Proof Of Service Of Summons
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1
2POS-010
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
FOR COURT USE ONLY
To keep other people from
seeing what you entered on
your form, please press the
TELEPHONE NO.:
FAX NO. (Optional):
Clear This Form button at the
E–MAIL ADDRESS (Optional):
end of the form when finished.
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
PLAINTIFF/PETITIONER:
CASE NUMBER:
DEFENDANT/RESPONDENT:
Ref. No. or File No.:
PROOF OF SERVICE OF SUMMONS
(Separate proof of service is required for each party served.)
1.
At the time of service I was at least 18 years of age and not a party to this action.
2.
I served copies of:
a.
summons
b.
complaint
c.
Alternative Dispute Resolution (ADR) package
d.
Civil Case Cover Sheet (served in complex cases only)
e.
cross-complaint
f.
other (specify documents):
3.
a. Party served (specify name of party as shown on documents served):
b.
Person (other than the party in item 3a) served on behalf of an entity or as an authorized agent (and not a person
under item 5b on whom substituted service was made) (specify name and relationship to the party named in item 3a):
4.
Address where the party was served:
5.
I served the party (check proper box)
by personal service. I personally delivered the documents listed in item 2 to the party or person authorized to
a.
receive service of process for the party (1) on (date):
(2) at (time):
b.
by substituted service. On (date):
at (time):
I left the documents listed in item 2 with or
in the presence of (name and title or relationship to person indicated in item 3):
(1)
(business) a person at least 18 years of age apparently in charge at the office or usual place of business
of the person to be served. I informed him or her of the general nature of the papers.
(home) a competent member of the household (at least 18 years of age) at the dwelling house or usual
(2)
place of abode of the party. I informed him or her of the general nature of the papers.
(physical address unknown) a person at least 18 years of age apparently in charge at the usual mailing
(3)
address of the person to be served, other than a United States Postal Service post office box. I informed
him or her of the general nature of the papers.
(4)
I thereafter mailed (by first-class, postage prepaid) copies of the documents to the person to be served
at the place where the copies were left (Code Civ. Proc., § 415.20). I mailed the documents on
(date):
from (city):
or
a declaration of mailing is attached.
(5)
I attach a declaration of diligence stating actions taken first to attempt personal service.
Page 1 of 2
Code of Civil Procedure, § 417.10
Form Adopted for Mandatory Use
PROOF OF SERVICE OF SUMMONS
Judicial Council of California
POS-010 [Rev. January 1, 2007]
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