Proof of Service PersonalCal. Super. - 6th Dist.April 2, 2020. I Clerk stanws date here whenform isfiled. SC-104 Proof of Servuce Electronically Filed :_'r 'p' -_ . "' 'c 1' “'3' Use this form to serve a person, a business, or a public entity. To learn more by SUpenor court Of CA’ about proofof service, read WhatIs “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, on 5/1 8/2020 4:32 PM Fom‘ SC‘IMC' Reviewed By: A. Granados To serve a business, you must serve one of the following people: Case #203C0831 02 - Owner (for a sole propr'ietorship) _ _ . Envelope: 4349733 - Partner (for a partnership) or general partner (for a hrmted partnerslup) - 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 street address: limited partnership) Superior Court of California 0 Any person authorized for service with the Secretary of State (cmporation, association, limited County 0f Santa Clara liability company [LLC], limited liability partnership {Lu}, limited partnership) 191 NORTH FIRST STREET To serve a public entity, you must first file a claim with that entity, then serve one of the following SAN IOSE’ CA 95 113 people: Fill in case number, case name, hearing date, day, time, and department below: ' Clerk (of a city or county) - Chief officer or director (of a public agency) case Number: zoscosmoz - Any person authorized for service by the entity gggejogqu ® a. Ifyou are serving a person, write the person’s name below: ' Against LUIS JOSHUA PEREZ CRUZ LUIS JOSHUA PEREZ CRUZ b. Ifyou are serving a business or entity, write the name of the business or Hearing Date: entity, the person authorized for sewice, and that person’s job title: I0/13I2020 Time: Dept: Business or Agency Name n00 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 G), or 0 Give a copy of all the dqcumcnts 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 CD, 0r 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 Q) usually receives mail (but not a U.S. Post Office box), ifthere is no known physical address for the person in (D and mail a copy of the documents lcfi 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 sews these court papers, in timefor theform ta befiled with the court at least 5 days before the hearing. ® I served the person in (D a copy of the documents checked below: O a. E SC-lOO, Plaintzfl’s Claim and ORDER t0 Go to Small Claims Court - b. U SC-120, Defendant’s Claim and ORDER t0 G0 t0 Small Claims Court M c. D Order for examination (Thisform must be personally served. Check theform that was served): Note: The court can issue a civil arrest warrant ifthe sewedparty does not come Io_ court only ifthe orderfor examination waspersonally served by a registeredprocess server, sheriff marshal, or someone appointed by the court. (l) D SC-134, Application and Order z‘o Produce Statement ofAssets and to Appearfor Examination (2) D AT-138/EJ-125, Application and Orderfor Appearance and Examination JudldalCouncllofCallfomla. ww.commfo.ca.gov Proof of Service . Case ID: 5834881 Revised Janua 1. 2009.0 1f IF m . _ Code otciwlpgcedure, §§g1%7§40?;15.1o.4152o (smau c'a'ms) SC 104' Page 1 °f2 ‘(I’TA HAVWTTTI' Case Number: 205C083102 _-: - 'ill out “a” or “b” below: a. Personal Service: Ipersonally gave copies of the documents checked in® to the person in (D : On (date): 5/12/2020 At (time): 11:38 AM Gender: MALE Age: 36-40 Skin Tone: LIGHT BROWN Hair: BLACK Eye Color: BLACK Height: SFT SIN - SFT 11IN Weight: 151 LBS - 170 LBS At this address: Home: 529 CHIECHI AVE APT 3 City: SAN JOSE State: CA Zip: 95 126 b. D Substituted Service: [personally gave copies of the documents checked in® (a, b, 0r d) to (check one): D A competent adult (at least 18) at the home 0f, and living with the person in (D, or D An adult who seems to be in charge where the person in (D 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 (D. I told that adult, “Please give these court papers to (name ofperson in (0)." Idid this on (date): At (time): At this address: City: State: Zip: Name or description of the 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. Imailed 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 ®, and I have attached that person’s completed Form SC-I 04A. © Agency Information: Name: LEGAL PURSUIT Phone: 4082884105 Address: 22 WEST ST. JOHN ST. SUITE B City: SAN JOSE State: CA Zip: 951 13 County of registration: SANTA CLARA Registration number: I585 Fee for service: $ 50.00 Process Server Information: County of registration: SANTA CLARA Registration number: 1585 © I declare under penalty of perjury under Califomia state law that I am at least 18 years old and not named in this case and that the information above is true and correct. Date 5l12/2020 I f, HECTOR TORRES ’ O r I’ Type orprint server ’s name Server signs here after serving Revlsed January 1. 2009 Proof of Service ' Case ID: 5834881 (Small Claims) 30-1 04, Page 2 Of 2 ‘TTA flAVnTI’T.‘
