Proof of Service PersonalCal. Super. - 6th Dist.March 11, 2020l) . , _ Clerk damps data ham when form b find. Proof of Servace Use this form to serve a person, a business, or a public entity. To learn more A about proof of service, mad What]: "ProofofService"?, Form SC-IMB. To learn more about how to serve a business or entity, read How to Serve a Business or Public Entity, Form SC-104C. To serve a business, you must serve one ofthe following people: ' Owner (for a sole proprietorship) APR 0 s 2020 ° Partner (for a pannership) or general partner (for a limited pannership) 3 , C k ofAtcllew c, S ma Clam - Any omcer or general manager (corporation or association) 5y t DEPUTY ~ Any petson authorized for service by the business (corporation, association, O general parmexship, lixnjted parmcxshjp) Fill m mun name anHWeI address: ‘ Any person a_uthorized for service with the Secretary of State (corporation, » 3mm” cw" ““mm‘l‘ 6mm” °f association, limited liability company [LLC], Limited liability pmemhip Santa Clara [LLP], limited pannemhip) 191‘ N. First Street To serve a public entity, you must first file a claim with that entity, 1hen sa“ 1°53: 9A 95 1 13 serve one of the following people: V [Small Claims] - Clerk (of a city or county) . - Chief officer or director (of a public agency) Fill in wse number. case name: hearing date. day, lime, and department below:‘ Any person authorized for service by the entity a Ifyou axe serving a person, write the person’s name below: . t Majid Ghafghaichi 205C828” Case Name: Howell v. Ghafghaichlil Case Number: {I fi b. Ifyou am serving a business or entity, write the name ofthe businws or entity, the person authorized for service, and that person's job title: Hearing Date: BusinmorAgmcyNune 4/10/20. Pusan Aumon'ud for Service Jobme Tlme: 1:00pm Dept: 15® Instructions to Server: You must be at least l8 years old and not be named in this case. Follow these steps: ' Give a copy of all the documents checked in® to the pegson in G), 0r ° Give a copy of all the documents checked in® to one of the following people: a. A competent adult (at least l8) living with, and at the home of the person in ®, or b An adult (at least 18) who seems to be m charge at the usual workplace ofthe person in @, 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 Ofi‘xcc box), if there Is no known physical addmss for the person in© and mail a copy ofthe documents lefi with one ofthe adults tn a, b, or c above to the peson in@. THEN ' Complete and sign this form, and - Give 0r mail your completed form to thc person who asked you to scrvc thcsc court papcrs, in limefor theform to befiled with the court a1 least 5 days before the hearing. ® l sewed the person In® a copy of the documents checked below: a. m SC-IOO, Plainlgfi‘s Claim and ORDER to Go to Small Claims Court fib. D SC-IZO, Defendant’s Claim and ORDER to Go lo Small Claims Cour! w fl c'. D Order féf éxia‘hi‘i‘na‘tion (7711'sform must bepeiiohally served Chégk the'form thb‘i was served):‘“ ’ Note: 77m court can issue a civil an'ext warrant Jtha servedparry does not come lo court only ifthe orderfor examination was personally served by a regislcredpmcess server. sherlfl marshal, or someone appointed by the court (1) D SC- 1 34, Application and Order IQ Produce Slalemenl ofAssels and to Appearfor Examination (2) D AT-I38/EJ-1 25, Application and Orderfor Appearance and Examination «L l Other (specyyy Sapporting Documentmmum Hum.» ' H scam} 10,2wmtmosfinuwzrm “W PFOOf Ofserlce age 9mum: Procedure,§§ “5340, 415.10.415.20 (Small lealms) Case Numbqr; ' ' 208C82893‘ Case name; Howell v. Ghafghaichi ® FiH out “a” or “b" below: a I Personal Service: I personally gave copia of the documents checked 1n© to the person in©z On (date): -_--3/17/20 At (“me)- _._-l 1'25 Ilam. D pm. At this address: 13941 Damon LN Ci‘y: Samloga Stme. CA Zip: 95070 b. D Substituted Service: I personally gave copies ofthc documents checked in© (a, b, or d) to {check one): D (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®usually receives mail, or has a private post oflice box (not a U.S. Post Office box), if there is no known physical address for the person Ln® I told that adult, "Please give these court papers to (name ofperson in© " I did this on (date): At (time): D am. D pm. At this address: ' City: State: Zip: Name or description ofthe person I gave the papers to: Afier sewing the court papers, I put copies of the documents listed in© in an envelope, sealed thé envelope, and put first-class prepaid postage on it. I addressed the envelope to the person in® at the addms where] lcfi the copies. I‘mailed the'envelope on (date) fm’m (city, Tstaté): by leaving it (check one): a. D At a U.S Postal Service mail drop, or b.D At an ofiice or business mzu‘l drop where I know the mail ls 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 @, and I have attached that person’ s completed Form SC-IO4A. ® Server's Information Namc; Jay Katofsky Phone; (888) 894-3535 Address: 43575 Mission Blvd, Ste 415 City: Fremont State; CA Zip: 94539 Fee for service: S [75.00 Ifyou are a registeredprocess server: county Ofregismoni Alameda Registration number: l 154 © I dedare under penalty of perjury under California state law that I am at least l8 years old and not named in this case and that the information above is tme and correct. Date: 3/20/2020 ff ~ 3 Jay Katofsky ‘ Type or print server 's name Server signs‘ here afier serving WWarm proof of “service 50-104, Page 2 of2 (Small Claims),
