Proof of Service Summons DLR Civil

Cal. Super. - 6th Dist.April 1, 2021

POS-01 0ndf‘\l’)ndAE4 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address) _ KENNETH M. SIGELMAN, ESQ. E-MAIL ADDRESS (Optional): L IUVUUI‘I'UI . . FOR COURT USE ONLY Santa Clara - CIVII SBN: 100238 KENNETH SIGELMAN & ASSOCIATES 1901 FIRST AVENUE, 2ND FLOOR SAN DIEGO, CA 921 01 TELEPHONE No.: (61 9) 238-381 3 System System FAX No. (Optional): (61 9) 238-1 866 Electronically Filed by uperior Court of CA,ATTORNEY FOR (Name): Plaintiff: Brayden Le, etc. SANTA CLARA SUPERIOR COURT STREET ADDRESS: 191 NORTH FIRST STREET MAILING ADDRESS: County of Santa Clara, on 7/13/2021 1:25 PM Reviewed By: System System CITY AND ZIP CODE: SAN JOSE, CA 951 13 ca$e #21 CV381 451 BRANCH NAMESAN JOSE DIVISION Envelope: 6836292 PLAINTIFF/PETITIONER: BRAYDEN LE, ETc. CASE NUMBER: 21cv381451DEFENDANT/RESPONDENT: GOOD SAMARITAN HOSPITAL, ET AL. Ref. No. or File No.:PROOF OF SERVICE OF SUMMONS Le BYFAX(Separate proof of service is required for each party served.) . At the time of service | was at least 18 years of age and not a party to this action. . | served copies of: summons complaint Alternative Dispute Resolution (ADR) package Civil Case Cover Sheet (served in complex cases only) cross-complaint other (specify documents): APPLICATION AND ORDER FOR APPOINTMENT OF GUARDIAN AD LITEM; CIVIL LAWSUIT NOTICE . a. Party served (specify name ofparty as shown on documents served): GOOD SAMARITAN HOSPITAL fiwgopw SE SEES b_ m Person (other than the party in item 3a) served on behalf of an entity or as an authorized agent (and not a person under item 5b on whom substituted service was made) (specify name and relationship to the party named in item 3a): JIM YATES - PERSON AUTHORIZED TO ACCEPT . Address where the party was served: 2425 SAMARITAN DRIVE SAN JOSE, CA 951 24 . | served the party (check proper box) a, m by personal service. | personally delivered the documents listed in item 2 to the party or person authorized to receive service of process for the party (1) on (date): 07/1 2/2021 (2) at (time): 12:28 pm b_ D by substituted service. On (date): at (time): | left the documents listed in item 2 with or in the presence of (name and title or relationship to person indicated in item 3b): (1) D (business) a person at least 18 years of age apparently in charge at the office or usual place of business of the person to be served. | informed him or her of the general nature of the papers. (2) D (3) D (home) a competent member of the household (at least 18 years of age) at the dwelling house or usual place of abode of the party. | informed him or her of the general nature of the papers. (physical address unknown) a person at least 18 years of age apparently in charge at the usual mailing address of the person to be served, other than a United States Postal Service post office box. | informed him or her of the general nature of the papers. <4) D | thereafter mailed (by first-class, postage prepaid) copies of the documents to the person to be served at the place where the copies were left (Code Civ. Proc., §41 5.20). | mailed the documents on (date): from (city): or D a declaration of mailing is attached. (5) D | attach a declaration of diligence stating actions taken first to attempt personal service. Page 1 of 2 Form Approved for Mandatory Use Judicial Council of California POS-01 0 [Rev. January 1, 2007] July 13, 2021 PROOF OF SERVICE OF SUMMONS Advanced Attorney Services, Inc. fax (61 9) 299-5058 Code of Civil Procedure, § 41 7.1 0 P0801 0-1/P81 4066 PETITIONER: BRAYDEN LE, ETC. CASE NUMBER: RESPONDENT: Goon SAMARITAN HOSPITAL, ET AL. 21°V381451 c. D by mail and acknowledgment of receipt of service. | mailed the documents listed in item 2 to the party, to the address shown in item 4, by first-class mail, postage prepaid, (1) on (date): (2) from (city): (3) D with two copies of the Notice and Acknowledgment of Receipt and a postage-paid return envelope addressed to me. (Attach completed Notice and Acknowledgement of Receipt.) (Code Civ. Proc., § 41 5.30.) (4) D to an address outside California with return receipt requested. (Code Civ. Proc., § 415.40.) d. D by other means (specify means 0f service and authorizing code section): D Additional page describing service is attached. 6. The "Notice to the Person Served" (on the summons) was completed as follows: D as an individual defendant. as the person sued under the fictitious name of (specify): as occupant. BY FAX On behalf of (specify): GOOD SAMARITAN HOSPITAL under the following Code of Civil Procedure section: 99.6w EDD D 416.10 (corporation) m 415.95 (business organization, form unknown) D 416.20 (defunct corporation) D 416-60 (minor) D 41 6.30 (joint stock company/association) D 41 5.70 (ward 0r conservatee) D 41 6.40 (association or partnership) D 41 6.90 (authorized person) D 41 6.50 (public entity) D 41 5.46 (occupant) D other: 7. Person who served papers a. Name: VALISTHA BHUNDHUMANI - Advanced Attorney Services, Inc. . Address: 3500 Fifth Ave., Suite 202 San Diego, CA 92103 Telephone number: (61 9) 299-2012 . The fee for service was: $ 189.40 . lam: (DQ90- (1) D not a registered California process server. (2) D exempt from registration under Business and Professions Code section 22350(b). (3) m re istered California process server: _ (i) owner D employee m Independent contractor. (ii) Registration No.2 1651 (iii) County: SANTA CLARA 8, E l declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. or 9_ D | am a California sheriff or marshal and | certify that the foregoing is true and correct. Date: 07/1 3/2021 Q Advanced Attorney Services, Inc. 3500 Fifth Ave., Suite 202 San Die o, CA 921 03 61 9) 29 -2012 an Diego County: 1584 VALISTHA BHUNDHUMANI W- (NAME OF PERSON WHO SERVED PAPERS/SHERIFF OR MARSHAL) POS-01O [Rev January 1, 2007] PROOF OF SERVICE OF SUMMONS Page2 of2 POS-01 0/P81 4066 July 13, 2021 Advanced Attorney Services, Inc. fax (619) 299-5058