Proof of Service SubstitutedCal. Super. - 6th Dist.May 15, 2020208C083342 1, _ Santa Clara - Civil Clerk siamps dale here whenform isfiled. SC-104 Proof of Servuce Electronically filed = Use this form to serve a person, a business, or a public entity. To leam 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 t0 serve a business or entity, read How to Serve a Business or Public Entity, 0n 7/1 5/2020 3:28 PMFm 501040 Reviewed By:D. Pinheiro To serve a business, you must serve one of the following people: C889 #208C083342 ' Owner (for a sole proptjietorship) I I ' I Env #4605043 - Partner (for a partnershlp) or general partner (for a lmuted partnership) 0 Any officer or general manager (corporation or association) ' Any person authorized for service by the business (corporation, association, general partnership, Fill in courtname and streeraddress: limited partnership) Sup erlor Court of California - Any person authorized for service with the Secretary of State (corporation, association, limited County 0f33m“ Clara liability company [LLC], limited liability partnership [LLP], limited partnership) $91 NOEEHCFRST STREET To serve a public entity, you must first file a claim with that entity, then serve one of the following AN Jo ’ A 951 13 people; Fill in case number, case name, hearing date, day, time, and department below: - Clerk (of a city 01' county) - Chief officer or director (of a public agency) case Number: ”mam“: - Any person authorized for service by the entity gggfigfig‘figc® a. Ifyou are sewing a person, write the person’s name below: ' Again“ ENRIQUE DE JESUS BALTAZAR GALLARDO BNRIQUE DE JESUS BALTAZAR GALLARDO 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: llllmozo Time: Dept: Business or Agency Name 1:00 PM 15 Person Authorized for Service Job Title ® Instructions t0 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® to one of the following people: a. A competent adult (at least 18) living with, and at the home 0f the person in ®, or b. An adult (at least 18) who seems to be in charge at the usual workplace of the person in @, or c. An adult (at least 18) who seems to be in charge where the person in® usually receives mail (but not a U.S. Post Office box), if there is no known physical address for the person in® and mail a copy of the documents lefi 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 timefar theform to befiled with the court at least 5 days before the hearing. ® I served the person in Q) a copy of the documents checked below: O . a. SC-IOO, Plaintz'fl’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 (Thisform must be personally served. Check theform that was served): Note: The court can issue a civil arrest warrant z‘fthe servedparty does not come. to court only iffhe orderfOr examination waspersonally served by a registeredprocess server. sherifif marshal, or someone appointed by the court. (1)D SC-134, Application and Order to Produce Statement ofAssets andio Appearfor Examination (2)D AT-l38/EJ-125, Application and Orderfor Appearance and Examination d. g Other (Specw; NOTICE To LITIGANTS; NOTICE T0 SMALL CLAIM LITIGANTS; Judicial Coundtomamonua. mmmurflnracagov Proof of Service Case ID: 5823991 Revised Jammy 1. 2009. Optional Form _ CodeorcMI Procedure. §§ 116.340.416.1o.415.2o {small c'a'ms) SC 104' Page 1 °f2 ‘nl "hvni‘f‘n Case Number: 2080383342 - . '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. E Substituted Service: Ipersonally gave copies of the documents checked in® (a, b, or d) to (check one): A competent adult (at least 18) at the home of, and living With the person in ®, 0r 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 no known physical address for the person in® I told that adult, “Please give these court papers to (name of person in (9).” Idid this on (date): 7/2/2020 At (time): 1:37 PM At this address: 373 EMERICK AVE City: SANJOSE State: CA 5km: 95127 x Name or description of the person I gave the papers to: STACY DO CO-RESIDENT Bender: FEMALE Age: 41-45 Skin Tone: HISPANIC Hair: BROWN Eye Color: BRO Height: SFT 4IN - SFT 7IN Weight: 171 LBS - 190 LBS ArummM Em»mug mes Irma b\yr qu mm m ' After serving the court papers, Iput copies ofthe documents listed in® in an envelope, sealed the envelope, and put first-class prepaid postage 0n it. Iaddressed the envelope to the person in® at the address where I left the copies. _ [mailed the envelope on (date): 07/02/2020 from (city, state): SAN JOSE, CALIFORNIA by leaving it (check one): , a. 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 (D, 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: PS 17 19 Fee for service: $ 58.00 Process Server Information: County of registration: SANTA CLARA Registration number: PSl7l9 © I declare under penalty of perjury under California 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 07/02/2020 xfiffiw / PAULINA A. ROCHA ’ " I -‘ Dpe orprint server 'S name Server signs here afler serving Revised Januann. 2009 Proof of Service Case FD". 5823991 {Small Claims) SC-1 04, Page 2 of 2 1TTA ITAV‘TIT"
