Proof of Service PersonalCal. Super. - 6th Dist.February 17, 2021roof of Personal service Clark stamps dare here whonfonnim. ® Person Seeking Protection F I L E DName; .Cuanh?‘ amnr' Mandoya® Person From Whom Protection ls Sought APR 2 6 2021 Name: JessaJerflande7 ® Notice to SewerThe sewer must: o Be 18 years ofage or older. lgé’ 0.. Q2 - ‘ . . . _ ‘ Io ??;gfnilgIC-Id- llgolwm ®°r® (-5,, x £ y,» I W? in ocun name and server address ' . _ FSBpEfor Court ofCaltfornia, CounW o Guve a ccpy of all documents ghecked m®to the person m . S nta c l ?You cannot send them by man.) Then c6131“: and sign this 1 g , N ar a orm and give or mail it to the person in FMS: s"- -191 N. First St. San Jose, CA 95113 Civil Division Court fills in case number when form la filed. PROOF 0F PERSONAL SERVICE “?“W'E” 21CH009866 ® I gave the person in ®a copy ofthc forms checked below:D CH-109, Notice ofCourt Hearing . D CH-l 10, Temporary Reslraining Order D CH-IOO, Requesrfor Civil Harassment Restraining Orders . D CH-IZO, ReSponse to Requesrfor Civil Harassment Restraining Orders (blank form) . D CH- l ZO-INFO, How Can I Respond Io a Requeslfor Civil Harassment Restraining Orders? CH- 1 30, Civil Harassment Restraining Order After Hearing . D CH-800, ProofofFirearms Turned In, Sold, or Stored (blank form) . D Other (specifi); ® l persmally gave copies of the documents checked above to the perSOn in@: a. On (date): Agri? 6, 7 071 b. At (lime): 1.‘L._Q' ()_._____ m a.m. D p.m. C. At this address: Elmunod (‘nrrerfional F‘aQiJ Lair; 7111 q Ahal QL 0‘.” no.9 3‘03?” Cityzw ¥+as State: CA Zip: 951335 ® Servers Information Name: ' ' Address: 1 £25 K01] (L410 1g City: San Jose State: EA Zip: 9811? Telephone: 40&9 95: 9 931 (Ify0u are a registeredprocess server).- County of registration; Registration number: Icgfrcetatre under penalty of perjury under the laws of the State of California that me irtformation above is true and Date: '4manna / J Teresa Wilkinson v 0A.”.- QXQ‘H Type or prim um; 's name Server m sign here “‘32:: W‘flfi‘wgammm“W Proof of Personal Service cn.aoo. pag- 1 on Coa- n! w V Proud". 5 527 s J (Civil Harassment Prevention) Mendoza , Cuauhtemoc V‘IVS IBVLSBZBBVI LZ :91 IZBZ/SZ/VB
