Proof of Service PersonalCal. Super. - 6th Dist.May 21, 2020208C083375 Santa Clara - Civil Proof of Service Use this form to serve a person, business, or public entity. To learn more about proof of service, read What Is Proof of Service?, Form SC-104B, To learn more Clerk stamps dale here whenform isfilea'. Electronically Filed about how to serve a business or public entity, read How to Serve a by Superior Court Of CA, Businessform SC-104C, . ' County of Santa Clara, To serve a business, you must serve one ofthe following people: ¥ 0n 6/22/2020 3:11 PM OOwner (for a sole proprietorship or a business, form unknown) Reviewed By: D. Pinheiro OPartner (for a partnership) or general partner (for a limited partnership) Case #203C083375 OAny officer or general manager (corporation or association) Envelope: 4488058 OAny person authorized for service by the business (corporation, association, General partnerShipa limited partnerShip) Fill in court name nndstreel address: .Any perSon authorized for service with the Secretary of State (corporation, association, limited-liability company (LLC), limited-liability partnership (LLP), limited partnership) To serve a public entity,you must first file a claim with that entity, then serve one of the following people: .Clerk (of a city or county) o Chief officer or director (of a public agency) Superior Court of California, County of 191 NORTH FIRST STREET SAN JOSE, CA 95113 o Any person authorized for service by the entity, Fill in case number, case name, hearing date, day, time, and ' department below: a. Ifyou are serving a person, write the person's name below: ' Case Number: Anet Tarpoff 205C083375 b. Ifyou are serving a business or public entity, Write the name of the Case Name: business or entity, the person authorized for service, and that person's Michael Verna, lndividualand DBA, job title: BlueTideVillas.com vs. ‘ Anet Tarpoff i Business or Agency Name Hearing Date: 8/28/2020 Person Aukhorized for Service - Job Title Tim§§3o AM Dep'tlé® Instructions to Sewer You must be at least 18 years old and not be named in this case. Follow these steps: . Give a copy of the doéuments checked in ®to the persop in , or . Give a copy of the documents checked in to: a. A competent adult (at least 18) at the home of and living with the person in (Dar b. An adult (at least 18) who seems to be in charge 0r c. An adult (at least 18) who seems to be in charge at the place where the person receives mail (not a U.S. Postal Service P.O. Box), if there is no known physical address for the person in Q). and mail a copy of the documents left with one of the adults in a, b, or c above to the person in (D. 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 the form t0 befiled with the court at least 5 days before the hearing. ® I sEerrved the person in CD a copy of the documents checked below: a. SC-IOO, Plaintiff‘s Claim and ORDER to Go to Small Claim Court b.D ‘ sc-120, Defendahts Claim and ORDER to Go to Sm,au Clams Court C. D Order for Examination (Thisform must be personally served. Put a check mark next t0 theform that was served): Note: The court can issue a civil arrest warrant ifz‘he servedparly does not come t0 court but only ifz‘he Order for Examination was personally served by a registeredprocess server, sheriff marshal, 0r someone appointed by the court. (1)D SC-134, Application and Order t0 Produce Statement ofAssets and t0 Appearfor Examination (2)D AT-138/EJ-125, Application and Orderfor Appearance and Examination d.D Other (speczfi): P293549 Judicial Council of California,www.courtinfo.ca.gov pROOF OF SERVICE SC-1 04, Page 1 of2 Revised January 1. 2009, Optional Form _ Code ofcevn Procedure,§§ 116.340, 415.10, 415.20 (Small ClaImS) Case Number: 20$C083375 Case name: Michael Verna lndivldualand DBA. BIueTideVlllas.com vs. Anet Tarpoff @ Fill out "a" or "b" below: am Personal Service: Ipersonally gave copies of,the documents checked in ®to the person in ®: On (date): 6/1 0/2020 At (time): 8:30 PM At this address: 2652 Camino Lenada st City: Oakland State: CA Zip: 94611 hm Substituted Servicezl personally gave copies of the documents checked in ® (aé 0r d) to (check one):A competent adult (at least 18) at the home of, and living with the person in, 0r An adult (at least 18) who seems to be in charge where the person in ® usually works 0r An adult (at least 18) who seems to be in charge where the person in (D receives mail, or has a private mailbox (not a U.S. Postal Service P.O. Box), ifthere is no known physical address for the person in . I told that adult, "Please give these court papers to (name ofperson in (D ). I did this on (date): At (time): At this address: City/State/Zip: l Name or description of the person I gave the papers to: Anet Tarpoff - Servee AGE: 60 HEIGHT: 5'5" WEIGHT: 210 HAIR: Natural Red RACE: White EYES: Brown After serving the court papers, Iput copies of the documents listed in ®in an envelope, sealed the envelope, and put flrst-class prepaid postage on it. I addressed the envelope to the person in ® at the address where I lefi the copies.’ l Imailed the envelope on (date): fiom (city, state): by leaving it at (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 CD With someone else I asked to mail the documents to the person in ® , and I have attached that person's completed Form SC-lO4A.’ ® Server's InformationNametm Phone: Address: 55 Santa Clara Ave.. Suite 146 City: Oakland. CA 94610 Fee for service: $ 65.00 (Ifyou are a registeredprocess server): County of registration: Alameda Registration number: 1520 © I declare, under penalty of perjury under California State law, that I am at least 18 years 01d and not listed in this case and that the information above is true and correct. Date: é/fi/g 2 ' Breeana Draper . Type 0r print server’s name Server signs e afi‘er serving i Revised January 1, 2009 PROOF OF SERVICE (Small Claims) SC-104. Pagezorz