Proof of Service PersonalCal. Super. - 6th Dist.April 29, 2020- _ Clerk stamps date here whenform isfiled. - SC-l 04 Proof of SerVIce _ _ Electronically flled Use this form t0 serve a person, a business, or a public entity. To learn more by SUper'Or court Of CA: about proofof service, read What Is “ProofofServz‘ce”?, Form SC-I 04B. To learn more County Of Santa Clara, about how to serve a business or entity, read How Io Serve a Business 0r Public Entity, on 6/ 1 0/2020 2:57 PM F011“ 30-1040 Reviewed By:D. Pinheiro To serve a business, you must serve one of the following people: C883 #2080083270 - Owner (for a sole proprietorship) Env #44391 09 ° Partner (for a partnership) or general partner (for a limited partnership) - Any officer or general manager (corporation or association) 0 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 Secretaly of State (corporation, association, limited County 0f Santa Clara liability company {LLC}, limited liability partnership {LLP}, limited partnership) 191 NORTH FIRST STREET To serve a public entity, you must first file a claim with that entity, then serve one offlle foilowing SAN JOSE’ CA 951 13 people: Fill in case number, case name, hearing date, day. time. and department below: ' Clerk (of a city or county) - Chiefofficer or director (of a public agency) ca“ Number: 205C083”) - Any person authorized for service by the entity gggilxfigc (D a. Ifycnu are serving a person, write the person’s name below: ' Again“ JUAN DIEGO ORTIZ ALMANZA JUAN DIEGO ORTIZ AIMANZA 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: 11/5/2020 Time: Dept: Business or Agency Name 1:00 pM 1 5 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 (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 @, or b. An adult (at lea'st 18) who seems to be in charge at the usual workplace of the person in ®, or c. An aduit (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), ifthere 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, h, or c above to the person in G). 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: O a. E SC-lOO, Plainnfl’s Claim and ORDER to Go t0 Small Claims Court b. D SC-IZO, Defendant’s Claim and ORDER to G0 t0 Small Claims Court fl c. D Order for examination (Thisform must be personally served. Check theform that was served): Note: The spurt can issue a civil arrest warrant ifthe servedparty does not come to court only ifthe orderfor examination was personally served by a registeredprocess server, sherifli marshal, or someone appointed by the court. (l)D SC-134, Application and Order to Produce Statement ofAssetS and t0 Appearfor Examination (2)D AT-138fE1-125, Application and Orderfor Appearance and Examination d. g Other (Speafi); NOTICETo LITIGANTS; NOTICE T0 SMALL CLAIM LITIGANTS; JudidalCouncliofCalfonia. mmurflnracagov Proof of Service C883 IDS 5342333 Revised January 1. 2009, Optional Form _ Code otCiviI Procedure. §§ 1 16.340.415.10. 415.20 {small c'a'ms) SC 104’ Page 1 0f 2 ITTA fiAVfiI’Y'I" Case Number: 2080183270 .: ‘ill out “a” or “b” below: a. E Personal Service: Ipersonally gave copies of the documents checked in C3) to the person in® : On (date): 6/3/2020 At (time): 1:33 PM Gender: MALE Age: 41 -45 Skin Tone: WHITE Hair: BLACK Eye Color: BROWN Height: SFT 4IN - SFT 7IN Weight: 131 LBS - 150 LBS At this address: Home: 802 DELAND AVE APT 3 City: SAN JOSE State: CA Zip: 95128 b. D Substituted Service: Ipersonally gave copies of the documents checked in C3) (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 D An adult who seems to be in charge where the person in® usually receives mail, or has a plivate 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 0n (date): At (time): At this address: City: State: Zip: Name 0r description 0f 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 (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 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 13 County of registration: SANTA CLARA Registration number: P81741 Fee for service: $ 58.00 Process Server Information: County of registration: SANTA CLARA Registration number: PSI741 © I declare under penalty of perjury under California state law that I am at least l8 years old and not named in this case and that the information above is true and correct. Date 6/4/2020 HECTOR TORRES > M Dpe orprint server ‘s name Server Signs here after serving Ravtaed January1. 2009 Proof of service Case ID: 5842333 (Small Claims) SC-1 04, Page 2 of 2 ‘(H‘A HAVWTTW
