Proof of Service PersonalCal. Super. - 6th Dist.October 15, 2018_ Clerk stamps dare here when form is filed. SC-1 04 Proof of Servuce ~31?! r v' _'_.'.‘ _ Use this form t0 serve a person, a business, 0r a public entity. T0 learn more about proof of service, read What Is ’ProofofService”?, Form SC-104B. T0 learn more about how to serve a business or entity, read How t0 Serve a Business 0r Public Entity, Form SC-104C. To serve a business, you must serve one ofthe following people: DEC 1 3 2019 as: ° Owner (fora sole proprietorship) e.._m i: g; ’ sci: El: 303g? Clara ° Partner (for a partnership) 0r general partner (for a limited partnership) HM b mggpuw ° Any officer 0r general manager (corporation or association) < g Ea3M0 Jr - Any person authorized for service by the business (corporation, association, general partnership, limited partnership) Fm in 09W name and Weft 8023”“? - Any person authorized for service with the Secretary of State (corporation, suPer'or court 0f cal'fmn'a’ C°unty °f association, limited liability company [LLC], limited liability partnership santa Clara [LLP], limited partnership) _ T0 serve a public entity, you must first file a claim with that entity, then 191 North FlrSt Street serve one ofthe following people: san Jose, ca 951 13 ° Clerk (ofa city or county) . Chief Officer 0r director (0f a public agency) Fill in case number, case name, hearing date, day, time, and deparimentbelow: ° Any person authorized for service by the entity ® a. Ifyou are serving a person, write the person’s name below ISSCO76O64CHRISTAIN FLORES Case Name: IUAREZ VS, FLORES Case Number: b. Ifyou are serving a business 0r entity, write the name 0f the business or entity, the person authorized for service, and that person’s job title: ‘ Hearing Date: Busmess or Agency Name 12/16/2019 Person Authorized for Service Job Title TimE: 8 :30 AM Dept: 6 ® Instructions to Server: You must be at least 18 years 01d and not be named in this case. Follow these steps: ° Give a copy 0f all the dOCuments checked in© to the person in@, 0r ° Give a cOpy of all the documents checked in® to one 0fthe following people: a. A competent adult (at least 18) living with, and at the home 0fthe person in G), 0r b. An adult (at least 18) who seems to be in charge at the usual workplace offhe persDn in ®, 0r c. An adult (at least 18) who seems t0 be in charge where the person in ©usually receives mail (but not a U.S. Post Office hex), if there is n0 known physical address for the person in© ana’ mail a copy 0fthe documents left with one 0fthe adults in a, b, or c above to the person in®€ THEN - Complete and sign this form, and - Give 0r mail your completed form to the person who asked you t0 serve these court papers, in timefor theform to befiled with the court at least 5 days before the hearing. ® l sewed the person in G) a copy of the documents checked below: a. D SC-l 00, Plaintifl’s Claim and ORDER t0 Go t0 Small Claims Court &b. D 30-120, Defendant’s Claim and ORDER to Go m Small Claims Court fig c. Order for examination (Thisform must be personally served. Check theform that was serveaD: Note: The court can issue a civil arrest warrant ifrhe servedparty does not come to court only ifrhe orderfor examination was personally served by a registeredprocess server, sheriff marshal, 0r someone appointed by the court, (1) D SC- 1 34, Application and Order to Produce Statement ofAssets and to Appearfor Examination (2) AT-13 8/EJ-125, Application and Orderfor Appearance and Examination d, Other (Specifi); SMALL CLAIMS SUBPOENA Judicial CouncilofCalifornia, wmvmurtr‘nfo,ca.gov ' SC-104, Pa e 1 0f2 Revised January 1, 2009, Optional Form PrOOf 0f serVIce g 9 Code ofCiviI Procedure. §§ 116.340, 415.10, 415.20 (Small Claims) Case Number: 188C076064 Case name: @ Fill out “a” or “b” below: a. Personal Service: Ipersonally gave copies of the documents checked in© to the person in©2 On (date):M At (time):M D a.m. D p.m. At this address: 946 NORTH 5TH STREET City: SAN JOSE State: CA Zip: 95130 b. D Substituted Service: I personally gave copies 0fthe documents checked in© (a, b, 0r d) to (check one): D A competent adult (at least 18) at the home 0f, and living with the person in® , 0r D An adult who seems t0 be in charge where the person in© usually works, 0r I D An adult who seems to be in charge where the person in®usually receives mail, 0r has a private post office box (not a U.S. Post Office box), if there is n0 known physical address for the person in®. ltold that adult, "Please give these court papers t0 (name 0f person in©." Idid this 0n (date): At (time): D am. D p.m. At this address: k i City: State: Zip: I Name 0r description 0f the person I gave the papers t0: Afier sewing the coun papers, I put copies of the documents listed in© in an envelope, sealed the envelope, and put first-class prepaid postage 0n it. I addressed the envelope to the person in at the address where I left the copies. I mailed the envelope 0n (date): from (city, state): by leaving it (check one): a. D At a U.S. Postal Service mail drop, 0r b. D At an office 0r business mail drop where I know the mail is picked up every day and deposited with the U.S. Postal Service, or cm With someone else I asked t0 mail the documents t0 the perSOH in G), find I have attached that person’s completed Form SC-104A. ' ® Server’s Information Name; PHILLIP ERKENBRACK Phone: 403-277-6700 Address: Court Services Unlimited, 255 North Market Street, Suite 130 : City: San Jose State; CA zip; 95110 Fee for service: $ 85.00 Ifyou are a registered process server: County 0f registration: sama Clara Registration number; 1283 ® I declare under penalty 0f perjury under California state law that I am at least 18 years 01d and not named in this case and that the information above is true and correct. Date:w . PHILLIP ERKENBRACK ’ Type or print server ’s name Server signthere after serving RevisedJanuary 1, 2009 Proof of Service SC-1 04, Page 2 of2 (Small Claims)
