ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): FAX NO. (Optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF IMPERIAL 220 Main Street, Brawley, CA 92227 415 East Fourth Street, Calexico, CA 92231 939 West Main Street, El Centro, CA 92243 1625 West Main Street, El Centro, CA 92243 2124 Winterhaven Drive, Winterhaven, CA 92283 PETITIONER: RESPONDENT: CASE NUMBER: DECLARATION OF REPRESENTATIVE OF PARTY FOR SMALL CLAIMS COURT (Code of Civil Proceeding § 116.540) I declare under penalty of perjury that I am over the age of 18 years and if sworn as a witness would testify as follows: I am authorized to appear for ___________________________, a party herein, on the basis set forth below. _____Corporation: I am a regular employee, or a duly appointed or elected officer or director, who is employed, appointed, or elected for purposes other than only to represent the corporation in small claims court. _____Partnership: I am either a partner, a regular employee, or a duly appointed or elected officer or director, who is employed, appointed, or elected for purposes other than only to represent the party in small claims court. _____Sole Proprietorship: (a) The claim can be proved or disputed by evidence of an account that constitutes a business record as defined in Evidence Code § 1271, and there is no other issue of fact in the case. (b) I am a regular employee of the party for purposes other than only to represent the party in small claims court, and I am qualified to testify to the identity and mode of preparation of the business record. _____Military Duty Out of State: The plaintiff will not personally appear, has submitted declarations to serve as evidence supporting his or her claim, is serving on active duty in the United States Armed Forces outside of this state, was assigned to his or her duty station after his or her claim arose and the assignment is for more than 6 months. I am serving without compensation and I have not appeared in small claims actions more than 4 times this calendar year. _____Incarceration: The party is incarcerated in a county jail, a Department of Corrections or Juvenile facility, will not personally appear and has submitted declarations to serve as evidence supporting his or her claim. I am serving without compensation and I have not appeared in small claims actions more than 4 times this calendar year. _____Nonresident Owner of Real Property: Defendant owner of real property does not live in California and is defending against a claim relating to property located here. Defendant has submitted written declarations to serve as evidence supporting his or her defense, allowing me to appear and participate on his or her behalf. I am serving without compensation and I have not appeared in small claims actions more than 4 times this calendar year. _____Owner of Rental Real Property: I am a property agent under contract with the owner of rental real property to manage the rental of real property involved herein, the owner has retained me principally to manage the rental of that property and not principally to represent the owner in small claims court, and the claim relates to the rental property. _____Association Created to Manage Common Interest Development (Civil Code § 1351): I am an agent, a management company representative, or a bookkeeper appearing on behalf of the association. _____Husband or Wife: I am suing or being sued with my spouse, the claim is a joint claim, my spouse has given his or her consent, and the interests of justice would be served. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this ______ day of ____________, at ________________________. _______________________________ Signature of Representative Form Approved for Optional Use SC-01 (Adopted 01/01/08, Revised 01/01/12) DECLARATION OF REPRESENTATIVE OF PARTY FOR SMALL CLAIMS COURT American LegalNet, Inc. www.FormsWorkFlow.com