Certificate Of Registration Individual Process Server Template

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State of California
(File Stamp)
County of Yolo
Term of Registration: Two (2) years
(See reverse for more information)
CERTIFICATE of REGISTRATION
I
P
S
NDIVIDUAL
ROCESS
ERVER
Business & Professions Code, Section 22350, 22351(a)
New Registration
Renewal Registration
(check one)
The undersigned individual declares that registration in the County of Yolo is proper because my
residence
principal place of business
(check one)
is located in this County.
Name: ___________________________________________________________________________________________
Address: _________________________________________________________________________________________
Telephone No: (_________) _____________________________________
Age: _____________________
Have you been a resident of California for at least one year immediately preceding
the filing of this certificate?
YES
NO
Have you ever been convicted of a felony?
If yes, attach a copy of your certificate of rehabilitation, expungement or pardon.
YES
NO
Will you perform the duties of the process server in compliance with the provision
of law governing the service of process in the State of California?
YES
NO
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Signature: ____________________________________________________
Date: __________________
Office Use Only:
Registration # __________________________
Bond Expiration Date _______________________
Temporary ID Issued On ____________________
Document # (Bond): ________________________
Permanent ID Card Expires _______________________
Recorded Date __________________
Initials__________
10/30/2015

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