Proof of Service SubstitutedCal. Super. - 6th Dist.March 24, 2020@fil. _ Clerk stamps date here whenfomz isfiied. “51*. ‘ SC-104 Proof of Servuce Electronically Filed n Use this form to serve a person, a business, or a public entity. To [cam more by SUperior court Of CA! about proof of service, read What Is “ProofofServz‘ce ”?, Form SC-104B. To learn more County of Santa Clara, about how to serve a busmess or enuty, read How to Serve a Busmess or Publzc Entity, on 6/2/2020 7:33 AM Form SC-104C. Reviewed By: A. Granados To serve a business, you must serve one of the following people: ° Owner (for a sole proprietorship) case #ZOSC083027 - Partner (for a partnership) or general partner (for a limited partnership) EnVGIOpe: 4401 1 05 0 Any officer or general manager (corporation 01' association) ~ Any person authorized for service by the businws (corporation, association, general partnership, Fill in com name and street address: limited partnership) Superior Court of California o Any person authorized for service with the Secretary of State (corporation, association, limited County 0‘ Santa Clara liability company [LLC], limited liability partnership [LLP], limited partnership) 191 NORTH FIRST STREET To sews a public entity, you must first file a claim with that entity, then serve one of the foilowing SAN JOSE’ CA 951 i3 peopie; Fill In case number. case name, hearing dare, day. time, and department below: ° Clerk (of a city 01' county) - Chiefofficer 01' director (of a public agency) case Number: zoscossoz” - Any person authorized for service by the entity gggigaggc (D a. If you are serving a person, write the person’s name beiow: ' Again“ J ANTONIA KHERNANDEZ J ANTONIA KHERNANDEZ 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: 9/3/2020 Time: Dept: Business or Agency Name 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® 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 l8) who seems to be in charge at the usual workplace of the person in ®, 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 lefi 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 rheform 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, Plaintzfl’s Claim and ORDER to Go to Small Claims Court b. D SC-IZO, Defendant’s Claim and ORDER t0 Go t0 Small Claims Court Q c. D Order for examination (Hisform must bepersonally served. Check lheform that was served)" . Note: The court can issue a civil arrest warrant z'fthe servedparty does not come to court only ifthe orderfor examination was personally served by a registeredprocess server, shenfif marshal, or someone appointed by the court. (1)D SC-l 34, Application and Order to Produce Statement ofAssets and to Appearfor Examination (2)D AT-l 38/EJ-125, Application and Orderfor Appearance and Examination d‘ E Other {Specw}. NOTICE T0 LITIGANTS; NOTICE To SMALL CLAIM LITIGANTS; JudidawoundlofCalilom'la. www.cominfo.ca.gav Proof of Service case [D2 5823981 Revised January 1, 2009, Optima Form _ Code or cm: Procedure. §§ 116.340, 415.10, 415.20 (small Claims) SC 104’ Page 1 0f 2 ITTA TPAVF‘I’T'I’.‘ Case Number: 2080183027 .. 'ill out “a” 0r “b” below: a. D Personal Service: Ipersonally gave copies of the documents checked in® to the person in (D : On (date): At (time): At this address: City: State: Zip: b. Substituted Service: Ipersonally gave copies of the 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 (D, or D An adult who seems to be in charge where the person in® usually works, or E A11 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 Q). Itold that adult, “Please give these court papers to (name ofperson in ®).” Idid this on (date): 5/23/2020 Mime): 12:31 PM At this address: 530 SHOWERS DRNUM 7-139 City: MOUNTAIN VIEW State: CA Zip: 94040 Name or description of the person I gave the papers to: DENISE ROIEMMeefiender: MALE Age. 51-55 Skin Tone: LIGHT BROWN Hair: BLACK Eye Color: BROWN Height: SFT SIN- SFT lllN Weight: 171 LBS- 190 LBS Confirmd 3' Antonia reccwcs m ml Mm bui- wax norm , After serving the co rt papers, Iput copies of the documents listed 1n C3) 1n an envelope, sealed the enveiope, 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): 05/23/2020 fiom (city, state): SAN JOSE, CALIFORNIA by leaving it (check one): a. 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: 951 l3 County of registration: SANTA CLARA Registration number: PS l 654 Fee for service: $ 55.00 Process Server Information: County of registration: SANTA CLARA Registration number: PS l 654 © I declare under penalty of pexjury under Califomia 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 05/23/2020 MARIANA MORENO ’ A \j /fl Type orprint server ’s name Server signs here fier serving Revised January1.2009 Proof of Service Case ID: 5823981 (Small Clalms) SC-‘l 04, Page 2 of 2 17TA WAVF‘I’TT?