5C-100
Plaintiff'sClaim and ORDER
toGoto Small ClaimsCourt
Clerkstampsdateherewhenformis filed.
Noticetothe person begin sued:
•You are the Defendant if yournameis listedin (2)onpage 2of this
form.The personsuingyouisthe Plaintiff.
•Youandthe Plaintiff must go to the courton the trial date listed below.If
youdonotgo to court, youmaylosethecase.
•
Ifyoulose,the courtcan order that yourwages, money, or propertybe
taken topay this claim.
•Bringwitnesses, receipts,andany evidenceyouneed to prove yourcase.
•Readpages2and 3of this form to understand the Plaintiffs claim against
youandpage4of this form to protect your rights.
Aviso al demandando:
•UstedeselDemandadosisu nombreFigurain (2)delapagina 2
deeste formula rio.Lapersonaque10 demandaesel Demandante.
•Ustedyel Demandante tienen que presentarseenla corteenla
fechadeljuicio indicada a continuacion.5inose presenta,puede
perderelcaso.
•5i pierdeelcasola cortepodrfa ordenar queIe quitendesu
sueldo, dinero u otrosbienespara pagar estereclamo.
~
T
112005
FIlloutcourtname andstreetaddress:
Superior Courtof california, Countyof Riverside
880North State Street
Hemet, CA 92543
Oerk fillsIn case number when fonnIS filed.
ICoseNumber:
HE5011184
•
L1evetestigos,recibos y cualquier otra prueba que necesitepara probarsucaso.
•Lealaspaginas 2 y 3de este formulariopara entenderlademandaensu contra yla pagina 5de este formulario
paraprotegersus derechos.
Order toGo to Court
The people in(1) and(2)mustgoto court on:(Clerk fillsout below)
Trial
Date
Date
1.11/10105
2.
_
Time
1:30PM
Department
H5
Nameandaddress of courtif different from above
3.
_
Date:10/11/05
Clerkby,VICKIEARVIZU
Instructionsforthe person suing:
•
YouarethePlaintiff.Thepersonyou aresuingistheDefendant.
•
Beforeyoufilloutthisform,readForm5C-150, Informationfor the Small Claims Plaintiff,toknowyourrights.Get
5C-150atanycourthouse,countylawlibrary,orgotowww.courtinfo.ca.gov/forms
•
Filloutpages2and 3ofthisform.Thentakeormail
ittothecourthouseclerk'sofficeandpayyourfee.The
clerk
willwriteyourtrialdateintheboxabove.
•
Youmusthavesomeone18orover--notyouoranyoneelse
involvedwiththiscase--giveeachDefendantacopy of
all5pagesofthisformandany pagesthisformtellsyoutoattach.Keep acopyforyourrecords.
•Goto court on your trial date listed above.Bringwitnesses,receipts,andanyevidenceyouneededtoprove
yourcase.
Judicial Councilof California, www.CQurtinfo.ca.Qov
Rev, January1,2005, Mandatory Form
CodeofCivil PrOCedure,§§ 116.110 at seq"
116.220(c), 116,340(g)
FORMCSCPC
Plaintiff'sClaim and ORDER
toGo toSmall ClaimsCourt
(Small Claims)
SC-100, Page 1of 5
SC-100A
Other Plaintiffs or Defendants
Case Number:
50/,!Irtf
IBlThis form is attached to FormSC-IOO, Item I or2.
G)Ifmore than one person is suing, give namesof other Plaintiffs (peoplewho are suing) below:
Other Plaintiffs name:
Phone:
_
Home address:
City:
State:
Zip:
_
Mailing address(ifdifferent):
_
City:
State:
Zip:
_
Is this Plaintiffdoing business under a fictitious name?DYes
0No
Ifyes, attach SC- I 03and write Fictitious Business Statement number here:
Phone:
_
Other Plaintiffs name:
_
Home address:
City:
State:
Zip:
_
Mailing address(ifdifferent):
City:
State:
Zip:
_
Is this Plaintiffdoing business under a fictitious name?0
Yes['-J No
Ifyes, attach SC- I 03and write Fictitious Business Statement number here:
Other Plaintiffs name:
Phone:
Home address:
Zip:
_
City:
State:
_
Mailing address(ifdifferent):
City:
State:
Zip:
_
Is this Plaintiffdoing business under afictitious name?L...JYesIJ No
Ifyes, attach SC-103and write Fictitious Business Statement number here:
_
oIf more than one person is being sued, give the namesof other Defendants (people who are being
sued) below:
Other Defendant's name:LiquorLicenseSpecialists
Phone:(310)459-3685
Home address:
City:
State:
Zip:
_
Mailing address(ifdifferent):17383SunsetBoulevard.#A310
City:PacificPalisades
Stare:CA
Z
~
:
~
9
~
0
~
2
~
7
~
2
~
__
Zip:
Zip:
_
Zip:
_
Zip:
_
State:
Other Defendant's name:
Phone:
_
Home address:
City:
State:
_
Mailing address(ifdifferent):
_
City:
State:
_
Other Defendant's name:
Phone:
_
Home address:
_
City:
State:
_
Mailing address(ifdifferent):
_
City:
JudidalCouncilofCalifornia
NewJanuary1,2005.MandatoryFClfI'n
CodeofCivilProcedure,§116.110elseq.
Other Plaintiffsor Defendants
(Small Claims)
SC-100A,Page _of _
o
Zip:
_
Zip:92543
Phone:(760)497-3795
S
t
a
t
e
:
"
,
C
"
,
A
~
_
Your name:JimRahman
CaseNulTt>er:
Describe your claim:
CDThe Plaintiff (the personwho is suing)is:
Nanre:JimRahman,dbaMay-J,Inc.
Home address:550N.StateStreet
City:Hemet
Mailing address(ifdijferent):
_
City:
State:
_
Ifmorethan one person is suing, attach Form SC-IOOAand check here:0
Is this Plaintiffdoing business under a fictitious name?[_IYes
0
No
Ifyes, attach Form SC-J03and write Fictitious Business Statement number here:
.
_
oThe Defendant (the person being sued) Is:
Name:CraigBlock.PresidentofLiquorLicenseSpecialists
Phone:(310)459-3688
Zip:
_
Home address:"
'
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_
.
_
City:
State:
_
Mailing address(ifdijferen():17383SunsetBoulevard,#A310
City:PacificPalisades
State:"
,
C
.
u
A
~
Zip:90272
Ifmorethan one person is being sued, attach Form SC-IOOAand check here:I)';J
Ifany Defendantis on active military duty, write his or her name here:
_
CDThe Plaintiff claims the Defendant owes$",-SLo'0""0""0"--
•(Explainbelow):
a.
Why does the Defendant owe the Plaintiff money?PleaseseeattachedD eclaration
c.
b.
When did this happen?(Date):
Ifno specific date, give the time period:Date started:,,0"'4u.l-'0'-'7u/'-'0"'4"---____ Through: 10LI."'1."'1.LI-"0"'4'----
_
How did you calculate the money owed to you?.=I--"a",m......
a..,s,-,k",l",·n",o"-",f",o.=r--,<S",S,-",-,O,-,O",O"-o"-"f--,<t,,,h,,,e,---,S,-,E,,,i,,,,S,,,O,,-O,,-,,,f.=i.un,,,d,,,e,,,r,,,s,
feerefunded
[X]Check hereifyouneedmore space. Attach one sheetofpaperor Form MC-030and write "SC-IOO, Item3"at
the top.
You must ask the Defendant (in person,in writing, or by phone) to pay you before you sue.
Have you done this?[XJYes
0
No
Ifno, explain why not:
Rev.January"2005
Plaintiff'sClaimandORDER
toGo toSmallClaimsCourt
(Small Claims)
SC-100.Page 2of 5
-+
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Jim Rahman v Liquor License Specialists - Small Claims Complaint
"I was solicited by Craig Block, President of Liquor License Specialists who
told me that they could find me a Liquor License to purchase for a finder's
fee. I was notified that Liquor License Specialists had… (More)
told me that they could find me a Liquor License to purchase for a finder's
fee. I was notified that Liquor License Specialists had… (More)
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