Proof of ServiceCal. Super. - 6th Dist.March 4, 2021CH 250 Proof of Service of Response by Clerk stamps date here when form is filed. ' Mail Electronically Filed ® Person Seeking Protection by Superior Court of CA, . - County of Santa ClaraN . J 1G b h d ’ame °e m 5° el on 6/16/2021 1:28 PM ® Person From Whom Protection ls Sought Reviewed By: K. Nguyen Your Name; Terrance Ugalde Case #21 CH009904 Envelope: 6662409® Notice to Server The server must: 0 Be 18 years 0f age 0r older. o Live 0r be employed in the county where the mailing took place. o Not be listed in items© or @ ofForm Fill in court name and street address: Superior Court of California, County of Santa Clara Civil DivisionCH- 1 00. I o Mail a copy 0f all documents 191 N- FlrSt Street checked in @ to the person in @. San Jose, CA 951 13 o Complete and sign this form and give it to the person in® Fill in case number: Case Number: Q1) PROOF 0F SERVICE BY MAIL 21CH009904 I am 18 years of age or older and not a party t0 this proceeding. I live or am employed in the county where the mailing took place. I mailed the person in® a copy of all documents checked below: a. Form CH-120, Response t0 Requestfor Civil Harassment Restraining Orders b. D Other (Speczfil): ® 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 address: 2545 Fountain Oaks Drive City: Morgan Hill State: CA Zip: 95037 _ c. On (date): 06/16/2021 Mailed from: City: San Jose State: CA ® Server’s Information Name: Bettv Mendez Address: 1010 West Tavlor Street City; San Jose State: CA Zip: 95126 Telephone: (408) 286-9210 (Ifyou are a registeredprocess 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: 06/1 6/2021 Betty Mendez ’ Type orprint server ’s name Server t0 sign here JudicialCouncilomanfornja, wwwcourtsmgov Proof of Service of Response by Mail CH-zso, Page1 om Rev. January 1, 2012, Optional Form . . . Code orcwn Procedure, § 527.6 (CIVII Harassment Prevention) For your protection and privacy, please press the Clear This Form button after you have printed the fom. I Print this form I I save this form I
