Acknowledgement ReceiptCal. Super. - 6th Dist.April 1, 2021POS-015 ATTORNEY 0R PARTY WITHOUT ATTORNEY STATE BAR No 250638 I EIectroniEfiHV’Fi‘Féfl’” NAME Yana G. Hennks, Esq. b s . C rt f CAmm NAME MCMURRAY HENRIKS, LLP y ”per'or °u ° ’ smsmooaess s11 Mshire Blvd” Suite 1640 County of Santa Clara, CITY Los Angeles STATE CA Z'PCODE 90017 on 7/20/2021 5:12 PM TELEPHONE No 323-931-6200 FAX N0 323'931'9521 Reviewed By' Pearl Lai E-MAIL ADDRESS yhenriks@law-mh.com I ATTORNEY FOR (Name) Plaintiff TORI D. MOSES case #21 CV381 458 SUPERIOR counT 0F CALIFORNIA, COUNTY 0F SANTA CLARA EnveloPe' 6889230 STREET ADDRESS 191 North First Street MAILING ADDRESS 191 North First Street CITY ANchP CODE San Jose 951 13 BRANCH NAME Downtown Superior Court Plaintiff/Petitioner: Tori D. Moses Defendant/Respondent: Hyatt Corporation. et al. CASE NUMBER NOTICE AND ACKNOWLEDGMENT OF RECEIPT-CIVIL 21CV381458 TO (insert name ofpany being served): Lusardi Construction Company, a Corporation NOTICE The summons and other documents identified below are being served pursuant to section 415.30 of the California Code of Civil Procedure. Your failure to complete this form and return it within 20 days from the date of mailing shown below may subject you (or the party on whose behalf you are being sewed) to liability for the payment of any expenses incurred in sewing a summons on you in any other manner permitted by law. If you are being served on behalf of a corporation, an unincorporated association (including a partnership), or other entity, this form must be signed by you in the name of such entity or by a person authorized to receive service of process on behalf of such entity. In all other cases. this form must be signed by you personally or by a person authorized by you to acknowledge receipt of summons. If you return this form to the sender, service of a summons is deemed complete on the day you sign the acknowledgment of receipt below. Date of mailing: July 15, 2021 fé“3 Lauren Freidenberg. Esq. (TYPE OR PRINT NAME) (SIGNATURE 0F SENDER-MUST NOT BE A PARTY IN THIS CASE) ACKNOWLEDGMENT 0F RECEIPT This acknowledges receipt of (to be completed by sender before mailing): 1. E A copy ofthe summons and of the complaint. 2. E Other (specify): Amended Summons, Amended Complaint. Civil Case Cover Sheet. Civil Lawsuit Notice (To be completed by recipient): 16 Z \ [??te this form is signed: 1°\\[ '20’W )/CW(AWQ- QQCAQ (QUKSH Co. LUSQ/o Co-«ykvutkm’ (TYPE OR PRINT YOUR NAME AND NAME OF ENTITY IF ANY. (SIGNATURE OF PERSON ACKNOWLEDGING RECEIPT WITH TITLE IF ON WHOSE BEHALF THIS FORM IS SIGNED) ACKNOWLEDGMENT IS MADE ON BEHALF OF ANOTHER PERSON 0R ENTITY) Page 1 of 1 Form Adopted (or Mandatory Use NOT'CE AND ACKNOWLEDGMENT OF RECEIPT_ CIVIL Coda OICIVII Procedure Judaciat Councfl of Calltomia §§ 415 30. 417 10 P0301 5 [Rev January 1. 2005] www courtlnlo ca gov
