Proof of Service PersonalCal. Super. - 6th Dist.March 10, 2020Electronically Filed by Superior Court of CA, County of Santa Clara, on 11/30/2020 12:00 AM Reviewed By: D. Pinheiro Case #20SC082873 Envelope: 5372127 Clerk stamps date here when form is filed. about proof of service, read What Is ’TroofofServz‘ce”?, 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 serVIe a business, you must serve one ofthe following people: 0 Owner (for a sole proprietorship) ° Partner (for a partnership). or general partner (for a limited partnership) ' Any officer or general manager (corporation 0r association) Fill in court name and street address:' Any person authorized for service by the business (corporation, association, general partnership, limited partnership) Superior Court of California, County of _ I _ _ Santa Clara 0 Any person authorlzed for serv1ce Wlth the Secretary of State (corpora’uon, 191 N First St association, limited iiability company [LLC], limited liability partnership San Jose CA 951 13 [LLP], limited partnership) To serve a public entity, you must first file a claim With that entity, then serve one Ofthe fOHOWing people: Fill in case number, case name, hearing date, 0 Clerk (of a city or county) day, time, and department below: 9 Chief officer or director (of a public agency) case Nugber: 9 Any person authorized for service by the entity zoscog 873 a. Ifyou are serving a person, write the person’s name below: case Name: Mario Cesar Hernandez Arzate b. If you are serving a business or entity, write the name of the business Hearing Date: December 9 2020 0r entity, the person authorized for service, and that person’s job title: Time: 8:30am Dept: 15 Business or Agency Name Person Authorized for Service Job Title lnstructians to Server: You must be at least 18 years 01d and not be named in this case. Follow these steps: 0 Give a copy 0f all the documents checked in® to the person in G) , 0r ° Give a copy of all the documents checked in® to one ofthe following people: a. A competent adult (at least 18) living with, and at the home 0f the person in CD , 0r b. An adult (at least 18) Who seems to be in charge at the usual workplace ofthe person in ® , 0r c. An adult (at least 18) Who seems to be in charge where the person in (D usually receives mail (but not a U.S. Post Office box), ifthere is no known physical address for the person in (D. and mail a copy of the documents left with one ofthe adults in a, b, or c above to the person in @. THEN 0 Complete and sign this form, and a Give 0r mail your completed form to the person who asked you to serve these court papers, in timefor theform t0 befiled with the court at least 5 days before the hearing. I sewed the person in CD a copy of the documents checked below: Q a a. SC-IOO, Plaintifir’s Claim and ORDER t0 G0 t0 Small Claims Court (EL f }b. D SC-IZO, Defendant’s Claim and ORDER t0 G0 t0 Small Claims Court ' '7 ' c. D Order for examination (This form must be personally served. Check the form that was served): Note: The court can issue a civil arrest warrant if the served party does not come to court only if the order for examination was personally served by a registered process server, sheriff, marshal, 0r someone appointed by the court. (1) E SC-134, Application and Order t0 Produce Statement ofAssets and to Appearfor Examination (2) D AT-138/EJ-125, Application and Orderfor Appearance and Examination d. D Other (specz’fiz): Judicial Council ofCalifornia, www.courts.ca.gov Proof of Service sc_1 04’ Page 1 ofz Rev. January 1, 2009, Optional Form _ Code ofcwn Procedure, §§ 116.340, 415‘10. 415.20 (Small Clalms) ‘9 Case Number: Case Name: 208C082873 G) Fill out “a” or “b” below: a. E Personal Service: Ipersonally gave copies of the documents checked in ® to the person in® on (date): November 26, 2020 At (time): 10:15 E am. D pm. At this address: 118 Nancy Ln APT #2 City: San Jose State: CA Zip: 95127 b. B Substituted Service: Ipersonally gave copies ofthe documents checked in © (a, b, 0r d) t0 (check one): fl A competent adult (at least 18) at the home of, and living with the person in CD , or fl An adult Who seems t0 be in charge where the person in ® usually works, or D An adult Who seems to be in charge where the person in CD usually receives mail, or has a private post office 'boX (not a U.S. Post Office box), ifthere is no known physical address for the person in G). Itold that adult, "Please give these court papers t0 (name 0f person in CD). Idid this 0n (date): At (time): D am. D p.111. At this address: 7 City: State: Zip: Name 0r description 0f the personI gave the papers to: »After serving the court papers, I put copies of the documents listed in® in an envelope, sealedl the envelope, and put first-class prepaid postage on it. I addressed the envelope to the person in @at the address where I left the copies. Emailed the envelope on (date): from (city, state): by leaving it (check one): a. El At a U.S. Postal Service mail drop, or ~b. B At an office or business mail drop Where I know the mail is picked up every day and deposited With the U.S. Postal Service, or c. D With someone else I asked to mail the documents t0 the person in CD , and I have attached that person’ s completed Form SC-104A. ® Server’s Information Name: Alex Melnik Phone: 408 416 7799 Address (sznown): 410 E Santa Clara St #103 r City: San Jose , State: CA Zip: 95113 Fee for service: $ 90.64 Ifyou are a registeredprocess server: County 0f registration: Santa Clara Registration number: 1714 ® I declare under penalty of 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: November 27, 2020 x Alex Melnik ’ fi km Type orprint server ’5 name Server signs here Ezfték serving Revised January 1, 2009 Proof Of SerVice 50-1 04, P399 2 0f 2 (Small Claims
