Superior Court of California, County of Contra Costa

LIMITED JURISDICTION
Civil Actions
PACKET

What you will find in this packet:

• Interpreter Request (MC-300e&s)

• Notice To Plaintiffs (CV-659a-INFO)

• Notice To Defendants (CV-659b-INFO)

• ADR Case Management Stipulation (CV-659d)

• Case Management Statement (CM-110)

• Case Questionnaire–Form Limited Civil Cases (DISC-010)

• Issue Conference Statement (CV-659c)

• Alternative Dispute Resolution (ADR) Information (CV-659e-INFO)

You Can Get Court Forms FREE at: www.cc-courts.org/forms

Civil-Limited Packet
CV-659 Rev. 1/1/24
 Superior Court of California, County of Contra Costa

Interpreter Request

If you need an interpreter, please complete the form below and submit it to any Filing Window or
courtroom.

Case Number: ____________________________

Case Type:
Criminal Small Claims – ($10,000 or less)
Traffic Civil - $25,000 over $25,000

Civil Harassment Civil – Other __________________

Conservatorship Family Law
Proceedings to terminate parental rights Unlawful Detainer
Dependent Adult Abuse Guardianship
Juvenile Elder Abuse

Party Requesting Interpreter: _____________________________________________________

Is interpreter for a witness? Yes No

Phone Number(s) where party can be reached: ______________________________________

Date of Hearing: __________________________ Time of Hearing: ________________

Department: _________ Location: Martinez Pittsburg Richmond Walnut Creek

Language Needed: Spanish Mandarin Cantonese Vietnamese

Other: _______________________________________

To avoid the risk that your hearing will have to be postponed, please submit this form a
minimum of one week in advance.

Current information about this program is available at our website:

www.cc-courts.org/interpreter

MC-300e&s Rev. 1/24/18

 Superior Court of California, County of Contra Costa

Solicitud Para Intérprete

Si necesita un intérprete, favor completar este formulario y presentarlo en cualquier ventanilla

para archivar documentos o con la secretaria del tribunal.

Número de Caso: __________________________

Tipo de Caso:
Criminal Demanda Civil – ($10,000 o menos)
Tráfico Demanda Civil -
$25,000 más de $25,000
Acoso Civil
Civil – otro tipo _________________
Conservador
Casos de Familia
Casos para Terminar Derechos de
Madre o Padre Juicio de Desalojo
Abuso de Adultos Incapacitados Tutela
Tribual de Menores Abuso de Personas Mayores

Persona que Necesita Intérprete: _________________________________________________

Marque aquí si esta persona es un testigo

Número Telefónico: ____________________________________________________________

Fecha de la Audiencia Judicial: _____________________ Hora: ____________________

Departmento: _________ Ciudad: Martinez Pittsburg Richmond Walnut Creek

Idioma Solicitado: Español Mandarín Cantonés Vietnamita

Otro Idioma: _________________________________

Para evitar la posibilidad que su audiencia sea aplazada, favor the presentar este formulario al
menos una semana antes de la fecha de su audiencia.

Información actualizada acerca de este servicio se encuentra en nuestra página web:

www.cc-courts.org/interpreter

MC-300e&s Rev. 1/24/18

 Superior Court of California, County of Contra Costa

NOTICE TO PLAINTIFFS
In Limited Jurisdiction Civil Actions

AFTER YOU FILE YOUR COURT CASE:

1. Have the forms the clerk gives you served on all defendants in this case:
a. The Complaint
b. The Summons
c. The Notice of Case Management Conference (shows hearing date and time)
d. The Notice to Defendants (Local Court Form CV-659b-INFO)
e. Blank: Case Management Statement (Judicial Council form CM-110)
f. Blank: Issue Conference Statement (Local Court Form CV-659c)
g. Blank: Stipulation to Attend ADR and Delay First Case Management Conference
90 Days (Local Court Form CV-659d)
h. Alternative Dispute Resolution (ADR) Information (Local Court Form CV-659e-INFO)

You may also fill out a Case Questionnaire for Limited Civil Cases (Judicial Council form DISC-010)
to help organize your case information. If you do, then you must serve the completed form and a
blank copy of the form on the defendant(s). Be sure to keep copies of everything you have served.
You do not file this form at court.

2. Within 60 days of the date you filed the complaint you must prove that the forms have
been served on (delivered to) the defendants correctly by filing the Proof of Service
form (POS-010) (completed by the person who did the service) with the court
3. Go to the case management conference on the date indicated on The Notice of Case
Management Conference.
4. Consider using mediation, arbitration, or neutral case evaluation (ADR) to resolve the
dispute. All parties must answer questions about ADR on the Case Management Statement
form. For more information, see the enclosed ADR information, visit www.cc-courts.org/adr
or email [email protected]
5. You may delay the first case management conference while you try to resolve the
dispute in ADR. If all parties agree to use ADR, complete and file the Stipulation to Attend
ADR and Continue First Case Management Conference 90 Days form to tell the court you
want to use this option.
All civil actions (except juvenile, probate, family, unlawful detainer, extraordinary writ, and asset
forfeiture 1) and personal injury cases where a party is claiming damages 2 must meet the Civil
Trial Delay Reduction time limits for filing documents and moving their cases forward. These
time limits are listed in California Rule of Court 3.110 and Local Court Rules; Title Three. If
parties miss these deadlines, a judge might issue an order (Order to Show Cause) for them to
explain in court why they should not have to pay a fine or have their case dismissed.
VIEW LOCAL COURT RULES AT: (WWW.CC-COURTS.ORG/RULES)

1
Health and Safety Code §11470 et seq.
2
Including claims for emotional distress and/or wrongful death.
Civil – Info / Instructions
CV-659a-INFO Rev. 8/16/16
 Superior Court of California, County of Contra Costa

NOTICE TO DEFENDANTS
In Limited Jurisdiction Civil Actions

YOU ARE BEING SUED. The packet you have been served should contain:
a. The Summons
b. The Complaint
c. The Notice of Case Management Conference (shows hearing date and time)
d. Blank: Case Management Statement (Judicial Council Form CM-110)
e. Blank: Issue Conference Statement (Local Court Form CV-659c)
f. Blank: Stipulation to Attend ADR and Delay First Case Management Conference 90 Days
(Local Court Form CV-659d)
g. Alternative Dispute Resolution (ADR) Information sheet (Local Court Form CV-659e-INFO)
h. Blank Case Questionnaire for Limited Civil Cases (Judicial Council Form DISC-010)
NOTE: If the plaintiff served a completed Case Questionnaire together with the blank form,
you must fill out the blank form and serve it on the plaintiff.

WHAT DO I DO NOW?
You must:
1. Prepare your response YOU COULD LOSE YOUR CASE—even before it is heard by a
judge or before you can defend yourself, if you do not prepare and file a response on time.
See the other side of this page for types of responses you can prepare.
2. Complete the Case Management Statement (CM-110)
3. File and serve your court papers on time Once your court forms are complete, you must
file 1 original and 2 copies of the forms at court. An adult who is NOT involved in your case
must serve one set of forms on the Plaintiff. If you were served in person you must file your
response in 30 days. If the server left a copy of the papers with an adult living at your home
or an adult in charge at your work or you received a copy by mail you must file your
response in 40 days.
4. Prove you served your court papers on time by having your server complete a Proof of
Service, (Judicial Council form POS-040), that must be filed at the court within 60 days.
5. Go to court on the date and time given in the Notice of Case Management Conference.
6. Consider trying to settle your case before trial If you and the other party to the case can
agree to use mediation, arbitration or neutral case evaluation, the Stipulation to Attend ADR
and Delay First Case Management Conference 90 Days can be filed with your other papers.
For more information read the enclosed ADR information, visit www.cc-courts.org/adr, or email
[email protected].

IMPORTANT! The court recommends consulting an attorney for all or part of your case. While you
may represent yourself, lawsuits can be complicated, and the court cannot give you legal advice.

COURT FEES: You must pay court fees the first time you file your papers. If you also file a motion, you must
pay another fee. If you cannot afford the fees, you may ask the court to waive (allow you not to pay) fees.
Use Judicial Council forms FW-001-INFO [information sheet]; FW-001 [application]; and FW-003 [order].

COURT FORMS: Buy forms at the Law Library (1020 Ward Street, Martinez, CA) or download them for free
at: www.courtinfo.ca.gov/forms

Civil – Info / Instructions

CV-659b-INFO Rev. 8/16/16
 WHAT KIND OF RESPONSES CAN I FILE?
1. If you disagree with some or all of what the plaintiff says in the complaint because you believe, or
know it is not true, you can file an ANSWER.
2. If you have a claim in the same case against the plaintiff, you may file a CROSS-COMPLAINT.
3. If you want to ask the court to do something on your behalf, you may file a MOTION (See TYPES OF
MOTIONS below)

HOW DO I PREPARE AN ANSWER?

There are two kinds of Answers you can use, depending on whether the Complaint was verified. You can tell if a
Complaint is verified because it says “Verified Complaint” and/or has a signed oath on the last page.

For complaints that are NOT verified:

Use Judicial Council form PLD-050 – General Denial

For complaints that ARE verified:

a. For personal injury, property damage, and wrongful death claims, use Judicial Council PLD-PI-003
(do not check number 2).
b. For contract claims, use Judicial Council PLD-C-010 (do not check number 3a).
c. Be sure to deny every claim with which you disagree. For example, you might write: “I believe, or know,
that the information in paragraph #__ is untrue/incorrect.” Continue your list until you have addressed
each paragraph in the Complaint.

NOTE: The Judicial Council Answer forms have spaces for your affirmative defenses. Be sure to include them or you
may not be able to use them later. To find out what your affirmative defenses might be, go to the law library and ask
the librarian to help you find the information you need.

If you want to file a Cross-Complaint, you must do so at the same time you file the Answer.
a. For a personal injury, property damage, and/or wrongful death Cross-Complaint, use Judicial Council form
PLD-PI-002.
b. For a contract Cross-Complaint, use Judicial Council PLD-C-001.

TYPES OF MOTIONS
Written motions are documents that ask the court to do something. You may have to file an Answer at the same time.
At this point in the case, you can only make Motions from the following list:
1. Demurrer (the facts stated in the complaint are wrong, or the deadline to file the lawsuit has passed);
2. Motion to Strike (the complaint is unclear; does not follow the law, “doesn’t matter”, etc.);
3. Motion to Transfer (the complaint is in the wrong court or there’s a more appropriate court);
4. Motion to Quash Service of Summons (you were not legally served);
5. Motion to Stay (put the case on hold); or
6. Motion to Dismiss (stops the case).
NOTE: Motions are very complicated and you may want to hire a lawyer to help you.

WHERE CAN I GET MORE HELP?

• Lawyer Referral Service: (925) 825-5700
• Bay Area Legal Aid: (800) 551-5554
• Contra Costa County Law Library: Martinez: (925) 646- 2783 Richmond: (510) 374-3019
• Ask the Law Librarian: www.247ref.org/portal/access_law3.cfm

Civil – Info / Instructions

CV-659b-INFO Rev. 8/16/16
 SUPERIOR COURT OF THE STATE OF CALIFORNIA
IN AND FOR THE COUNTY OF CONTRA COSTA
_______________________________________________

_______________________________________________
Plaintiff(s) / Cross Plaintiff(s)

vs. ADR Case Management Stipulation

(Limited Jurisdiction Civil Cases)
__________________________________________

__________________________________________ CASE NO.: ______________________

Defendant(s) / Cross Defendant(s)

 ALL PARTIES STIPULATING TO ADR AND DELAYING THEIR CASE MANAGEMENT CONFERENCE 90 DAYS
MUST SIGN AND FILE THIS FORM AND THEIR CASE MANAGEMENT STATEMENTS AT LEAST 15 DAYS
BEFORE THEIR CASE MANAGEMENT CONFERENCE.
 PARTIES MUST ALSO SEND A COPY OF THIS FILED STIPULATION TO THE ADR OFFICE:
EMAIL: [email protected] FAX: (925) 608-2109 MAIL: P.O. BOX 911, MARTINEZ, CA 94553

Counsel and all parties agree to delay their case management conference 90 days to attend ADR and
complete pre-ADR discovery as follows:
1. Selection and scheduling for Alternative Dispute Resolution (ADR):
a. The parties have agreed to ADR as follows:
i.  Mediation ( Court-connected  Private)
ii.  Arbitration ( Judicial Arbitration (non-binding)  Private (non-binding)  Private (binding))
iii.  Neutral case evaluation
b. The ADR neutral shall be selected by (date): __________________ (no more than 14 days after filing this form)
c. ADR shall be completed by (date): __________________ (no more than 90 days after filing this form)
2. The parties will complete the following discovery plan:
a.  Written discovery: ( Additional page(s) attached)
i.  Interrogatories to:
ii.  Request for Production of Documents to:
iii.  Request for Admissions to:
iv.  Independent Medical Evaluation of:
v.  Other:
b.  Deposition of the following parties or witnesses: ( Additional page(s) attached)
i. ____________________________________________________________________________________
ii. ____________________________________________________________________________________
iii. ____________________________________________________________________________________
c.  No Pre-ADR discovery needed
3. The parties also agree: _____________________________________________________________________________
__________________________________________________________________________________________________
4. Counsel and self-represented parties represent they are familiar with and will fully comply with all local court rules related to
ADR as provided in Title Three; Chapter 5, will pay the fees associated with these services, and understand that if they do
not, without good cause, comply with this stipulation and all relevant local court rules, they may be subject to sanctions.

______________________________________________ _______________________________________________
Counsel for Plaintiff (print) Fax Counsel for Defendant (print) Fax

______________________________________________ _______________________________________________
Signature Signature

______________________________________________ _______________________________________________
Counsel for Plaintiff (print) Fax Counsel for Defendant (print) Fax

______________________________________________ _______________________________________________
Signature Signature

THIS SECTION WILL BE COMPLETED BY THE COURT CLERK ONLY.

The Case Management Conference set for _________________ is vacated and rescheduled for ____________ at:
 8:30 a.m.  1:30 p.m.  ____________
PLAINTIFF / PLAINTIFF’S COUNSEL MUST NOTIFY ALL PARTIES OF THE CASE MANAGEMENT CONFERENCE.

Local Court Form (Mandatory) Local Court Rule 3.4(h)(2)

CV-659d Rev 10/14/16
 CM-110
ATTORNEY OR PARTY WITHOUT ATTORNEY STATE BAR NUMBER: FOR COURT USE ONLY
NAME:
FIRM NAME:
STREET ADDRESS:
CITY: STATE: ZIP CODE:
TELEPHONE NO.: FAX NO.:
EMAIL 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 MANAGEMENT STATEMENT CASE NUMBER:

(Check one): UNLIMITED CASE LIMITED CASE

(Amount demanded (Amount demanded is $35,000
exceeds $35,000) or less)

A CASE MANAGEMENT CONFERENCE is scheduled as follows:

Date: Time: Dept.: Div.: Room:
Address of court (if different from the address above):

Notice of Intent to Appear by Telephone, by (name):

INSTRUCTIONS: All applicable boxes must be checked, and the specified information must be provided.
1. Party or parties (answer one):
a. This statement is submitted by party (name):
b. This statement is submitted jointly by parties (names):
2. Complaint and cross-complaint (to be answered by plaintiffs and cross-complainants only)
a. The complaint was filed on (date):
b. The cross-complaint, if any, was filed on (date):
3. Service (to be answered by plaintiffs and cross-complainants only)
a. All parties named in the complaint and cross-complaint have been served, have appeared, or have been dismissed.
b. The following parties named in the complaint or cross-complaint
(1) have not been served (specify names and explain why not):

(2) have been served but have not appeared and have not been dismissed (specify names):

(3) have had a default entered against them (specify names):

c. The following additional parties may be added (specify names, nature of involvement in case, and date by which
they may be served):

4. Description of case
a. Type of case in complaint cross-complaint (Describe, including causes of action):

Page 1 of 5

Form Adopted for Mandatory Use

Judicial Council of California
CASE MANAGEMENT STATEMENT Cal. Rules of Court,
rules 3.720–3.730
CM-110 [Rev. January 1, 2024] www.courts.ca.gov
 CM-110
PLAINTIFF/PETITIONER: CASE NUMBER:

DEFENDANT/RESPONDENT:

4. b. Provide a brief statement of the case, including any damages (if personal injury damages are sought, specify the injury and
damages claimed, including medical expenses to date [indicate source and amount], estimated future medical expenses, lost
earnings to date, and estimated future lost earnings; if equitable relief is sought, describe the nature of the relief):

(If more space is needed, check this box and attach a page designated as Attachment 4b.)
5. Jury or nonjury trial
The party or parties request a jury triaI a nonjury trial. (If more than one party, provide the name of each party
requesting a jury trial):

6. Trial date
a. The trial has been set for (date):
b. No trial date has been set. This case will be ready for trial within 12 months of the date of the filing of the complaint (if
not, explain):

c. Dates on which parties or attorneys will not be available for trial (specify dates and explain reasons for unavailability):

7. Estimated length of trial

The party or parties estimate that the trial will take (check one)
a. days (specify number):
b. hours (short causes) (specify):
8. Trial representation (to be answered for each party)
The party or parties will be represented at trial by the attorney or party listed in the caption by the following:
a. Attorney:
b. Firm:
c. Address:
d. Telephone number: f. Fax number:
e. Email address: g. Party represented:
Additional representation is described in Attachment 8.
9. Preference
This case is entitled to preference (specify code section):
10. Alternative dispute resolution (ADR)
a. ADR information package. Please note that different ADR processes are available in different courts and communities; read
the ADR information package provided by the court under rule 3.221 of the California Rules of Court for information about the
processes available through the court and community programs in this case.
(1) For parties represented by counsel: Counsel has has not provided the ADR information package identified
in rule 3.221 to the client and reviewed ADR options with the client.
(2) For self-represented parties: Party has has not reviewed the ADR information package identified in rule 3.221.
b. Referral to judicial arbitration or civil action mediation (if available).
(1) This matter is subject to mandatory judicial arbitration under Code of Civil Procedure section 1141.11 or to civil action
mediation under Code of Civil Procedure section 1775.3 because the amount in controversy does not exceed the
statutory limit.
(2) Plaintiff elects to refer this case to judicial arbitration and agrees to limit recovery to the amount specified in Code of
Civil Procedure section 1141.11.
(3) This case is exempt from judicial arbitration under rule 3.811 of the California Rules of Court or from civil action
mediation under Code of Civil Procedure section 1775 et seq. (specify exemption):

Page 2 of 5
CM-110 [Rev. January 1, 2024]
CASE MANAGEMENT STATEMENT
 CM-110
PLAINTIFF/PETITIONER: CASE NUMBER:

DEFENDANT/RESPONDENT:

10. c. In the table below, indicate the ADR process or processes that the party or parties are willing to participate in, have agreed to
participate in, or have already participated in (check all that apply and provide the specified information):

The party or parties completing If the party or parties completing this form in the case have agreed to
this form are willing to participate in or have already completed an ADR process or processes,
participate in the following ADR indicate the status of the processes (attach a copy of the parties' ADR
processes (check all that apply): stipulation):
Mediation session not yet scheduled
Mediation session scheduled for (date):
(1) Mediation
Agreed to complete mediation by (date):
Mediation completed on (date):

Settlement conference not yet scheduled

(2) Settlement Settlement conference scheduled for (date):
conference Agreed to complete settlement conference by (date):
Settlement conference completed on (date):

Neutral evaluation not yet scheduled

Neutral evaluation scheduled for (date):
(3) Neutral evaluation
Agreed to complete neutral evaluation by (date):
Neutral evaluation completed on (date):

Judicial arbitration not yet scheduled

(4) Nonbinding judicial Judicial arbitration scheduled for (date):
arbitration Agreed to complete judicial arbitration by (date):
Judicial arbitration completed on (date):

Private arbitration not yet scheduled

(5) Binding private Private arbitration scheduled for (date):
arbitration Agreed to complete private arbitration by (date):
Private arbitration completed on (date):

ADR session not yet scheduled

ADR session scheduled for (date):
(6) Other (specify):
Agreed to complete ADR session by (date):
ADR completed on (date):

Page 3 of 5
CM-110 [Rev. January 1, 2024]
CASE MANAGEMENT STATEMENT
 CM-110
PLAINTIFF/PETITIONER: CASE NUMBER:

DEFENDANT/RESPONDENT:

11. Insurance
a. Insurance carrier, if any, for party filing this statement (name):
b. Reservation of rights: Yes No
c. Coverage issues will significantly affect resolution of this case (explain):

12. Jurisdiction
Indicate any matters that may affect the court's jurisdiction or processing of this case and describe the status.
Bankruptcy Other (specify):
Status:

13. Related cases, consolidation, and coordination

a. There are companion, underlying, or related cases.
(1) Name of case:
(2) Name of court:
(3) Case number:
(4) Status:
Additional cases are described in Attachment 13a.

b. A motion to consolidate coordinate wiII be filed by (name party):

14. Bifurcation
The party or parties intend to file a motion for an order bifurcating, severing, or coordinating the following issues or causes of
action (specify moving party, type of motion, and reasons):

15. Other motions

The party or parties expect to file the following motions before trial (specify moving party, type of motion, and issues):

16. Discovery
a. The party or parties have completed all discovery.
b. The following discovery will be completed by the date specified (describe all anticipated discovery):
Party Description Date

c. The following discovery issues, including issues regarding the discovery of electronically stored information, are
anticipated (specify):

Page 4 of 5
CM-110 [Rev. January 1, 2024]
CASE MANAGEMENT STATEMENT
 CM-110
PLAINTIFF/PETITIONER: CASE NUMBER:

DEFENDANT/RESPONDENT:

17. Economic litigation

a. This is a limited civil case (i.e., the amount demanded is $35,000 or less) and the economic litigation procedures in Code
of Civil Procedure sections 90-98 will apply to this case.
b. This is a limited civil case and a motion to withdraw the case from the economic litigation procedures or for additional
discovery will be filed (if checked, explain specifically why economic litigation procedures relating to discovery or trial
should not apply to this case):

18. Other issues

The party or parties request that the following additional matters be considered or determined at the case management
conference (specify):

19. Meet and confer

a. The party or parties have met and conferred with all parties on all subjects required by rule 3.724 of the California Rules
of Court (if not, explain):

b. After meeting and conferring as required by rule 3.724 of the California Rules of Court, the parties agree on the following
(specify):

20. Total number of pages attached (if any):

I am completely familiar with this case and will be fully prepared to discuss the status of discovery and alternative dispute resolution,
as well as other issues raised by this statement, and will possess the authority to enter into stipulations on these issues at the time of
the case management conference, including the written authority of the party where required.

Date:

(TYPE OR PRINT NAME) (SIGNATURE OF PARTY OR ATTORNEY)

(TYPE OR PRINT NAME) (SIGNATURE OF PARTY OR ATTORNEY)

Additional signatures are attached.

CM-110 [Rev. January 1, 2024]

CASE MANAGEMENT STATEMENT Page 5 of 5

For your protection and privacy, please press the Clear

This Form button after you have printed the form. Print this form Save this form Clear this form
 DO NOT FILE WITH THE COURT DISC-010
THIS IS NOT AN ANSWER OR RESPONSE TO THE COMPLAINT
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
Plaintiff (name): CASE NUMBER:

Defendant (name):
CASE QUESTIONNAIRE—FOR LIMITED CIVIL CASES
(Under $35,000)
Requesting Party (name):
Requesting Party (name):

—INSTRUCTIONS—

A. The purpose of the case questionnaire is to help the parties settle their differences without spending a lot
of money. This is accomplished by exchanging information about the case early in the lawsuit. The
exchange of case questionnaires may be started only by a plaintiff (or cross-complainant) in a limited civil
case. The case questionnaire is optional, and if plaintiff (or cross-complainant) exercises the option, only
this form may be used.

B. Instructions for plaintiffs (and cross-complainants)

1. Under Code of Civil Procedure section 93, a plaintiff (or cross-complainant) may serve a completed
case questionnaire and a blank questionnaire with a complaint (or cross-complaint).
2. This is the only way you can require defendants (or cross-defendants) to serve you with a completed
case questionnaire.

C. Instructions for defendants (and cross-defendants)

1. If you have been served with a completed case questionnaire by a plaintiff (or cross-complainant),
then you must fill in the blank case questionnaire. Your completed case questionnaire must be served
on that same plaintiff (or cross-complainant) with your answer to the complaint (or cross-complaint).
2. THIS IS NOT AN ANSWER OR RESPONSE TO THE COMPLAINT.

D. Instructions for all parties

1. ALL QUESTIONS REFER TO THE INCIDENT OR AGREEMENT IN THIS LAWSUIT ONLY.
2. Answer each question. If a question is not applicable, answer “NA.”
3. Your answers are not limited to your personal knowledge, but you are required to furnish information
available to you or to anyone acting on your behalf, whether you are a plaintiff, defendant,
cross-complainant, or cross-defendant.
4. Type or legibly print your answer below each question. If you cannot completely answer a question in
the space provided on the case questionnaire, check the “attachment” box and put the number of the
question and the complete answer on an attached sheet of paper or form MC-025. You should not put
part of an answer on the case questionnaire and part on the attachment. You may put more than one
answer on each attached page.
5. When you have completed the case questionnaire, sign the verification and serve the original.
6. You may compel compliance with these requirements under Code of Civil Procedure section 93.
7. DO NOT FILE THIS CASE QUESTIONNAIRE WITH THE COURT.

Page 1 of 4
Form Adopted for Mandatory Use
Judicial Council of California
CASE QUESTIONNAIRE—FOR LIMITED CIVIL CASES Code of Civil Procedure, § 93
www.courts.ca.gov
DISC-010 [Rev. January 1, 2024] (Under $35,000)
 DO NOT FILE WITH THE COURT DISC-010

Plaintiff (name): CASE NUMBER:

Defendant (name):

—QUESTIONS—

1. FOR ALL CASES

a. State your name and street address.

b. State your current business name and street address, the type of business entity, and your title.

c. Describe in detail your claims or defenses and the facts on which they are based, giving relevant dates.
See attachment for answer number 1c.

d. State the name, street address, and telephone number of each person who has knowledge of facts relating to this lawsuit, and
specify his or her area of knowledge.
See attachment for answer number 1d.

e. Describe each document or photograph that relates to the issues or facts. You are encouraged to attach a copy of each. For
each that you have described but not attached, state the name, street address, and telephone number of each person who
has it.
See attachment for answer number 1e.

DISC-010 [Rev. January 1, 2024]

CASE QUESTIONNAIRE—FOR LIMITED CIVIL CASES Page 2 of 4

(Under $35,000)
 DO NOT FILE WITH THE COURT DISC-010

Plaintiff (name): CASE NUMBER:

Defendant (name):

1. f. Describe each item of physical evidence that relates to the issues and facts; give its location; and state the name, street
address, and telephone number of each person who has it.
See attachment for answer number 1f.

g. State the name and street address of each insurance company and the number of each policy that may cover you in whole or
part for the damages claimed.
See attachment for answer number 1g.

2. FOR PERSONAL INJURY OR PROPERTY DAMAGE CASES

a. Describe each injury or illness that you received and your present complaints about each.
See attachment for answer number 2a.

b. State the name, street address, and telephone number of each physician, dentist, or other health care provider who treated or
examined you; the type of treatment; the dates of treatment; and the charges by each to date.
See attachment for answer number 2b.

c. Itemize the medical expenses you anticipate in the future.

See attachment for answer number 2c.

d. Itemize your loss of income to date, give the name and street address of each source, and show how the loss is computed.
See attachment for answer number 2d.

DISC-010 [Rev. January 1, 2024]

CASE QUESTIONNAIRE—FOR LIMITED CIVIL CASES Page 3 of 4

(Under $35,000)
 DO NOT FILE WITH THE COURT DISC-010

Plaintiff (name): CASE NUMBER:

Defendant (name):

2. e. Itemize the loss of income you anticipate in the future, give the name and street address of each source, and show how the loss
is computed.
See attachment for answer number 2e.

f. Itemize your property damage, and state the amount or attach an itemized bill or estimate.
See attachment for answer number 2f.

g. Describe each other item of damage or cost that you claim, and state the amount.
See attachment for answer number 2g.

3. FOR CASES BASED ON AGREEMENTS

a. In addition to your answer to 1e, state all the terms and give the date of any part of the agreement that is not in writing.
See attachment for answer number 3a.

b. Describe each item of damage or cost you claim, state the amount, and show how it is computed.
See attachment for answer number 3b.

VERIFICATION
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Date:

(TYPE OR PRINT NAME)

(SIGNATURE)

DISC-010 [Rev. January 1, 2024]

CASE QUESTIONNAIRE—FOR LIMITED CIVIL CASES Page 4 of 4

(Under $35,000)
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 ATTORNEY/PRO PER FOR: FOR COURT USE ONLY

Superior Court of California, County of Contra Costa

 MARTINEZ
PLAINTIFF:

DEFENDANT:

CASE NUMBER:
ISSUE CONFERENCE STATEMENT

DATE: DEPARTMENT: TIME:

Please provide a brief narrative statement regarding the following:

1) Description of your claims or defenses and facts and law on which they are based. Include extent of
injuries, contentions regarding liability, any unusual evidentiary or legal issues anticipated at trial, and all
matters of fact believed by any party to be appropriate for stipulation.

2) All witness lists, which includes a brief statement of anticipated testimony.

3) Has previously stated estimated length of trial changed? If yes, what is the estimated length of trial?

Local Court Form – Mandatory

CV-659c Rev 8/16/16
4) An exhibit list, which includes a description of each item.

5) A proposed statement of the case to be read to the jury.

Date: ______________ ___________________________________ ____________________________________

TYPE OR PRINT NAME SIGNATURE OF PARTY OR PARTY’S ATTORNEY

Local Court Form – Mandatory

CV-659c Rev 8/16/16
 CONTRA COSTA COUNTY SUPERIOR COURT
ALTERNATIVE DISPUTE RESOLUTION (ADR) INFORMATION

All judges in the Civil Trial Delay Reduction Program agree that parties should consider using
Alternative Dispute Resolution (ADR) to settle their cases. To tell the court you will use ADR:
• Choose ADR on the Case Management Form (CM-110);
• File a Stipulation to Attend ADR and Continue First Case Management Conference
90-Days (local court form); or
• Agree to ADR at your first court appearance.

Questions? Email [email protected] or call (925) 608-2075

MEDIATION
Mediation is often faster and less expensive than going to trial. Mediators help people who have a
dispute talk about ways they can settle their case. Parties call or visit the ADR Programs office to
get a list of mediators. After parties have agreed on a mediator, they must write a summary (5 pages
or less) explaining the facts, legal arguments, and legal authority for their position. They must send
this summary to the other parties and the mediator at least 5 court days before mediation starts.

ALL parties and attorneys must go to mediation. Mediation can be held whenever and wherever the
parties and the mediator want, as long as they finish before the court deadline. In some kinds of
court cases, parties have the chance to mediate in the courthouse on their trial day.

Most mediators begin by talking with the parties together, helping them focus on the important
issues. The mediator may also meet with each party alone. Mediators often ask parties for their
ideas about how to settle the case. Some mediators tell the parties how much money they think a
case is worth, or tell them what they think might happen if the case went to trial. Other mediators
help the parties decide these things for themselves. No matter what approach a mediator takes,
decisions about settling a case can only be made when all the parties agree.

If the parties go through the court ADR program, mediators do not charge fees for the first half hour
spent scheduling or preparing for mediation. They also do not charge fees for the first two hours of
mediation. If parties need more time, they must pay that person’s regular fees. Some mediators ask
for a deposit before mediation starts. Mediators who do this must give back whatever is left after
counting the time he or she spent preparing for or doing the mediation. A party whose court fees
have been waived (cancelled) may ask if their mediation fees or deposit can be waived.

If parties agree about how they will settle their case, they can choose to keep it private, write it up as
a contract, or ask the judge to make it a court order. What parties say and agree to in mediation is
confidential (private).

PRIVATE MEDIATION
Private mediation works in the same way as judicial mediation, but the parties do not go through the
ADR Programs office. Parties choose a mediator on their own, and pay the mediator’s normal fees.

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 JUDICIAL ARBITRATION (non-binding)
In judicial arbitration, an independent attorney (arbitrator) looks at the evidence, listens to the parties
and their witnesses, and decides how the case will be settled. Judicial arbitration is less formal than
court. Parties call or visit the ADR Programs office to get a list of arbitrators. If they cannot agree on
an arbitrator, the court will assign one. The judge can send cases to arbitration if there is less than
$50,000 in dispute. The person who started the court case can make sure the case goes to
arbitration if they agree to limit the amount they are asking for to $50,000. Parties can also agree
they want to use judicial arbitration. The arbitrator must send their decision (award) to the court
within 10 days of the last hearing. The award becomes a court judgment unless a party asks the
court to review the case within 30 days. Parties must use the ADR-102 form to ask for a new court
hearing (called a trial de novo.) Judicial arbitrators charge $150 per case or per day.

PRIVATE ARBITRATION (non-binding and binding)

Private, non-binding arbitration is the same as judicial arbitration, except that the parties do not go
through the ADR Programs office to choose an arbitrator, and the arbitrator’s award will not become
a judgment of the court unless all parties agree. Parties must pay the arbitrator’s normal fees.

Binding arbitration is different from judicial or private non-binding arbitration because the arbitrator's
decision is final. Parties give up their right to have a judge review their case later (except for reasons
listed in California Code of Civil Procedure, Section 1286.2.) Binding arbitration rules are listed in
California Code of Civil Procedure, Sections 1280-1288.8. Parties may also agree any time before
the judge has made a decision that ends the case to switch to binding arbitration. Parties choose the
arbitrator on their own, and must pay the arbitrator's normal (not $150) fees.

SETTLEMENT MENTOR CONFERENCE

Settlement mentors are independent, experienced trial attorneys that a judge has assigned to help
parties look for ways to settle their case. The conference is free and is held in the courthouse. It is
often held on the morning of trial, but it can be scheduled anytime. These conferences usually last
two or three hours. Parties do not present evidence and do not call witnesses. Parties can ask the
settlement mentor to keep some information confidential (private) from the other party, but not from
the judge. The settlement mentor can share any information with the judge, or involve the judge in
settlement discussions. All principals, clients, and claims representatives must attend the settlement
mentor conference.

NEUTRAL CASE EVALUATION

In neutral case evaluation, an independent attorney (evaluator) reviews documents and listens to
each party’s side of the case. The evaluator then tells the parties what they think could happen if the
case went to trial. Many people use the evaluator’s opinion to reach an agreement on their own, or
use this information later in mediation or arbitration to settle their case.

Parties call or visit the ADR Programs office to get a list of evaluators. After parties have agreed on
an evaluator, they must write a summary (5 pages or less) explaining the facts, legal arguments,
and legal authority for their position. They must send this summary to the other parties and the
evaluator at least 5 court days before evaluation starts. ALL parties and their attorneys must go to
neutral case evaluation. The evaluation can be held whenever and wherever the parties and the
evaluator want, as long as they finish before the court deadline. If the parties go through the court’s
ADR program, evaluators do not charge any fees for the first half hour spent scheduling or preparing
for the evaluation conference. They also do not charge fees for the first two hours of the evaluation.
If parties need more time, they must pay that person’s regular fees. Some evaluators ask for a
deposit before evaluation starts. Evaluators who do this must give back whatever is left after
counting the time he or she spent preparing for or doing the evaluation. A party whose court fees
have been waived (cancelled) may ask if their evaluation fees or deposit can be waived.

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 TEMPORARY JUDGE
Some parties want a trial, but want to choose who will decide the case and when the trial will take
place. Parties can agree on an attorney that they want the court to appoint as a temporary judge for
their case. (See Article 6, Section 21 of the State Constitution and Rule 3.900-3.910 of the California
Rules of Court.) Temporary judges have nearly the same authority as a superior court judge to
conduct a trial and make decisions. As long as the parties meet the court deadline, they can
schedule the trial at their own and the temporary judge’s convenience.

Each of the temporary judges on the court’s panel has agreed to serve at no charge for up to 5 court
days. If the parties need more time, they must pay that person’s regular fees. All parties and their
lawyers must attend the trial, and provide a copy of all briefs or other court documents to the
temporary judge at least two weeks before the trial. These trials are similar to other civil trials, but
are usually held outside the court. The temporary judge’s decision can be appealed to the superior
court. There is no option for a jury trial. The parties must provide their own court reporter.

SPECIAL MASTER
A special master is a private lawyer, retired judge, or other expert appointed by the court to help
make day-to-day decisions in a court case. The special master’s role can vary, but often includes
making decisions that help the discovery (information exchange) process go more smoothly. He or
she can make decisions about the facts in the case. Special masters can be especially helpful in
complex cases. The trial judge defines what the special master can and cannot do in a court order.

Special masters often issue both interim recommendations and a final report to the parties and the
court. If a party objects to what the special master decides or reports to the court, that party can ask
the judge to review the matter. In general, the parties choose (by stipulation) whom they want the
court to appoint as the special master, but there are times (see California Code of Civil Procedure
Section 639), when the court may appoint a special master or referee without the parties’
agreement. The parties are responsible to pay the special master’s regular fees.

COMMUNITY MEDIATION SERVICES

Mediation Services are available through non-profit community organizations. These low-cost
services are provided by trained volunteer mediators. For more information about these programs
contact the ADR Program at [email protected]

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