Proof of Service Summons DLR CivilCal. Super. - 6th Dist.November 23, 202020CV373934 Santa Clara - CIVII POS-01 0 ATTORNEY 0R PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR couRT USE ONLY System Sy stem Lorl J. Costanzo, SBN 142633; Mallory A. Barr, SBN 3 17231- Costanzo Law Firm, APC 111 W. St. John Street, Suite 700 Electronically Filed b San Jose, CA 951 13 . TELEPHONE No.: (408) 993-8493 FAX No. (Optional): (408) 993-8496 superlor court Of CA, E-MAILAooaess(Optional); lori@costanzo-law.com; mallory.barr@costanzo-law.com ounty 0f santa Clara, ATTORNEY FOR (Name): Plaintiff Erick Raich 1/1 2/2021 12:01 PM SUPERIOR COURT 0F CALIFORNIA, COUNTY 0F Santa Clara eviewed By: System System O R STREET ADDRESS: 191 N. First Street MAILING ADDRESS: 191 N. First Street gfijzlfing?\sla3273389133 CITY AND ZIP CODE: San Jose, 951 13 BRANCH NAME: Civil PLAINTIFF/PETITIONER: Erick Raich CASE NUMBER: DEFENDANT/RESPONDENT: Foothill-De Anza Community College District 20CV373934 Ref‘ No. or File No.2 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. | served copies of: a- summons complaint Alternative Dispute Resolution (ADR) package Civil Case Cover Sheet (served in complex cases only) cross-complaint other (specify documents): Civil Lawsuit Notice HDIII b C d. e f 9° m . Party served (specify name ofparty 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): Jayne Chipman, Attorney for Defendant Foothill-De Anza Community College District 4. Address where the party was served: IPlaza de Jennings Chipman, LLP - 1000 Marina Village Parkway, Suite 110, Alameda, CA 94501 I 5. | served the party (check proper box) a_ E by personal service. | personally delivered the documents listed in item 2 to the party or person authorized to receive service of process for the party (1) on (date): (2) at (time): b. E by substituted service. 0n (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) E (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. (2) E (home) a competent member ofthe household (at least 18 years of age) at the dwelling house or usual place of abode of the party. | informed him or her ofthe general nature ofthe papers. (3) E (physical address unknown) a person at least 18 years of age apparently in charge at the usual mailing address of the person to be served, other than a United States Postal Service post office box. | informed him or her of the general nature of the papers. (4) E | 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 . | mailed the documents on (date): from (city): or a declaration of mailing is attached. (5) E I attach a declaration of diligence stating actions taken first to attempt personal service. Page 1 of 2 Form Adopted for Mandatory Use PROOF OF SERVICE OF SUMMONS Code of Civil Procedure, §417.1O Judicial Council of California POSO10 [Rev. January 1, 2007] CASE NUMBER: 20CV373934 PLAINTIFF/PETITIONER: Erick Raich DEFENDANT/RESPONDENT: Foothill-De Anza Community College Distn'ct 5_ c_ by mail and acknowledgment of receipt of service. | mailed the documents listed in item 2 to the party, to the address shown in item 4, by first-class mail, postage prepaid, (1) on (date): 12/16/2020 (2) from (city): San Jose, CA (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) E to an address outside California with return receipt requested. (Code Civ. Proc., § 41 5.40.) d_ E by other means (specify means of service and authorizing code section): E Additional page describing service is attached. 6. The "Notice to the Person Served" (on the summons) was completed as follows: a. E as an individual defendant. b- E as the person sued under the fictitious name of (specify): C- E as occupant. d- 0n behalf of (specify): Defendant Foothill-De Anza Community College District under the following Code of Civil Procedure section: 416.10 (corporation) E 415.95 (business organization, form unknown)E 416.20 (defunct corporation) E 416.60 (minor)E 416.30 (joint stock company/association) D 416.70 (ward or conservatee)E 416.40 (association or partnership) D 416.90 (authorized person)E 416.50 (public entity) D 415.46 (occupant)E other: 7. Person who served papers a. Name: Jeremy Dvorak Address: Costanzo Law Firm, APC - 111 W. St. John Street, Suite 700, San Jose, CA 95 1 13b. c. Telephone number: (408) 993-8493 d. The fee for service was: $ 0,00 e. | am: (1) I not a registered California process server. (2) exemptfrom registration under Business and Professions Code section 22350(b). (3) a registered California process server: (i) E owner E employee E independentcontractor. (ii) Registration No.2 (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. E I am a California sheriff or marshal and | certify that the foregoing is true and correct. Date: 1/12/2021 IJeremy Dvorak I ’ W DWQM (NAME OF PERSON WHO SERVED PAPERS/SHERIFF OR MARSHAL) iSIGNATURE ) Page 2 of 2POW" [Rev'mw ”w" PROOF 0F SERVICE 0F SUMMONs POS-015 ATTORNEY OR PARTY WITHOUT ATTORNEY; STATE BAR NO: NAME: Lori J. Costanzo, SBN 142633; MalloryA. Barr, SBN 317231 FIRM NAME: Costanzo Law Firm, APC STREET ADDRESS: 111 W. St. John Street, Suite 700 CITY: San Jose STATE; CA ZIP CODE: 95113 TELEPHONE NO. ; (408) 993-8493 FAX NO. : (408) 993-8496 E-MAIL ADDRESS: lori@costanzo-law.com; mallory. barr@costanzo-law.com ATTORNEY FOR (Name): Plaintiff Erick Raich SUPERIOR COURT OF CALIFORNIA, COUNTV OF Santa Clara STREET ADDRESS: 191 N. First Street MAILING ADDRESS: 191 N. First Street CITY AND ZIP CODE: San Jose, 95113 BRANCH NAME: Civil Plaintiff/Petitioner: Erick Raich Defendant/Respondent: Foothill-De Anza Community College District NOTICE AND ACKNOWLEDGMENT OF RECEIPT-CIVIL FOR COURT USE ONLY CASE NUMBER: 20CV373934 TO (insert name of party being served): Defendant Foothill-De Anza Community College District NOTICE The summons and other documents identified below are being served pursuant to section 415. 30 of the California Code of Civil Procedure. Your failure to complete this form and return it within 20 days from the date of mailing shown below may subject you (or the party on whose behalf you are being served) to liability for the payment of any expenses incurred in serving a summons on you in any other manner permitted by law. If you are being served on behalfof a corporation, an unincorporated association (including a partnership), or other entity, this form must be signed by you in the name of such entity or by a person authorized to receive service of process on behalf of such entity. In all other cases, this form must be signed by you personally or by a person authorized by you to acknowledge receipt of summons. If you return this form to the sender, service of a summons is deemed complete on the day you sign the acknowledgment of receipt below. Date of mailing: 12/16/2020 Jeremy Dvorak (TYPE OR PRINT NAME) (SIGNATURE SENOE UST NOT BE A PARTY IN THIS CASE) ACKNOWLEDGMENT OF RECEIPT This acknowledges receipt of fto be completed by sender before mailing): 1. | x ] A copy of the summons and of the complaint. 2. [ x -| Other (specify): Santa Clara County ADR Information Sheet Civil Lawsuit Notice Civil Case Cover Sheet (To be completed by recipient): Date this form is signed: / // r^ne. ^ f^pr^^ 6^^HOD^^ IR NAME AND NAME OF ENTIFi'. IFANY ON WHOSE BEHALF THIS.FORM IS SIGNED) ^^t^nt^s ^ C^fiffTio^) JLU> ftffvrnc^s f^- ^^a^)^ ^?/W/ ^cftr? ef ^^ry ' U< <; \7^^^ ^- ^/^/^z^i ^ (SIGKATUREt)F PERSON ACKNOWLEDGING F^CEIPT, WITH TITLE IF ACKNOWLEDGMENT IS MADE ON BEHALF OF ANOTHER PERSON OR ENTITY) hn Form Adopted for Mandatory Use Judicial Council of California POS-015 [Rev. January 1, 2005] NOTICE AND ACK OWLEDGMENT OF RECEIPT - CIVIL Page 1 of 1 Code of Civil Procedure, §§415.30, 417. 10 www. co urtinfb.ca.gov