Proof of Service SubstitutedCal. Super. - 6th Dist.April 30, 2019SC-1 04 £3936? 6f§ervice ‘ Clerk aamps date here when form is fled. .‘Use this. form toaserye;a.person,‘a.bnsiness,.or=a public enfity..Tolleam.more.=.' about proofof service, read Whatls "ProofofService"?, Form SC- 104B. To leam more about how to serve a business or entity, read How to Serve a Business or Public Entiw, For‘m SC 104C. I’ To serve a business, you must serve one ofthe following people. ° Owner (for a sole proprietorship) - Partner (foré partnership) or general partner (for a limited partnershipr' ' “ ‘ ' Any officer or general manager (corporation or association) .7 - Any person authorized for service by the busmess (corporation, association, general partn’ership, li'mited partn'er'ship) ‘ " ' '“ ' ' - Any person authorized for service.with the‘ Secreta‘ry‘of State-(corpo‘ration, association, limited liability company [LLC], Vlimited liability parlnershipm [LLP], limited partnprship) ,; J; M m .,. f r. To serve a public entity, you must firs: file a claim with that entity, then serve one of the following people. y a , ° Clerk (of a city or county) ~ Chief ofiicer or director (of a public agency) - Any pegson authorized for service by the entity _ a. Ifyou are sewing a person, write the person’s name below: Benjamin Malelega Taele l"‘.‘;.-' I. L' I I ~ Jui" f .1le .:\. “E“ .t‘n 1,. Lax... , ,u, b. lfyou are sewing a business or entity, write the name of the business y or entity, the person authorized for service, and that person’s job title: 1. ,l. ryfl H I. h 1 , .t . BusinssorlAgcncy’thc, "1U, u). H .va ‘ PersonAumorizedrorSmiee- JobTiue . J v " ® Instructions to Server: You must be at least 18 years old and not be named'In this case. Follo_w these steps. . v ~ Give a copy of all the dqcuments checked in© to the person in® or I ' Give a copy 0f all the documents checked in© to one of the following people. 1a. A competent adult (at least 18) living with, and at the home of the person inI; 'l . r4, I avid Pinheiro ‘ ’ Fill in ébuh'na‘rnegand stre'el address: \ ‘VS‘upe'rrlolr Cgur; qf California. County of Santa Clara,“ . , " 191N Fifsééfl,‘ \ SanJose, CA 95113 .4 Civil Division ”' Fill In case number, case name,’ hean’ng date, .day; lime, end department below: . Case Number. _ 19SC078629 Ht ri I,‘,./ Case Name. I v Trajn vs': Taelé‘ ‘ ‘ {‘1‘ .w .y‘ ~~" ””499 °"‘°v‘~r-1/7/20201r ‘ “me: 1:00pm r J j ' Dept: 14 g ‘u'l or 3 b An adult (at least I8) who seems to be 1n charge at the usual workplace o_f the person in (D, or c. An adult (at least 18) who seems to be m charge where the person in ®usually receives mail (but not a U. S. Post omce box), ifthere Is no known physical address for the person ‘in®. ' H C 7 3f ’ " and mail a copy ofthe documents Iefi with one ofthe adults 1n a, b, or c THEN - Complete and Sig] this form, and i+- above to the person in@U ,. l"«-I 1" "4 u. ° Give or mail your completed fon'n to the person who asked you to serve these court papers, in timéfor theform to befiled with the court a1 least 5 days before the hearing. ® I served the person in ® a copy of the documents checked below a. I SC- 100, Plainnfik Claim a_nd ORDER Io Go to Small Claims Court‘: b D SC- [20, Defendant’s Claim and ORDER to Go to Small Claims Court c. D Ordermmauon (?.?iisfor'rh must be personatlly'wserved Check theférm zh_at was served). I ' fiwd ;' -:\.~:m m. 5N.” 1p; Note. The court can issue a civil arrest warrant ifthe servedparty does no! come to court only iflhe orderfor examination waspersonally served by a registeredprocess server, sherifl marshal, or someone appointed by the court, (1) D SC- 134, Application and Order to ‘Produce Statement ofAssets and to Appearfor Examination (2) D AT-138/EJ- 125, Applicationand Orderfor Appearance and Examination V d D Other (specyy): \ Jddl'dal Gourd ol Cambmh’thum'IMcagav “'"' ' Rmmuaryiflooofiumwonn Cod. dc“Hm. 55 ”6.30, “5,10, 4‘520 ”:Proof of.Servicé (Small Clalms) w.‘_-.~_ ._.. . ._ v_fi "w-.. ' 'SC'-104,'Pa'ge '1 of 2'Q - “fl Q #:541757 ‘1': "1 fl 3 ‘ r a Cease Number: i7 ' yr v \ - 1 . , tint! U 51 ‘1‘ , , a , - . -’ , 19'sco7362. ..M_ Case nme: rm» m“: . ,ac“n ”fnam-w-Wn-u :a W...- h. _, ¥ _ ‘ ® Fillout"a" or“b"below: 5 Viv Wm' ‘ I m‘. 2:. a D PersonalService: [personally gave copies o‘fthe documents checkedm®to the personm® H ¥ 0mm); ' At(nme).___w ‘ I Elam En) min ‘- 2 _ Atthipsaddmssza‘r V , -, , , ”nfln r; . J . ,Cityz' ' "n 5 ~ Staten uzip~ ' n b l. Subshtuted Servuce I personally gave copies of the documents checked m© (a b,- or 4) to (check one). ° '“ ““4 l 7A Competentadult(at least l8)1atthe home of, and living with (he person in@, or ~: : ‘1 ‘ ‘ - ‘ D An adultwho seems to be m charge where the person.in© usually'works or‘z n ; EL. " '1 dvr u D An adult who seems to be m charge where the person in®usually receives mail, or has a private; post office box (not a U. S. Post Office box), if there ls no known physical addre'ss‘ for die p‘erson I I told that adult, "Pléase give these coun papers to (name ofperson in®." " " ' ‘ h ‘ * ”‘1 ' ' :I did this on (dare)~‘:1 1/23/2019 VA At (time). 7_‘;40 D aJnid I _ - __ - _ Atthis address:4:557 Blossom Garden Cir 1m: ,M m; g- . . x J .m. i-m/ Qty SanJosé " » ‘-' :4: usage ”CM Zipr 95122: y r , 5 Name or description ofthe person I gave the papers to. "Juan Doe" H|SPamC Male Gray Half. ‘5"8 fit, brown eyes, 49 years old, 1651bs V“ " '1'" ' "' '_‘ ' "’- ""“ "‘ ’ ‘ " " " I" 'I .LLLH v "muwvz :..x mu .3 « l; 7 g -7- w Afier serving the.court papers, I put copies ofthe documents listed m® m an envelope, sealed the envelope, and pyt first-class prepa'id postage on it. I addressed the envelope to the person in® at the addIESS where I V - . ,._._‘ lefl the copies- _........ I mailed the envelope on (dale). l 1/23/2019 from (city, state). Fremom, CA by leavingit(check one): n. ‘ '13:,- m / .mi", Lug: « x ‘ a-AtaUSPostalServncemaxldropmi’M”" 1'; '“W'E " ““5 C b.D At an ofi‘lce or business mail drop where l know the mail ls pick'ed u‘p 'evéry day and deposited with the US Postal Service or «i v. .." ’ 3': .‘v 4 f. ‘ 3‘” 'N: " )HL.‘ ; .5 5‘ c.U With someone els'e I asked to mail the 'documerits to the person in (D, and'I havé attached that person’ s r v , H.‘ v ‘ completedFonn’SC- 104A‘.‘ ‘ w ' ‘ ‘ * -‘ ‘ “ ‘ ‘ A; I, ~ .21.") r .h! n fut- ( 1"‘y‘,u',‘.,l .1" M',."‘lw "1: ‘u‘JI qvfiln: Z“, .3 Server’s Information 1,, , ”41.37;, a mm. _ “A1,, ‘ , , m. ,3. ‘ Name: Jay Katofsk‘y, u u; .u ‘1 ; ‘ | ' .; ,u gm." h Jr.» ; v. » , .zxph'ong. 4888894 3535.; AddreSS' 43575 Mission Blvd, Ste 415 ‘ I . U I i . City: Fremont r M. mun“, . n x e r StatenuwCA. aZip‘u-A94539u .'.\ a ~ .‘ \ I, s: ~~“'m muv .‘w. xin-m L,‘ 1; A Fee for service. S 150.00 "‘ " ‘ " ' " 1 .1; 3m uth :4.“ it gar. ,9 n 2E“: w: "~24: w“ w "2‘“ ‘li! Ifyou are a registeredproces‘s server. County 0f regstralion: Alameda ‘ * “\‘ I " ' L "'v Registration number; 1154 ‘ l ' , I ' ‘..‘ ) -' ‘”‘ I ‘ ”‘23“. ':~".1\ i \‘w-‘J‘ I declare under penalty ofperjury under California state ’law that] am at least. 18 years old and not named m this case and that the information above ls true and correct. " ‘1. .l 'u \\ J . I 1 \ a - 1 l Date 11/23/2019. n A .. - ,- . , .- -. . ‘ ) Jay Katofsky > Type or print server’s ham'e ' ' ’ 7 I r ' x v" I (Small Claims) A . -- \
