_field__5
c_page_property_li_lia_field__6
c_page_property_li_lia_field__7
c_page_property_li_lia_field__8
c_page_property_li_lib_field__6
c_page_property_li_lib_field__7
c_page_property_li_lib_field__8
c_page_li_lib_field__1
c_page_li_lib_field__2
c_page_li_lib_field__3

Suggested Screen 1:

c_page_cash_li_lic_field__1
c_page_cash_li_lic_field__2
c_page_cash_li_lic_field__3
c_page_cash_li_lic_field__4
c_page_property_li_lic_field__1
c_page_property_li_lic_field__2
c_page_property_li_lic_field__3
c_page_property_li_lic_field__4
c_page_property_li_lic_field__5
c_page_li_lia_field__1
c_page_li_lia_field__2
c_page_li_lia_field__3
c_page_li_lic_field__1
c_page_li_lic_field__2
c_page_li_lic_field__3

Suggested Screen 2:

c_page_title_field__1
c_page_title_field__2
c_page_title_field__3
c_page_employment_item_field__1
c_page_employment_li_lia_field
c_page_employment_li_box_ch__1
c_page_employment_li_box_ch__2
c_page_employment_li_box_ch__3
c_page_employment_li_box_ch__4
c_page_employment_li_box_ch__5
c_page_employment_li_box_ch__6
c_page_employment_li_box_field
c_page_employment_item_field__2
c_page_employment_item_field__3
c_page_employment_item_field__4
c_page_employment_item_field__5
c_page_cash_li_item_field
c_page_cash_li_lia_field__1
c_page_cash_li_lia_field__2
c_page_cash_li_lia_field__3
c_page_cash_li_lia_field__4
c_page_li_item_ch__1
c_page_li_item_ch__2
c_page_li_item_field__1
c_page_li_item_ch__3
c_page_li_item_ch__4
c_page_li_item_field__2
c_page_li_item_field__3
c_page_li_item_field__4

Suggested Screen 3:

c_page_sign_date
c_page_sign_print_name

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Judgment Debtor's Statement of Assets (Small Claims)

About This Form:

Identified Data Fields:

Create an Interactive Version of this Form:

The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02