Proof of Service PersonalCal. Super. - 6th Dist.March 11, 2020208C082936 - ' Santa Clara - Civil _ I Clerk stamps dare here whenform isfiled. _ .-- SC-104 Proof of Servuce .-. . _ Electronically filed - Eh Use this form to serve a person, a business, or a public entity. To learn more by Superior Court of CA, about proofof sewice, read What Is “ProofofService”?, Form SC-104B. To learn more County Of Santa Clara, about how to serve a business or entity, read How to Serve a Business or Public Entity, 0n 4/2 1 [2020 2 :1 5 PMFm“ SC'I‘MC' Reviewed By:D. Pinheiro Tooserve a(ftgusinesls, you nglist SEW; one of the following pcople: Case #2030082936 - wner or a so c propne ors 1p o Partner (for a partnership) or general partner (for a limited partnership) Env #4269539 - Any officer or general manager (corporation or association) o Any person authorized for service by the business (corporation, association, general partnership, Fill in court name and street address.- limited partnership) Superior Court of California - Any person authorized for service with the Secretaly of State (corporation, association, limited County 0f Santa Clara liability company [LLC], limited liability partnership [LLP], limited partnership) 191 N 15‘ S‘- To serve a public entity, you must first file a claim with that entity, then serve one of the following san Iosc’ CA 951 l3 people: Fill in case number, case name, hearing date, day, time, and depamnenr below: * Clerk (of a city 0r county) - Chiefofficer or director (of a public agency) case Number: mscoszg‘“ - Any person authorized far service by the entity Eggilggggc (D a. Ifyou are serving a person, write the person’s name below: ' Again” ARTUR0 AYALA RIVERA ARTURO AYALA RIVERA b. Ifyou are serving a business or entity, write the name of the business or Hearing Date: entity, the person authorized for service, and that person’s job title: 7I2/2020 Time: Dept: Business or AgencyName 1:00 PM 15 Person Authorized for Service Job Title ® Instructions t0 Server: You must be at least 18 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 (D, or ° Give a copy of all the documents checked in C3) to one of the following people: a. A competent adult (at least 18) living with, and at the home of the person in (D, or b. An adult (at least 18) who seems to be in charge at the usual workplace of the person in Q), or c. An adult (at least 18) who seems to be in charge where the person in® usually receives mail (but not a U.S. Post Office box), if there is no known physical address for the person in® and mail a copy of the documents left with one of the adults in a, b, or c above to the person in® THEN - Complete and sign this form, and - Give or mail your completed form to the person who asked you to serve these court papers, in timefor theform to befiled with the court at least 5 days before the hearing. ® I served the person in© a copy of the documents checked below: O a. E SC-IOO, Plainzzfi’s Claim and ORDER to Go to Small Claims Court b. D SC-120, Defendant’s Claim and ORDER to Go to Small Claims Court fl c. D Order for examination (Thisform must bepersonally served. Check theform that was served): Note: The court can issue a civil arrest warrant ifthe servedparzy does not come to court only fifths orderfor examination was personally served by a registeredprocess server, sherzfi marshal, or someone appointed by the court. (1)D SC-134, Apph‘cation and Order t0 Produce Statement ofAssets and to Appearfor Examination (2)D AT-138lEJ-125, Application and Orderfor Appearance and Examination d. E Other (specw): NOTICE T0 LITIGANTS, Judlclai Councfl of California. www.cowfinfomgov Proof of SeNice Case ID‘. 5808694 Revised January 1. 2009. Options! Form _ Code ofcwil Pmoedure. §§ 116.340, 415.10. 415.20 (smau c'alms) SC 104' Page 1 0f 2 an wtvrs‘fi'fl Case Number: 205C082936 a. Personal Service: Ipersonally gave copies of the documents checked in® to the person in (D : On (date): 3_/2__2_/_2£0____ At (time): ifigL Gender: MALE Age: 36-40 Skin Tone: HISPANIC Hair: BLACK Eye Color: BROWN Height: SFT SIN - SFT 11INWeight: 131 LBS - 150 LBS At this address: Home: 210 GURRIES DR City: GILROY State: CA Zip: 95020 b. D Substituted Service: Ipersonally gave copies of the documents checked in C3) (a, b, or d) to (check one): D A competent adult (at least 18) at the home of, and living with the person in G), 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 office box (not a U.S. Post Office box), if there is no known physical address for the person in ®. Itold that adult, “Please give these court papers to (name ofperson in ®).” Idid this 0n (date): At (time): At this address: City: State: Zip: Name or description ofthe person I gave the papers to: After serving the court papers, Iput 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 left 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 to mail the documents to the person in (D, and I have attached that person’s completed Form SC-l 04A. ® Agency Information: Name: LEGAL PURSUIT Phone: 4082884105 Address: 22 WEST ST. JOHN ST. SUITE B City: SAN JOSE State: CA Zip: 95113 County of registration: SANTA CLARA Registration number: 1585 Fee for service: $ 50.00 Process Server Information: County of registration: SANTA CLARA Registration number: 1585 © I declare under penalty of pexjury under California state law that} am at least 18 years old and not named in this case and that the information above is true and correct. Date 3/24/2020 HECTOR TORRES ’ w Type orprint server‘s name Server Signs here after serving Revised January1. 2009 Proof of Service Case 1D: 5808694 (Small Claims) SC-1 04, Page 2 of 2 ‘YTA WAVT-‘T‘l'n
