Judgment Debtor's Statement of Assets (Small Claims)
California · Judicial Council of California · Effective January 1, 2011
This form asks the person who lost a small claims case and owes money to list their assets, job details, and income sources. It is a statement that must be mailed to the person who won the case.
The court describes it as: Tell the person who won your small claims case about your job, what you own, and where you keep your money.
Where this fits in a case
JudgmentStage: Judgment
This form is used by the person who lost a small claims case and owes money after a judgment has been entered. The person must complete and mail this form to the winner unless they pay the judgment or appeal it.
Usually filed by the person responding.
Official instructions
How-to guides published by the court for this form.
Common questions
- Who should fill out this form?
- The form is for the judgment debtor, which is the person or business that lost the small claims case and owes money. You must mail it to the judgment creditor (the person who won).
- What happens if I don't file this form?
- If you do not pay the judgment or appeal, and you do not file this form, you might have to go to court to answer questions and could face penalties from the court.
- Does mailing this form stop the judgment from being enforced?
- The instructions state that mailing this completed form does not stop the enforcement of the judgment.
Revision history
No changes recorded since we started tracking this form on October 9, 2026. The current version took effect January 1, 2011.
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