Proof of Service PersonalCal. Super. - 6th Dist.March 16, 20202080082942 C] k d I h f ifiidI. .‘ . ' . _ - - er sramps ate Ierew en om: s e . ‘ re, _- SC-104 Proof of Servnce samac'ara C'V” El tr n. H fl dL_fifi - ec 0 Ica y Ie :"’5'h3' Use this form to serve a person, a business, or a public entity. To learn more by SUpenor court Of CA! about proof of service, read What Is “ProofofService“?, Form SC-104B. To learn more county 0f santa Clara, about how to serve a business or entity, read How t0 Serve a Business or Public Emily, 0n 4/ 1 6/2020 8203 AM Form 30-1040 Reviewed By:D. Pinheiro To serve a business, you must serve one of the following people: case #208C082942 - Owner (for a sole proprietorship) Env #4257691 0 Partner (for a partnership) or general partner (for a limited partnership) - Any officer or general manager (corporation or association) - Any person authorized for service by the business (corporation, association, general partnership, Fill in court name and meet address.- limited partnership) Superior Court of California - Any person authorized for service with the Secretary of State (corporation, association, limited conflty 0f Santa Clam liability company [LLC], nmited iiabiuty pannership [LLP], limited parmcrship) 191 N 13‘ St To serve a public entity, you must first file a claim with that entity, then serve one of the foilowing san 1083' CA 951 13 people: Fifi in case number, case name, hearing date, day, time, am! department below: - Clerk (of a city or county) - Chief officer or director (ofa public agency) case Number: 2080mm“ - Any person authorized for service by the entity ggggmgc® a. If you are serving a person, write the person’s name below: ' Agaiw MA ROSALINA AYALA CERDA MA ROSALINA AYALA CERDA b. Ifyou are serving a busipess or entity, write the name of the business or Hearing Date; entity, the person authorized for service, and that person’s job titie: 7/2/2020 Time: Dept: Business or Agency Name 1:00 PM 15 Person Authorized for Service Job Title ® Instructions to 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 @, or 0 Give a copy of all the documents checked in® to one of the following people: a. A competent adult (at least 18) living with, and at the home of the person in G), 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 (D 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 0 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. SC-IOO, Plaintiff’s Claim and ORDER to Go t0 Small Claims Court b. D SC-120, Defendant’s Claim and ORDER t0 Go t0 Small Claims Court M c. D Order for examination (I‘kz'sform must be personally served. Check theform that was served : Note: The court can issue a civil arrest warrant ifthe servedparty does not come to court only z'fthe orderfor examination was personafly served by a registeredprocess server, sherifif marshal, or someone appointed by the court. (1)D 80134, Application and Order t0 Produce Statement ofAssets and to Appearfor Examination (2)D AT-l 38/EJ-125, Application and Orderfor Appearance and Examination JudlcialCouncll of CaEforma, mvw.cowfinfo.ca.gov Proof of Service C836 ID! 5776178 Revlsed January 1, 2009, Optima! Form _ Code crown Procedure. §§ 116.340, 415.1c,415.2o (smal' Claims) SC 104’ Page 1 0f 2 ‘ITA nAVfi'l‘l'T.‘ Case Number: 2080182942 . 'ill out “a” or “b” below: a. Personal Service: Ipersonally gave copies of the documents checked in© t0 the person in® : 0n (date): 3/30/2020 At (time): 2:45 PM Gender: FEMALE Age: 56-60 Skin Tone: HISPANIC Hair: BLACK Eye Color: BROWN Height: SFT 4]:N - SFT 7IN Weight: 151 LBS - 170 LBS At this address: Home: 1441 MOUNT LASSEN DR City: SAN JOSE State:L zip: 95127 b. D Substituted Service: Ipersonally gave copies of the documents checked in C3) (a, b, or aD to (check one): D A competent adult (at least 18) at the home of, and living with the person in (D, 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 ®).” I did this on (date): At (time): At this address: City: State: Zip: Name or description of the person I gave the papers to: After sewing 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 le the copies. ~ I mailed the enveiope 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 ®, and I have attached that person’s completed Form SC-104A. ® Agency Information: Name; LEGAL PURSUIT Phone: 4082884105 Address: 22 WEST ST. JOHN ST. SUITE B City: SAN JOSE State: CA Zip: 95113 County 0f 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 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 4/1/2020 3 HECTOR TORRES } M7 Type orprint server ’s name Server signs here afler serving Revised January 1. 2609 Proof of Service case ID: 5775178 (Small Claims) 3C4 04. Page 2 0f 2 ‘TYA UAVfiITTT
