Proof of Service PersonalCal. Super. - 6th Dist.March 12, 2020f I SC-1 04 Proof of Service Use this form to serve a person, a business, or a public entity. To learn more about proof of service, read What Is "P{oofofSer-viceW, Form SC-104B. To learn more about how t0 serve a business or entity, read How t0 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) - Partner (for a partnership) or general partner (for a limited partnership) ° Any officer or genera] manager (corporation or association) ° Any person authorized for service by the business (corporation, association, general partnership, limited partnership) - Any person authorized for service with the Secretary of State (corporation, association, limited liability company [LLC], limited liability partnership [LLP], limited partnership) To serve a public entity, you must fimt file a claim with that entity, then serve one ofthe following people: ° Clerk (ofa city or county) - Chief officer 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: Daniela Alvarez b. Ifyou are serving a business or entity, write the name 0fthe business 0r entity, the person authorized for service, and that person’s job title: Business or Agency Name Person Authorized for Service Instructions to Sewer: Job Tide Cferk stamps dare here when form is filed Fill in court name and street address: Superior Court of California. County of Santa Clara, Superior Court Civil Division 191 N. First St. San Jose, Ca 951 13 Fill in case number, case name, hearing date, day, lime. and department below: Case Number: 20$C082896 Case Name: Fokchoy Lee vs Daniela Alvarez Hearing Date: 4/28/2020 Time: 6:00pm Dept: 57 You must be at least 18 years 01d and not be named in this case. Follow these steps: ° Give a copy of all the documents checked in® to the person in (D, 0r - Give a copy of all the documents checked in© t0 one 0fthe 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 ofthe person in (D, or c. An adult (at least 18) who seems to be in charge where the person in (Dusually receives mail (but not a U.S. Post Office box), ifthere is no known physical address for the person in® and mail a copy ofthe documents lefi with one ofthe adults in a, b, or c above to the person in@. THEN ' - Complete and sign this form, and ' ~ t Give or mail your completed form to the person who asked you to serve these court papers, in timefor Ihefonn to befiled with the court at least 5 days before the hearing. ® | sewed the person in© a copy of the documents checked below: a. SC-IOO, Plainnfi°s Claim and ORDER t0 Go r0 Small Claims Court b. D SC-120, Defendant’s Claim and ORDER to Go t0 Small Claims Court @423 c. D Order for examination (Yhisfimn must be personally served Check theform that was served): Note: The court can issue a civil arrest warrant IfIhe servedparty does not come lo court (mly ifrhe orderfor examination was personally served by a registeredprocess server, sherifi: marshal, 0r someone appoimed by the court. (1) D SC- 1 34, Application and Order t0 Produce Statement ofAssets and r0 Appearfbr Examination (2) B AT-138/EJ-125, Application and Orderfbr Appearance and Examination d. D Other (specffil): Mdal Council of California. mmfinfia.a,gov Revised January 1. 2009, Optional Form Code 01 Civfl Procedurs, §§ 116.340. 415.10. 415,20 Proof of Service (Small Claims) SC-104, Page ‘l of2 .9 Case Number: 205C082896 Case name- Fokchoy Lee ® Fill out “a” or “b” below: a. Personal Service: I personally gave copies ofthe documents checked 1n© to the person in©2 On (date):W At (WW):3'41- D a.m. I p.111. At this address: 1430 Tully Rd. Suites 41 1-412 City: san Jose State:__CA Zip: 95122 b. D Substituted Service: I personally gave copies 0fthe 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 t0 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 office 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 court papersto (name-ofrperson in 6).“ -~-- # - 1did this on (date): At (time): D am. D p.m. At this address: City: State: Zip: Name or description of the person I gave the papers to: Afier serving the court papers, I put copies of the documents listed in© in an envelope, sealed the envelope, and put first-class prepaid postage on it. I addressed the envelope to the person in® at the address where I lefi the copies. I mailed the envelope on (date): from (city, state): by leaving it (check one): a. D At a U.S. Postal Service mail drop, or b. D 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 t0 mail the documents to the person in ®, andI have attached that person’s completed Form SC-l 04A. ® Server’s Information Name; Queenie Orteza Phone: 5 10-680-8233 AddreSS: 3368 Methilhavcn Lane , , City: San Jose State; CA Zip: 95121 Fee for service: $ 55 Ifyou are a registeredprocess server: County Ofregismtioni santa Clara Registration number: PS 1 672 ® I declare under penalty of perjury under California state law thatI am at least 18 years old and not named in this case and that the information above is true and correct. Date. 3/1 9/2020 Queenie Ortcza ’ K Type orprint server ’s name Server s'fgns beg after serving nmseaJanuary 1,2009 proof of Service 80-104, Page 2 of2 (Small Claims)
