Proof Of Service Of Summons Page 2
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1
2PLAINTIFF/PETITIONER:
CASE NUMBER:
DEFENDANT/RESPONDENT:
by mail and acknowledgment of receipt of service. I mailed the documents listed in item 2 to the party, to the
5.
c.
address shown in item 4, by first-class mail, postage prepaid,
(1) on (date):
(2) from (city):
(3)
with two copies of the Notice and Acknowledgment of Receipt and a postage-paid return envelope addressed
to me. (Attach completed Notice and Acknowledgement of Receipt.) (Code Civ. Proc., § 415.30.)
(4)
to an address outside California with return receipt requested. (Code Civ. Proc., § 415.40.)
by other means (specify means of service and authorizing code section):
d.
Additional page describing service is attached.
6. The "Notice to the Person Served" (on the summons) was completed as follows:
a.
as an individual defendant.
b.
as the person sued under the fictitious name of (specify):
c.
as occupant.
d.
On behalf of (specify):
under the following Code of Civil Procedure section:
416.10 (corporation)
415.95 (business organization, form unknown)
416.20 (defunct corporation)
416.60 (minor)
416.30 (joint stock company/association)
416.70 (ward or conservatee)
416.40 (association or partnership)
416.90 (authorized person)
415.46 (occupant)
416.50 (public entity)
other:
Person who served papers
7.
a. Name:
b. Address:
c. Telephone number:
The fee for service was: $
d.
e. I am:
(1)
not a registered California process server.
(2)
exempt from registration under Business and Professions Code section 22350(b).
a registered California process server:
(3)
(i)
owner
employee
independent contractor.
(ii)
Registration No.:
(iii)
County:
8.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
or
9.
I am a California sheriff or marshal and I certify that the foregoing is true and correct.
Date:
(NAME OF PERSON WHO SERVED PAPERS/SHERIFF OR MARSHAL)
(SIGNATURE )
POS-010 [Rev. January 1, 2007]
Page 2 of 2
PROOF OF SERVICE OF SUMMONS
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