Tenant Petition For Rent Withholding For Failure To Register Form Page 4

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PROOF OF SERVICE
I
____________________C
,
,
AM A RESIDENT OF
OUNTY AND WAS
AT THE TIME OF SERVICE
OVER
. O
______________________________(
), I
EIGHTEEN YEARS OF AGE
N
DATE
SERVED ONE COPY OF THE
(
): __________________________________________________________
FOLLOWING DOCUMENT
S
____________________________________________________________________________________
: (
)
BY
CHECK APPROPRIATE BOX
D
(
):
ELIVERING THE DOCUMENTS IN PERSON TO THE FOLLOWING INDIVIDUAL
S
[
:]
PRINT NAME OF EACH PARTY SERVED
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
P
,
-
LACING THE DOCUMENTS
ENCLOSED IN A SEALED ENVELOPE WITH FIRST
CLASS POSTAGE
,
U.S. P
S
,
:
FULLY PAID
INTO A
OSTAL
ERVICE MAILBOX
ADDRESSED AS FOLLOWS
[
:]
PRINT NAME AND ADDRESS AS SHOWN ON ENVELOPE OF EACH PARTY SERVED
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
I
S
C
DECLARE UNDER PENALTY OF PERJURY OF THE LAWS OF THE
TATE OF
ALIFORNIA THAT THE
.
FOREGOING IS TRUE AND CORRECT
___________________________________________________
______________________________
(
)
(
)
SIGNATURE
DATE
____________________________________________________
(
)
PRINTED NAME

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