Small Claims Intake Sheet |

Process Service Network™
21218 Merridy Street
Chatsworth, CA 91311
(800)417-7623

Small Claims Intake Form

Please fill out the form completely and press send so we may file and serve your Small Claims case.

Plaintiff

Name *

Street Address *

City *

State *

Zip Code *

Email *

Phone *

Individual Authorized to Sign *

If your business is a DBA, Fictitious Business Statement No.

Expires (mm/dd/year)

DEFENDANT #1 (Exact legal name of Defendant)

Name

Street Address

City

State

Zip Code

Phone

Is address?

Home

Business

DEFENDANT #2 (Exact legal name of Defendant)

Name

Street Address

City

State

Zip Code

Phone

Is address?

Home

Business

Amount Suing for

City debt incurred

Date incurred

Reason

Time you request hearing (include AM/PM)

Are there dates when you will NOT be available during next 2 months?

How did you determine the amount of the claim (i.e. Invoices, balance sheets, correspondence)?

Comments/Additional information

Optional Service

RUSH service – add $135.00

Locate defendant - add $85.00

Process Service Network (PSN) is not responsible for errors, omissions, or the outcome of any Small Claims case. No legal advice is offered by PSN. Plaintiff assumes responsibility for any liability arising out of this assignment and releases PSN, its agents, owners and employees for any liability. It is agreed that if service cannot be made at the address provided and service is made at an additional address, charges shall apply at the current published rates and will be automatically billed to accounts in good standing or charged to the credit card on file if paid by credit card. All fees are normally recoverable as court costs. No refunds can be made after case is assigned. Client has read and agrees with the Terms & Conditions set forth on our website.