Proof of Service PersonalCal. Super. - 6th Dist.March 2, 2020SC-1 O4 Proof of Service Use this form to serve a person, a business, 0r a public entity. To learn more about proof of service, read What Is ’TroofofService"?, Form SC-104B. To learn more about how to serve a business 0r entity, read How to Serve a Business or Public Entity, Form SC-104C. To serve a business, you must serve one of the following people: - Owner (for a sole proprietorship) ° Partner (for a partnership) or general partner (for a limited partnership) 0 Any officer or general manager (corporation or association) - Any person authorized for service by the business (corporation, association, general partnership, limited partnership) - Any pemon authorized for service with the Secretary of State (corporation, association, Hunted liability company [LLC], limited liability partnership [LLP], limited parlnership) To serve a public entity, you must first file a claim with that entity, then serve one ofthe following people: - Clerk (of a city or county) ° Chief ofiicer or director (of a public agency) ° Any person authorized for service by the entity ® a. Ifyou are serving a person, write the person’s name below: b. Ifyou are serving a business or entity, write the name ofthe business or entity, the person authorized for service, and that person’s job title: S & P Auto Inc.dba Speedee Oil Change and Tune Up Businfis or Agency Name Pravm J Patel Owner Person Authorimd for Service Job Title ® Instructions to Server: Cierk stamps date here when folm is filed. .eCOUurt assaanInm"W _ DEPUTV Fm in court name and street address: Superior Court of Callfomla, County of Santa Clam, Superior Court Civil Division 191 N. First St. San Jose, Ca 951 13 Fill in case number, case name, hearing date, day. time. and department below: Case Number: 20$C082824 Case Name: Shcmimnifihemirani vs S&P Auto Inc. dba Speedee Oil Change Hearing Date: 4/8/20 Time: 3:30am Dept: 14 You must be at least I8 years old and not be named in this case. Follow these steps: ° Give a copy of all the documents checked in® to the person in CD, or ° Give a copy ofall the documents checked in© to one ofthe following people: a. A competent adult (at least 18) living with, and at the home ofthe person in ,or b. An adult (at least 18) who seems to be in charge at the usual workplace ofthc person in G), or c. An adult (at least 18) who seems to be in charge where the peISOn in®usually receives mail (but not a U.S. Post Office box), if there is no known physical addmss for the person in® and mail a copy ofthe documents left with one ofthe adults in a, b, 0r c above to the person in G). TEEN ° Complete and sign this form, and ° Give or mail your completed form to the person who asked you to serve thwe court papers, in timefor lheform to beflled with the court at least 5 days before the hearing. © | served the person in® a copy of the documents checked below: a. SC-lOO, Plainnfl's Claim and ORDER to Go to Small Claims Court b. D SC-120, Defendant's Claim and ORDER to G0 t0 Small Claims Court @433 c. D Order for examination (Thisform must be personally served. Check theform that was served): Note: The court can issue a civil arrest warrant [fthe servedparty does not come to court only t_‘fthe orderfor examination was personally served by a registeredprocess server, shenfi,‘ 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, Application and Orderfor Appearance and Examination d, Other (Specw): SC-lOOA, Attachment SC-8006, Attachment SC-8020 Jamaal Coma] of Sammie. mywpoum’nfo.mgov Revised January 1. $09. Optional Fem! Codao'fCM] Pmaaduw. §§ 116.340. 415.10. 415.20 Proof of Service (Small Claims) 80-104, Page 1 of29 5X Case Number: 20$C082824 case name- Shemirani,Shemirani vs S&P Auto Inc.dba Speedee Oil @aFill out “a” or “b" below:.l Personal Service: I pemonally gave copies ofthe documents checked'1n© to the person in©1 On (date):m_- At (Wm?) .3-47- D am. I pm. At this address: 5564 Monterey Road City: San Jose State. CA Zip: 95 I38 b. D Substituted Service: Ipersonally gave copies ofthe documents checked in© (q, b, or d) t0 (cheek one): U A competent adult (at least 18) at the home of, and living with the person in® , or D An adult who seems to be in charge where the person in® usually works, or D An adult who seems to be in charge where the person in®usuafly receives. mail, or has a private post ofiice box (not a U.S. Post Office box), if there is no known physical address for the person in© I told that adult, "Please give these com papers to (name ofperson in CD." Idid this on (date): At (time): D am. D pm. At this address: City: State: Zip: Name or description 0fthe person I gave the papers to: Afier serving the court papers, I put copies ofthe documents listed in© in an envelope, sealed the envelope, ' and putfirst-class prepaid postage on it. I addressed the envelope to the person in® at the address Where I left the copies. I mailed the envelope on (date); fiom (city, state): by leaving it (check one): a. D At a U.S. Postal Service mail drop, or b. U At an office or business mail drop where I know the mail i5 picked up every day and deposited with the U.S Postal Service, or c.D With someone else I asked to mail the documents to the person in G), and I have attached that person’ s completed Form SC-104A. ® Server’s Information Name: Queenie 011623 I Phone: 408-475-4494 Address: 3368 Methilhaven Lane City: san Jose State: CA Zip: 95 121 Fee for service: $ 75 Ifyou are a registeredprocess server; County Ofregistl'ationt santa Clara Registration number: PSI672 ® I declare under penalty of peljury under Califomia state law that I am at least 18 years old and not named in this case and that the information above is true and correct. Date: 3/13/20 R Queenie Orteza ’ ‘\ Type orprint server ’s name , Server si s heffler serving ‘ Rewseuanuarynzooe I proof of service V 50-104. Page 2 of2 (Sman Claims)
