Proof of Service PersonalCal. Super. - 6th Dist.February 26, 2021Clerk stamps date here when form 1's filed Proof of Personal Service ® ::g:°"3°22‘":ii°gj: Am p E l L E DMAR 1® Person From Whom Protection ls Sought C, 1, 2021 Name: ja- r”) V 9+1] 1:0 rr0(/\} QVGWM 04°C; £22 Cou” 4.33:9® Notice to Server _\ rx sgm 02% The server must: g? 2'; j» I UTY - Be 18 years ofage or older. ‘3 /:"\/\ n, fl K Fill in court name and street address: ' ' ‘ f I \ § >47 f - . .o Not be llsted 1n ltems® 0r (1:3) “J ”A ~ L41] I Superior Court of California, County ofomem cmoo. ’ / g: z7 Santa Clara ° Give a copy ofall documents checked in® t0 the person in®, $91 JN. Flréfgfi 13 (You cannot send them by mail.) Then complete and sign this an 058’ form and give 0r mail it Lo the person in®. PROOF 0F PERSONAL SERVICE ® I gave the person in®a copy ofthe forms checked below: Case Number:l] diam} gal CH-l 09, Notice ofCourt Hearing CH-l 10, Temporal}; Restraining Order CH-lOO, Requestfor Civil Harassment Restraining Orders CH-120, Response to Requestfbr Civil Harassment Restraining Orders (blank form) CH-120-TNFO, How Gan I Respond t0 a Requestfor Civil Harassment Restraining Orders? CH-l 30, Civil Harassment Restraining Order After Hearing CH-800, ProofofFireanns Turned In, Sold, 0r Stored (blank form) Other {specyfizfi Decl. CV-5014 and Civil Case Cover Sheet CM~010 :09 rfio 9.0 Fran EIDIEIIE ® I personally gave copies 0f the documents checked above to the person in®z a. On (dare): ?/{[ /2} b. Atflime): /o:o o E a.m. D pm. c. Atthis address: )4) //‘ flgzflfr- J7“. City: J21” 3-5/6 State; (a Zip; fr/A ® Server's Information Name: 135/”! T7 f’fiW‘N-C fflkzyxf‘ 797W? Address: MI xo- /~"%’r7‘ f7? City: f4” 30f€ State: C4 Zip: 7f// a Telephone: {[fyou are a registered process server): County of registration: Registration number: I declare under penalty ofpeljury under the laws ofthe State of California that the information above is true and correct. Date: ?////;~l féflfié‘ F4>x4/"/- >Z-‘Z-7 Type or print server '3 name Sewer r0 sign here Judlu‘al Council or Califomia, wwcounscagov - CH-zoo, P 1 f1 Ramada.“ 20,409”an Proof of Personal Servuce age ° W9°'C‘“'P’°°9d”'°- “27-5 ' (Civil Harassment Prevention)
