Proof of Service SubstitutedCal. Super. - 6th Dist.April 2, 2020. ‘ ' 208C083104 u SC 104 Proof of Service Santa Clara _ Civil Clerk stamps date here whenform isfiled. Electronically filed Use this fonn to serve a person, a business, or a public entity. To learn mérc by superior COUVt 0f CA. about proofof 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 to Serve a Business or Public Entity, on 5/22/2020 8:26 AM Fm“ 301040 Reviewed ByzD. Pinheiro To serve a business, you must serve one of the following people: case #208C0831 04 - Owner (for a sole propr’ietorship) ' ' _ Env #4369728 - Partner (for a partnerslnp) or general partner (for a [muted 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 street address: limited partnership) Superior Court of California - Any person authorized for service with the Secretary of State (corporation, association, limited County 0f Santa Clara liability company [LLC], limited liability partnership [LLPL limited parmership) _ éilNljglgTHggssfgmfiT To serve a public entity, you must first file a claim with that entity, then serve one of the following E’ people; F!!! it: case number, case name, hearing dare, day, time, and department below: - Clerk (of a city or county) - Chief officer or director (of a public agency) cage Number: ”sewn“ - Any person authorized for service by the entity Eggi¥fi$fic® a. If you are serving a person, write the person’s name below: ' Agni“, MARTINA PLANCARTE MARTMA PLANCARTE b. If you are serving a business or entity, write the name of the business or Heaflng Date: entity, the person authorized for service, and that person’s job title: 10/13/2020 Time: Dep t.: 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 g 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 18) who seems to be in charge at the usual workplace ofthe person in ®, 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), if there is no known physical address for the person in (D and mail a copy of the documents Iefl with one 0f 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 sews 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: a a. SC-lOO, Plaintzfl’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 . M c. D Order for examination (This'form must bepersonally served; Check theform that was served): Note: The court can issue a civil arrest warrant zfthe servedparty does not come t0 court only ifthe orderfor examination waspersonaily served by a registeredprocess server, shenflj marshal, or someone appointed by the court. (l)D SC-134, Application and Order to Produce Statement ofAssez‘s and t0 Appearfor Examination (2)D AT-138/EI-125, Application and Orderfor Appearance and Examination d_ Other (Specm; NOTICE To LITIGANTS; NOTICE T0 SMALL CLAIM LITIGANTS; JudiciatCouncilofCatifomia, wwcourflnfacagov Proof of Service case ID: 5335279 Ravlsad Janus 1.2009.0pfionai Form - - Codeotcm Panama. §§ 116.340. 415.10.41520 (small c'a'ms) sc 104' Page 1 0f 2 ‘ITA 11“va Case Number: 208C083104 .. 'ill out “a” 0r “b” below: a. D Personal Service: Ipersonally gave copies of the documents checked in® to the person in© : On (date): At (time): At this address: City: State: Zip: b. Substituted Service: Ipcrsonally gave copies of the documents checked in® (a, b, or d) to (check one): E A competent adult (at least 18) at the home of, and living with the person in ®, or D An adult who seems to be in charge where the person in® usualiy works, or D An adult who seems to be in charge where the person in (D 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 (9).” Idid this on (date): 5/13/2020 At (time): 7:58 PM At this address: 26 S 19TH ST APT 6 City: SAN JOSE State: CA Zip: 951 l6 X Name or description of the pexson I gave the papers to: ORLANDO DO@ROTHERFender: MALE Age: 51- 55 Skin Tone: HISPANIC Hair: GRAY Eye Color: BROWN Height. 5FT OIN- FT 3IN Weight: 171 . LBS- 190 LBS Lo“HWA MM ma We; mre bw- was no+ In r After sewing the co papers, Iput copies of the ocuments listed 1n 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. . Imailed the envelope on (date): 05l13/2020 from (city, state): SAN JOSE, CALIFORNIA by leaving it (check one): a.E At aU S. Postal Service mail dr0p, or b. D At an office or business mail drop where I know the mail'1s 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 Q), and I have attached that person’s completed Form SC-104A. © Agency'lnformation: 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 719 Fee for service: $ 50.00 Process Server Information: - ‘ County ofregistration: SANTA CLARA Registration number: PS 1719 © I declare under penalty ofperjury 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 05i131‘2020 ”W" _,___..--... PAULINA A. ROCHA ’ F) C/fi/Q Type orprinz server ’s name Server signs here dfler serving Revised January 1. 2009 Proof of Service Case ID: 5835279 (Small Claims) SC-1 04, Page 2 of 2 ‘TTA fiAvWTYY?
