Proof of Service PersonalCal. Super. - 6th Dist.April 6, 2020sc 104 proof of Service saifsg.:$::12m am Electronically filed ' "'- - L‘ Use this form to serve a person, a business, or a public entity. To learn more by superior court 0f CA, about proof of service, 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 orPuinc Entity, 0n 5/20/2020 4:01 PMFm SC'IMC' Reviewed By:D. Pinheiro To sews a business, you must serve one of the following people: case #203C0831 1 3 o Owner (for a sole proprjetorship) . D I Em, #4358503 - Partner (for a partnershlp) or general partner (for a hmlted partnershlp) 0 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 sn-eer address: limited partnership) Superior Court of California ' Any person authorized for service with the Secretary of State (calporation, association, limited County 0f Santa Clara liability company [LLC], limited liability partnership [LLP], zimitcd partnership) éiINljggflcfissfgmfifiT To serve a public entity, you must first file a claim with that entity, then serve one of the foilowing ’ people: Fill in case number, case name, hearing dale, day. . Clerk (ofa City or county) gm a1]: degaflfim rim”; - Chiefofficer or director (of a public agency) age "m er’ "S 083 3 - Any person authorized for service by the entity gggigaglfic® a. Ifyou are serving a person, write the person’s name below: ' Again“ LARRY JOSEPH HERRERA LARRY JOSEPH HERRERA 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: 1011312020 Time: Dept: Business or Agency Name E :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 . Give a copy of all the documents checked in C3) to one of the following people: a. A competent adult (at least 18) iiving with, and at the home of the person in CD, or b. An adult (at least 18) who seems to be in charge at the usual workplace of the person in (D, 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 (D 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: a a. SC-lOO, Plaintzfl’s Claim and ORDER to Go to Small Claims Court ‘ b. U SC-IZO, Defendant’s Claim and ORDER to Go to Small Claims Court w c. D Order for examination (Thisform must bepersonally served. Check theform that was served): Note: The court can issue a civil arrest warrant ifthe servedparty does not come to court only fifthe orderfor examination was personally served by a registeredprocess server, shenfif marshal, or someone appointed by the court. (l)D SC-134, Application and Order to Produce Statement ofAssets and to Appearfor Examination (2)D ATu138/EJ-125, Application and Orderfor Appearance and Examination d_ E Other (SpeCW); NOTICE TO LITIGANTS; NOTICE TO SMALL CLAIM LITIGANTS; Judlcle: Council or Cannomia, www.coumnro.ca.gov Proof of Service Case ID: 5834856 Revised January 1. 2009, Optional Form u Code otCivit Procedure, §§ 11s.34o,41s.1o. 415.20 (small Claims) SC 104' Page 1 °f 2 ‘IrrA filVfiTTfl Case Number: 203C083 l 13 'ill out “a” 0r “b” below: a. Personal Service: Ipersonally gave copies of the documents checked in® to the pemon in® : On (date): 5/13/2020 At (time): 8:56 PM Gender: MALE Age: 46-50 Skin Tone: HISPANIC Hair: WHITE Eye Color: BROWN Height: SFT OIN - SFT BIN Weight: 171 LBS - 190 LBS At this address: Home: 2792 OTHELLO AVENUE City: SAN JOSE State: CA Zip: 95122 b. D Substituted Service: Ipersonally gave copies of the documents checked in® (a, b, 0r c0 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 U 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 n0 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 serving the court papers, Iput copies ofthe 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 (dare): fiom (city, stare): by leaving it (check one): a. C] At a U.S. Postal Service mail drop, 0r 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 G), 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: 951 l3 County of registration: SANTA CLARA Registration number: PS l 719 Fee for service: S 50.00 Process. Server Information: County of registration: SANTA CLARA Registration number: PS 1 7 19 © I declare under penalty of pexjury 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 5115/2020 PAULINA A. ROCHA } K? M2Q Type or print server ’s name Server signs hergafler serviné RevisedJanuam. 2009 Proof of Service Case ID: 5834856 {Small Claims) SC-1 04, Page 2 of 2 111'A TEA'V'TH'Y‘I'!
