Proof of Service Mail

Cal. Super. - 6th Dist.April 28, 2020

. . Case Number: Proof of Servuce by Mall zoscomsz See insu'uctions on other side. This form is attached to the document checked in ® below. Server’s information Name: KEVIN B. WILLIAMS Phone: (415) 424-8221 Street or mailing address: 176 BRADFORD STREET City:SAN FRANCISCO State: CA Zip: 94110-5704 D Check here ifyou are a registered process server, and write: County where registered: Registration #: ® Form or document served Electronically Filed _ b Superior Court of CA,g. D Form SC 105, Requesffor: Court Order andAnswer £0unty of Santa Clara, - D Form SC-109, Authorizatlon t0 Appear on 8/3/2020 12.00 AM C D Form SC-l 14, Request to Amend Claim Before Hearing Reviewed By: E_ Martinez d- D Form SC-133, Judgment Debtor’s Statement ofAssets Case #2030083252 e D Form SC-150, Request to Postpone Trial EHVGIOPEI 4697546 f D Form SC-221, Response to Request to Make Payments g- E Other document allowed to be served by mail (specifiz): D Check here lfthere is not enough space below ta list the document served. List the document on a separatepage, and write “SC-IIZA, Item 2” at the top. DECLARATION OF KEITH WILLIAMS IN SUPPORT OF SMALL CLAMS JUDGMENT ; W/ EXHIBITS ® Server’s declaration a. I am 18 or older. I am not a party to this small claims case. Ilive or work in the county where I did the mailing described below. b. Iplaced copies ofthe document checked in® and an unsigned copy of this page in a sealed envelope, addressed as follows: D Check here ifthere is not enough space below to list allparties served. List their names and addresses an a separate page, and write “SC-I12A, Item 3 " at the top. Name of party sewed Mailing address on the envelope ROBERT FELDER 2063 REDBUD WY, ANTIOCH CA 94509 c. On (date ofmailing): August 1, 2020 Iplaced each envelope in the mail, with postage paid, at (cm: and state ofmailing): San Francisco, California. I declare under penalty ofpeljury under the laws ofthe State of California that the information above is true and correct. Date: August 1, 2020 Is/ KEVIN B.w1LLIAMS k @M 3 WW4 Type orprint server’s name Server signs here wmfirzszzszmmmw Proof of Service by Mail 8°41“ Cal. Rulsa ofCoufl. rule 3.2107 (Small Claims) Instructions for Form SC-1 12A, Proof of Service by Mail (771i?page is uotpart 0fthe ProofofService and does not need t0 be copied, served, orfiled.) Form SC-1 12A can be used to show the court that these documents were served by mail: Form SC-l 05, Requestfor Court Order andAnswer Form SC-109, Authorization to Appear Form SC-l l4, Request to Amend Claim Before Hearing Form SC-133, Judgment Debtor ’s Statement ofAssets Form SC-150, Request to Postpone Trial Form SC-22l , Response to Request to Make Payments Other documents that are allowed to be served by mail Form SC-1 12A cannot be used to prove servlce of these forms: ' Form SC-100, Plaintlfl’s Claim and ORDER t0 G0 t0 Small Claims Court 0 Form SC-120, Defendant’s Claim and ORDER t0 G0 t0 Small Claims Court For information about serving these fonns, see Form SC-104, ProofofService, and Form SC-104B, What Is “ProofofService ".7 The sewer (the person who will do the mailing): - Must not be a party (plaintiff or defendant) in the case - May be a friend, relative, co-worker, or other helpful person - Must be 18 or older - Must live or work in the county where the mailing takes place Follow these steps to use Form sc-1 12A: 1. Prepare Form SC-112A by filling in: D - The case number US - The document to be served, in item ® * MA”: - The names and addresses of the parties to be served, in item® *Prepare a separate Form SC-I12Afor each document to be served. 2. Give the server: - The partially completed Form SC-l 12A - One copy of the document to be served for each party to be served 3. Ask the server to: ~ Fill out the remainder ofthe Form SC-l 12A. ~ Mail eachparty to be served: - An unsigned copy of the completed Form SC-l 12A and - The document to be served (checked in Item® ). o Sign a sepamte Form SC-l 12A for each document served, and give it to back you. 4. File these papers with the small claims court clerk: - The original ofeach document served, with - The signed, original ProofofService by Mail attached Need help? For flee help, contact your county’s Small Claims Advisor: Or go to “County-Specific Court Information” at www.courtinfo.ca.gov/selfheIp/smallclaims. “WW-m Instructions for Proof of Service by Mail 33-11“ (Small Claims) For your protectlon and privacy, please press the Clear Thls Form button after you have prlnmed the form. I Print this form I I save this form I