Proof of Service SubstitutedCal. Super. - 6th Dist.May 28, 2020Electronically Filed by Superior Court of CA, County of Santa Clara, on 7/1/2020 9:36 AM Reviewed By: D. Pinheiro Case #20SC083441 Envelope: 4535020 20SC083441 Santa Clara - Civil Clerk stamps date here whenform isfiled 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 about how to serve a business or public entity, read How to Serve a Business,Form SC-104C, . To serve a business, you must serve one of the following people: 'Owner (for a sole proprietorship or a business, form unknown) OPartner (for a partnership) or general panner (for a limited partnership) OAny officer or general manager (corporation or association) OAny person authorized for service by the business (corporation, association, General partnelfihip’ lgrfl‘itEd pamerSItIIilpL S f S ( Fill in court name andslreetaddress: .An erson aut orize or service wi t e ecreta o tate co oration, _ _ _ asszgation, limited-liability company (LLC), Innitgi-liability pagxership super” CW" °' ca"f°"“a' °°""'V °f (LLP), limited partnership) same Cllara To serve a public entity,y0u must first file a claim with that entity, then 191 N" F'rSt St‘ serve one of the following people: sa" ”59- CA 95113 oClerk (of a city or county) o Chief officer or director (of a public agency) o Any person authorized for service by the entity. Fill in case number, case name, hearing date, day. n'me, and department below: a. Ifyou are serving a person, write the person's name below: Case Number: 20$C083441 Case Name: Mary Ellen Kenworthey vs. Nanda Journeys, LLC b. Ifyou are serving a business or public entity, write the name of the business or entity, the person authorized for service, and that person's job title: Manda Journjvs. LLC Business or Agency Name Hearing Date: 8/1 2/2020 N. I I - - ' u l Person Authorized tor Service - Job Title T'mggw AM 069:3® Instructions to Server You must be at least 18 years old and not be amed in this case. Follow these steps: . Give a copy of the documents checked in to the person in , or o Give a copy of the documents checked in t0: a. A competent adult (at least 18) at the home of and living with the person in ®or 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 ®. and mail a copy of the documents left with one of the adults in a, b, or c above t0 the person in ®. THEN .Complete and sign this form, and .Give 0r mail your completed form to the person who asked you to serve these court papers, in timefor the qform to befiled with the court at least 5 days before the hearing. X I® l swerved the person in (D a copy of the documents checked below: r J a. sc-1oo, Plaintiffs Claim and ORDER to Go to Small Claim Court KL) b.D SC-120, Defendants Claim and ORDER to Go to Small Clams Court Ln 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 ifthe servedparty does not come t0 court but only ifthe Order for Examination was personally served by a registeredprocess server, sherifl 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-l38/EJ-125, Application and Orderfor Appearance and Examination d.D Other (Specifil): Wb) S6088 Judicial Council of California,www.courtinfo.ca.gov PROOF OF SERVICE SC-1 04, Page 1 of 2 Revised January 1, 2009, Optional Form . Code of Civil Procedure,§§ 116.340, 415.10, 415.20 (Small Claims) Case Number: 20$C083441 Case name: Mag Ellen Kenwortheg vs. Nanda Journeys. LLC @ Fill out "a" or "b" below: a.D Personal Service: I personally gave copies 0fthe documents checked in ®to the person in (D: On (date): At (time): At this address: City: State: Zip: A competent adult (at least 18) at the home of, and living with the person in, or An adult (at least 18) who seems to be in charge where the person in ® usually works or 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), if there is no known physical address for the person in . hm mSubstituted Servicezl personally gave copies ofthe documents checked in ® (aé or d) to (check one): D D Itold that adult, "Please give these coun papers to (name ofperson in (D ). I did this on (date):6l25l2020 At (timeJ.-8:20 PM At this address: 204 ADDIeton Dr City/State/Zip: Ajtos CA 95003 Name or description ofthe person I gave the papers to: JOHN DOE - Husband AGE: 50's HEIGHT: 5'10" WEIGHT: 250 HAIR: SIP RACE: White EYES: After serving the court papers, I put copies 0f the documents listed in ®in an envelope, sealed the envelope, and put first-class prepaid postage on it. I addressed the envelope t0 the person in CD at the address where I left the copies. Imailed the envelope on (date): 6/29/2020 fi‘om (city, state): Monterey. CA, QA by leavin it at (check one): a. At a U.S. Postal Service mail drop, 0r b. MAt an office or business mail drop where I know the mail is picked up every day and deposited with the U.S. Postal Service, 0r CD With someone else I asked to mail the documents to the person in ® , and I have attached that person's completed Form SC-104A. ® Server's Information Name: Christopher Kulvicki Phone: (§§1l 384-4030 Address: 2511 Garden Road. Suite B-100 City: Mmerev. CA 93940 Fee for service: $ 71.50 (Ifyou are a registeredprocess server): County of registration: Santa Cruz Registration number: 1 28 © I declare, under penalty of perjury under California State law, that I am at least 18 years 01d and not liste case and that the information above is true and correct. Documents served in accordance with COVID-19 Safe Serving Policy, Which incl es social 1g? _ _. ' ' distancing. ,1f // :53! ._____- - .Date; 6/29/2020 / £7 f f E - - . - - ' Christopher Kulvicki > i, 5 ’ A f; 1"] .4 f Type or print server’s name Server S?Efis here afiéraééiiné/ (J ( Revised January1,2009 PROOF OF SERVICE (Small Claims) 3C-104. Pagezorz