Proof of ServiceCal. Super. - 6th Dist.March 4, 2021Electronically Filed by Superior Court of CA, County of Santa Clara, on 6/10/2021 11:33 AM Reviewed By: K. Nguyen Case #21CH009904 Envelope: 6623439 Proof of Service of Response by Clerk Stamps date here When form is filed. ® ® @ Person Seeking Protection Namc: Joel Grabscheid Person From Whom Protection ls Sought Your Name: Terrance Ugalde Notice to Server The server must: 0 Be 18 years of age or older. Fill in court name and street address: Superior Court of California. County of o Live or be employed in the county where the mailing took place. o Not be listed in items or of Form CHJOO ® © Civil Division o Mail a copy of all documents 19] N' F'rSt Street checked in @ t0 the person in G). 33“ Jose, CA 951 13 o Complete and sign this form and give it to the person in ®. Santa Clara Fill in case number: Case Number: 2 1 CH009904PROOF 0F SERVICE BY MAIL I am 18 years of age or older and not a party to this proceeding. I live or am employed in the county where the mailing took place. l mailed the person in® a copy of all documents checked below: a. Form CH- l 20, Response t0 Requestfor Civil Harassment Restraining Orders b. B Other (specg'b'z): I placed copies of the documents checked above in a sealed envelope and mailed them as described below: a. Mailed to (name): Joel Grabscheid b. To this addressz 17180 COPPER HILL Dr.. City; Morgan Hm State:L Zip: 95037 c. On (date): 06/10/2021 Mailed from: City: San Jose State: CA Server’s Information Name: Bettv Mania, Address: 1010 West Tavlor Street City; San Jose State: CA Zip: 95126 Telephone: (408) 286-92 1 O (Ifyou are a registered process server): County of registration: Registration number: I declare under penalty of perjury under the laws of the State of California that the information above is true and correct. Date: 06/10/2021 Betty Mendez. > Type 0r print server 's name Server m sfihere mm:Counc-IorCamomia wwwcourrmgov Proof of Service of Response by Mail CH-zso, Page 1 onRev. January 1, 2012, Optional Form _ , .Code orcwu procedure. g 527.5 (CIVII Harassment Preventlon) For your protection and privacy, please press the Clear This Form button afteryou have printed the form. Lprint this form] LSave this form] Clear this form
