Certificate Of Corporation Registration As A Process Server Form
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2(File Stamp)
State of California
County of PLACER
Term of Registration: 2 years
CERTIFICATE OF CORPORATION REGISTRATION AS A PROCESS SERVER
California Business & Professions Code Sections 22350, et seq.
The undersigned declare that
(Name of Corporation or Partnership)
________________________________________.
Is:
a __________________ corporation
a partnership at
(State of Incorporation)
Registration in _________________ County is proper because the principal place of business is located in this County.
If corporation or partnership, have you been organized and in existence
continuously for at least one year immediately preceding the filing of this
certificate? Or, has a responsible managing employee, partner or officer been
YES
NO
previously registered under this chapter?
If corporation or partnership, have any officers or general partners ever been
convicted of a felony? If yes, attach a copy of a certificate of rehabilitation,
YES
NO
expungement or pardon.
Will all applicable officers or general partners will perform his/her/its duties as a
process server in compliance with the provision of law governing the service of
process in the State of California.
YES
NO
This is page 1 of _____ attached pages of additional partners or corporate officers.
Each of the undersigned declare(s) under penalty of perjury under the laws of the State of California that the foregoing is true
and correct except for the personal information contained herein; and, as to that personal information, each declares under
penalty of perjury under the laws of the State of California that the foregoing is true and correct only to the extend that it
applies to him/her.
1. Name: ____________________________________________ Age: _______ Phone: _______________
Dated: ___________ Signature: ____________________________________________________________
2. Name: ____________________________________________ Age: _______ Phone: _______________
Dated: ___________ Signature: ____________________________________________________________
3. Name: ____________________________________________ Age: _______ Phone: _______________
Dated: ___________ Signature: ____________________________________________________________
4. __________________________________________________ Age: _______ Phone: _______________
Date: ____________ Signature: ____________________________________________________________
For Official Use Only:
Registration #: ____________________ (If a renewal, a new # must be assigned if there is a lapse of
three years or more in the period of registration).
Expiration Date: ____________________
Permanent ID Card mailed: ______________
Rev. 1/2016
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