Forms
Guides
Help
About
Start with SC-100
CA Small Claims
Forms
Guides
Help
About
Start with SC-100
Search
⌘K
MC-350EX: MC 350EX Form | CA Small Claims
MC-350EX
Miscellaneous
Fillable PDF
MC 350EX Form
Guided
One question at a time
Sections
Step by step
Full form
All fields at once
1
p1_caption_sf
Bar No Ft
Atty Name Ft
Atty Firm Ft
Atty Street Ft
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
DC
Atty City Ft
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
DC
Atty State Ft
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
DC
Atty Zip Ft
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
DC
Phone Ft
Fax Ft
Email Ft
Atty For Ft
Crt County Ft
Street Ft
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
DC
Mailing Add Ft
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
DC
City Zip Ft
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
DC
Branch Ft
Case Number Ft
Case Name Ft
Field 19
Field 20
Hearing Date Time Ft
Hearing Dept Ft
Hearing Time Ft
2
list
fill text 19
check box 6
check box 7
check box 8
check box 9
fill text 25
check box 12
Claimant Name
Hearing Date Ff
Clm Dob
fill text 23
check box 4
check box 5
Field 14
Field 15
Cb Choice1 Cb
Cb Choice1 Cb
Not Subj Of Claim Cb
Subj Of C Laim Sb
Settl Amount
$
Pending Case No
Pending Case Date
Cb Choice1 Cb
Settl Amount
$
Field 25
Field 26
Field 27
Field 28
Field 29
Addl Def Of Cb
Disb Of Cb
Judgment Date
Hearing Date Ff
Hearing Time Ff
Incident Place
Field 36
Field 37
Field 38
Field 39
Field 40
Incident Of Cb
fill text 43
Inci Desc Of Cb
Field 44
Injuries Of Cb
Field 46
Treatment Of Cb
Recovery Cb
Recovery Cb
Text Field
Disb Of Cb
Cb Choice1 Cb
Text Field
Disb Of Cb
Settl Amount
$
Field 56
Settl Amount
$
Field 58
Settl Amount
$
Field 60
Settl Amount
$
Field 62
Settl Amount
$
Disb Of Cb
Settl Amount
$
Settl Amount
$
Settl Amount
$
Settl Amount
$
Settl Amount
$
Medicare Cb
Medicare Cb
Settl Amount
$
Medi Cal Cb
Medi Cal Cb
Field 75
Date Field
check box 61
Settl Amount
$
Health Plan Cb
Settl Amount
$
Health Plan Cb
Settl Amount
$
Health Plan Cb
Health Plan Cb
Settl Amount
$
Medi Cal Cb
Medi Cal Cb
Settl Amount
$
Oth Exp Items
Other Exp Payee
Oth Exp Amount
$
Oth Exp Items
Other Exp Payee
Oth Exp Amount
$
Oth Exp Items
Other Exp Payee
Oth Exp Amount
$
Oth Exp Items
Other Exp Payee
Oth Exp Amount
$
Oth Exp Items
Other Exp Payee
Oth Exp Amount
$
Oth Exp Items
Other Exp Payee
Oth Exp Amount
$
Oth Exp Items
Other Exp Payee
Oth Exp Amount
$
Oth Exp Items
Other Exp Payee
Oth Exp Amount
$
Oth Exp Total
Settlement Def Cb
Health Plan Cb
Health Plan Cb
Health Plan Cb
Settlement Def Cb
Settl Amount
$
Settlement Def Cb
Settl Amount
$
Settlement Def Cb
Settl Amount
$
Oth Exp Total
Settl Amount
$
Settl Amount
$
Settl Amount
$
Settl Amount
$
Settl Amount
$
Settl Amount
$
Settl Amount
$
Atty Rep Other Cb
Atty Rep Other Cb
Atty Exp Fees Cb
Atty Exp Fees Cb
Atty Fee Payee
$
Atty Fee Date
Atty Fee Amount
$
Atty Fee Payee
$
Atty Fee Date
Atty Fee Amount
$
Atty Fee Payee
$
Atty Fee Date
Atty Fee Amount
$
Atty Fee Payee
$
Atty Fee Date
Atty Fee Amount
$
Atty Fee Payee
$
Atty Fee Date
Atty Fee Amount
$
Atty Fee Payee
$
Atty Fee Date
Atty Fee Amount
$
Atty Fee Payee
$
Atty Fee Date
Atty Fee Amount
$
Settlement Def Cb
Atty Fee Total
$
Grdnshp Cb
Grdnshp Crt
Grdnshp Case No
Proceeds To Grdn Cb
Settl Amount
$
Proceed To Pet Dep Cb
Settl Amount
$
Proceednot Grdn Cb
Not Estate Dep Cb
Dep Acts Amount
$
Not Estate Inv Cb
Inv Amount
$
Not Estate Tfr Cb
Tfr Amount
$
No Grdnshp Cb
No Grdnshp Dispo Cb
Amount
$
No Grdnshp Dispo Cb
Amount
$
No Grdnshp Dispo Cb
Amount
$
No Grdnshp Dispo Cb
Amount
$
No Grdnshp Dispo Cb
Amount
$
No Grdnshp Dispo Cb
Amount
$
No Grdnshp Dispo Cb
Amount
$
No Grdnshp Dispo Cb
Amount
$
Cty Name
No Grdnshp Dispo Cb
Amount
$
Addl Orders Cb
Addl Orders
Addl Order Of Cb
check box 11
Date
Print Name
Pp Att
3
footer_sub
Button
4
px_caption_sf
Case Name Ft
Case Number Ft
Case Name Ft
Case Number Ft
Case Name Ft
Case Number Ft
Case Name Ft
Case Number Ft
Case Name Ft
Case Number Ft
5
xxx_fix
Disb Of Cb
Settlement Pay To Others Cb
Settlement Pay To Others Cb
Settl Amount
$
Settlement Def Cb
Field 6
Settl Amount
$
Field 8
Settl Amount
$
Field 10
Settl Amount
$
Field 12
Settl Amount
$
Disb Of Cb
Settlement Def Cb
Settlement Def Cb
6
title_party_name
Case Name Ft
7
case_number
Case Number Ft
8
sign_sub
Date
Print Name
Date
Print Name
Submit form