Notice To Property Owner Form Page 2

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PROOF OF SERVICE DECLARATION
(CA Civil Code §§ 8100-8118)
I, _________________________________________________ declare that I served copies of the
above California Preliminary Notice—Private Works
by personally delivering copies to _____________________________________________
(name and title of person served) at ___________________________________________
(address) on ______________________________ (date), at __________________ (time).
by first-class registered or certified mail, express mail, or overnight delivery, postage prepaid,
addressed to each of the parties at the address shown above on _________________ (date).
Attached to this declaration is (attach one):
Documentation provided by the United States Postal Service showing that
payment was made to mail the notice using registered or certified mail, or
express mail.
Documentation provided by an express service carrier showing that payment was
made to send the notice using an overnight delivery service.
A return receipt, delivery confirmation, signature confirmation, tracking record, or
other proof of delivery or attempted delivery provided by the United States Postal
Service, or a photocopy of the record of delivery and receipt maintained by the
United States Postal Service, showing the date of delivery and to whom
delivered, or in the event of nondelivery, by the returned envelope itself.
A tracking record or other documentation provided by an express service carrier
showing delivery or attempted delivery of the notice.
by leaving the notice and mailing a copy in the manner provided in Section 415.20 of the Code
of Civil Procedure for service of summons and complaint in a civil action, on
____________________ (date).
I declare, under penalty of perjury under the laws of the State of California, that the foregoing is true
and correct.
Signature: ________________________________________________________________
Signed at _____________________________________, on _________________, 20____.

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