Form CIV-105 Request for Entry of Default (Fair Debt Buying Practices Act) - California

Form CIV-105 is a California Courts form also known as the "Request For Entry Of Default (fair Debt Buying Practices Act)". The latest edition of the form was released in January 1, 2018 and is available for digital filing.

Download a PDF version of the Form CIV-105 down below or find it on California Courts Forms website.

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CIV-105
STATE BAR NO.:
ATTORNEY OR PARTY WITHOUT ATTORNEY:
FOR COURT USE ONLY
NAME:
FIRM NAME:
STREET ADDRESS:
CITY:
STATE:
ZIP CODE:
TELEPHONE NO.:
FAX NO.:
E-MAIL ADDRESS:
ATTORNEY FOR (name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
Plaintiff/Petitioner:
Defendant/Respondent:
CASE NUMBER:
REQUEST FOR
Entry of Default
Judgment
(Application)
For use only in actions under the Fair Debt Buying Practices Act (Civ. Code, § 1788.50 et seq.)
1.
On the complaint or cross-complaint filed
a.
on (date):
b.
by (name):
c.
Enter default of defendant (names):
d.
I request a judgment under Civil Code section 1788.60 and Code of Civil Procedure section 585 against defendant
(names):
(Testimony may be required. Check with the clerk regarding whether a hearing date is needed.)
Default was previously entered on (date):
e.
2.
Judgment to be entered.
Amount
Credits acknowledged
Balance
a.
$
$
$
Demand of complaint*
b.
Interest
$
$
$
c.
Costs (see page 3)
$
$
$
d.
Attorney fees
$
$
$
e.
TOTALS
$
$
$
(* Must be established by business records, authenticated through a sworn declaration, submitted with this application. (Civ.
Code, §§ 1788.58(a)(4), 1788.60(a).))
3.
This action is not barred by the applicable statute of limitations (Civ. Code, § 1788.56).
4.
Requirements for the complaint.
a.
The complaint alleges ALL of the following (Civ. Code, §§ 1788.58, 1788.60):
(1) That the plaintiff is a debt buyer;
(2) A short, plain statement regarding the nature of the underlying debt and the consumer transaction from which it is
derived;
(3) That the plaintiff is EITHER the sole owner of the debt OR has the authority to assert the rights of all owners of the debt;
(4) The debt balance at charge-off and an explanation of the amount and nature of, and reason for, all post-charge-off
interest and fees, if any, imposed by the charge-off creditor or any subsequent purchasers of the debt;
(5) The date of the default OR the date of the last payment;
(6) The name and address of the charge-off creditor at the time of charge-off in sufficient form so as to reasonably identify
the charge-off creditor, and the charge-off creditor's account number associated with the debt;
Page 1 of 3
Form Adopted for Mandatory Use
REQUEST FOR ENTRY OF DEFAULT
Code of Civil Procedure, § 585;
Judicial Council of California
Civil Code, § 1788.60
(Fair Debt Buying Practices Act)
CIV-105 [New January 1, 2018]
www.courts.ca.gov
CIV-105
STATE BAR NO.:
ATTORNEY OR PARTY WITHOUT ATTORNEY:
FOR COURT USE ONLY
NAME:
FIRM NAME:
STREET ADDRESS:
CITY:
STATE:
ZIP CODE:
TELEPHONE NO.:
FAX NO.:
E-MAIL ADDRESS:
ATTORNEY FOR (name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
Plaintiff/Petitioner:
Defendant/Respondent:
CASE NUMBER:
REQUEST FOR
Entry of Default
Judgment
(Application)
For use only in actions under the Fair Debt Buying Practices Act (Civ. Code, § 1788.50 et seq.)
1.
On the complaint or cross-complaint filed
a.
on (date):
b.
by (name):
c.
Enter default of defendant (names):
d.
I request a judgment under Civil Code section 1788.60 and Code of Civil Procedure section 585 against defendant
(names):
(Testimony may be required. Check with the clerk regarding whether a hearing date is needed.)
Default was previously entered on (date):
e.
2.
Judgment to be entered.
Amount
Credits acknowledged
Balance
a.
$
$
$
Demand of complaint*
b.
Interest
$
$
$
c.
Costs (see page 3)
$
$
$
d.
Attorney fees
$
$
$
e.
TOTALS
$
$
$
(* Must be established by business records, authenticated through a sworn declaration, submitted with this application. (Civ.
Code, §§ 1788.58(a)(4), 1788.60(a).))
3.
This action is not barred by the applicable statute of limitations (Civ. Code, § 1788.56).
4.
Requirements for the complaint.
a.
The complaint alleges ALL of the following (Civ. Code, §§ 1788.58, 1788.60):
(1) That the plaintiff is a debt buyer;
(2) A short, plain statement regarding the nature of the underlying debt and the consumer transaction from which it is
derived;
(3) That the plaintiff is EITHER the sole owner of the debt OR has the authority to assert the rights of all owners of the debt;
(4) The debt balance at charge-off and an explanation of the amount and nature of, and reason for, all post-charge-off
interest and fees, if any, imposed by the charge-off creditor or any subsequent purchasers of the debt;
(5) The date of the default OR the date of the last payment;
(6) The name and address of the charge-off creditor at the time of charge-off in sufficient form so as to reasonably identify
the charge-off creditor, and the charge-off creditor's account number associated with the debt;
Page 1 of 3
Form Adopted for Mandatory Use
REQUEST FOR ENTRY OF DEFAULT
Code of Civil Procedure, § 585;
Judicial Council of California
Civil Code, § 1788.60
(Fair Debt Buying Practices Act)
CIV-105 [New January 1, 2018]
www.courts.ca.gov
CIV-105
Plaintiff/Petitioner:
CASE NUMBER:
Defendant/Respondent:
4.
a.
(7)
The name and last known address of the debtor as they appeared in the charge-off creditor's records prior to the sale of
the debt;
(8)
The names and addresses of all persons or entities that purchased the debt after charge-off, including the plaintiff debt
buyer, in sufficient form so as to reasonably identify each such purchaser; and
(9)
That the plaintiff has complied with Civil Code section 1788.52.
b.
A copy of the contract or other document described in Civil Code section 1788.52(b) is attached to the complaint.
5.
Documentation requirements for default judgment. ALL of the following documents are submitted with this request for default
judgment (Civ. Code, § 1788.60(a)–(c)):
a.
A copy of the contract or other document evidencing the debtor's agreement to the debt, authenticated through a sworn
declaration. See Civil Code section 1788.52(b) regarding documentation, including for revolving credit accounts.
b.
Business records, authenticated through a sworn declaration, to establish:
(1) That the plaintiff is EITHER the sole owner of the debt OR has the authority to assert the rights of all owners of the debt;
(2) The debt balance at charge-off, and an explanation of the amount and nature of, and reason for, all post-charge-off
interest and fees, if any, imposed by the charge-off creditor or any subsequent purchasers of the debt;
(3) The date of the default OR the date of the last payment;
(4) The name and address of the charge-off creditor at the time of charge-off in sufficient form so as to reasonably identify
the charge-off creditor, and the charge-off creditor's account number associated with the debt;
(5) The name and last known address of the debtor as they appeared in the charge-off creditor's records prior to the sale of
the debt; and
(6) The names and addresses of all persons or entities that purchased the debt after charge-off, including the plaintiff debt
buyer, in sufficient form so as to reasonably identify each such purchaser.
Date:
(TYPE OR PRINT NAME)
(SIGNATURE OF PLAINTIFF OR ATTORNEY FOR PLAINTIFF)
(1)
Default entered as requested on
(date):
FOR COURT
(2)
Default NOT entered as requested(state reason):
USE ONLY
Clerk, by
, Deputy
6.
Legal document assistant or unlawful detainer assistant (Bus. & Prof. Code, § 6400 et seq.). A legal document assistant or
did
did not
unlawful detainer assistant
for compensation give advice or assistance with this form. If declarant has
received any help or advice for pay from a legal document assistant or unlawful detainer assistant, state:
a.
Assistant's name:
c.
Telephone no.:
b.
Street address, city, and zip code:
d.
County of registration:
e.
Registration no.:
f.
Expires on (date):
7.
Declaration under Code Civ. Proc., § 585.5 (for entry of default under Code Civ. Proc., § 585(a)). This action
a.
is
is not
on a contract or installment sale for goods or services subject to Civ. Code, § 1801 et seq. (Unruh Act).
b.
is
is not
on a conditional sales contract subject to Civ. Code, § 2981 et seq. (Rees-Levering Motor Vehicle Sales
and Finance Act).
c.
is
is not
on an obligation for goods, services, loans, or extensions of credit subject to Code Civ. Proc., § 395(b).
REQUEST FOR ENTRY OF DEFAULT
Page 2 of 3
CIV-105 [New January 1, 2018]
(Fair Debt Buying Practices Act)
CIV-105
CASE NUMBER:
Plaintiff/Petitioner:
Defendant/Respondent:
8.
Declaration of mailing (Code Civ. Proc., § 587). A copy of this Request for Entry of Default was
a.
not mailed to the following defendants, whose addresses are unknown to plaintiff or plaintiff's attorney (names):
b.
mailed first-class, postage prepaid, in a sealed envelope addressed to each defendant's attorney of record or, if none,
to each defendant's last known address as follows:
(1)
(2)
To (specify names and addresses shown on the envelopes):
Mailed on (date):
I declare under penalty of perjury under the laws of the State of California that the foregoing items 6, 7, and 8 are true and correct.
Date:
(TYPE OR PRINT NAME)
(SIGNATURE OF DECLARANT)
9.
Declaration of nonmilitary status (required for a judgment). No defendant named in item 1c of the application is in the military
service as that term is defined by either the Servicemembers Civil Relief Act, 50 U.S.C. App. § 3911(2), or California Military and
Veterans Code section 400(b).
10.
Memorandum of costs (required if money judgment requested). Costs and disbursements are as follows (Code Civ. Proc.,
§ 1033.5):
a.
$
Clerk's filing fees ..............................................
b.
$
Process server's fees ........................................
c.
Other (specify):
$
d.
$
e.
TOTAL .............................................................
$
f.
Costs and disbursements are waived.
g.
I am the attorney, agent, or party who claims these costs. To the best of my knowledge and belief this memorandum of costs
is correct and these costs were necessarily incurred in this case.
I declare under penalty of perjury under the laws of the State of California that the foregoing items 9 and 10 are true and correct.
Date:
(TYPE OR PRINT NAME)
(SIGNATURE OF DECLARANT)
Page 3 of 3
CIV-105 [New January 1, 2018]
REQUEST FOR ENTRY OF DEFAULT
(Fair Debt Buying Practices Act)
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Download Form CIV-105 Request for Entry of Default (Fair Debt Buying Practices Act) - California

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