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OA
SUPERIOR COURT OF CALIFORNIA
COUNTY OF SAN FRANCISCO
Document Scanning Lead Sheet
Feb-02-2016 9:31 am
| Case Number: CSM-16-851486
Filing Date: Feb-02-2016 9:28
Filed by: ELIAS BUTT
Juke Box: 001 Image: 05257178
PROOF OF SERVICE ON CLAIM
AYESHA KHALID VS. JORGE CASTRILLO
001005257178
Instructions:
Please place this sheet on top of the document to be scanned.fom Tt7.} Proof of Service ie stamps dale ere when form
meee
Use this form to serve a person, a business, or a public entity. To learn more 3 3 wi os
about proof of service, read What Is "Proof of Service"?, Form SC-104B. To F I D
learn more about how to serve a business or entity, read How to Serve a Sy erie Coun of ca fornia
Business or Public Entity, Form SC-104C.
To serve a business, you must serve one of the following people: FEB +2 PAN8
* Owner (for a sole proprietorship)
+ Partner (for a partnership) or general partner (for a limited partnership)
+ Any officer or general manager (corporation or association)
+ Any person authorized for service by the business (corporation, association,
general partnership, limited partnership) ,
+ Any person authorized for service with the Secretary of State (corporation,
association, limited liability company [LLC], limited liability partnership
[LLP], limited partnership)
To serve a public entity, you must first file a claim with that entity, then
serve one of the following people:
* Clerk (of a city or county) a — a
+ Chief officer or director (of a public agency) in case number, case name, hearing date,
+ Any person authorized for service by the entity Gay, time, andi department below:
If you are serving a person, write the person’s name below Case Number:
a. ‘ou. :
you are semving 2 person Pe CSM-16-851486
Jorge Castrillo
Name:
b. If you are serving a business or entity, write the name of the business orn ive Castrillo
or entity, the person authorized for service, and that person’s job title:
Superior Court of California, County of
Small Claims Superior Court
400 McAllister, Room 103
San Francisco, California 94102
Business of Agency Name
Hearing Date: March 04, 2016
‘Person Authorized for Service Job Title
Time: 3:30pm Dept: 506
@) Instructions to Server:
You must be at least 18 years old and not be named in this case. Follow these steps:
* Give a copy of all the documents checked in ® to.the person in ®, or
* Give a copy of all the documents checked in@ to one of the following people:
a. A competent adult (at least 18) living with, and at the home of the person in @, or
b. An adult (at least 18) who seems to be in charge at the usual workplace of the person in@), or
c. An adult (at least 18) who seems to be in charge where the person in @usually reteives mail
(but not a U.S. Post Office box), if there is no known physical address for the person in@.
and mail a copy of the documents left with one of the adults in a, b, or c above to the person in@).
THEN
* Complete and sign this form, and
+ Give or mail your completed form to the person who asked you to serve these court papers, in time for
the form to be filed with the court at least 5 days before the hearing.
@) I served the person in @ a copy of the documents checked below: : Q
a. [Z] SC-100, Plaintiff's Claim and ORDER to Go to Small Claims Court
b. 10 sc-120, Defendant's Claim and ORDER to Go to Small Claims Court
c. (0 Order for examination (This form must be personally served. Check the form that was served):
Note: The court can issue a civil arrest warrant if the served party does not come to court only if the order for
examination was personally served by a registered process server, sheriff, marshal, or someone appointed by the court.
() Cl sc-134, Application and Order to Produce Statement of Assets and to Appear for Examination
(2) DD AT-138/EJ-125, Application and Order for Appearance and Examination
d. © Other (specify):
Judicial Council of Califofnia, www.courtinfo.ca.gov. Proof of Service SC-104, Page 1 ¥
Revised January 1, 2009, Optional Form -
Code of Civil Procedure, §§ 116.340, 415.10, 415.20 (Small Claims)Case name: Khalid vs Castrillo
Case Number:
CSM-16-851486
Fill out “a” or “b” below:
a. Personal Service: I personally gave copies of the documents checked in © to the person in@:
On (date): 01/27/16 At (time): 9:36 Oam. Mpm.
At this address; 3501 Anza Street #4
City; San Francisco State:__Ca__ ip, _94121
b. (1 Substituted Service: I personally gave copies of the documents checked in@) (a, b, or d) to (check one):
(1 A competent adult (at least 18) at the home of, and living with the person in@ , or
O An adult who seems to be in charge where the person in@) usually works, or
An adult who seems to be in charge where the person in@)usually receives mail, or has a private
post office box (not a U.S. Post Office box), if there is no known physical address for the person in).
I told that adult, "Please give these court papers to (name of person in| @."
I did this on (date): At (time): Oam. O pm.
At this address:
City: State: Zip:
Name or description of the person I gave the papers to:
After serving the court papers, I put copies of the documents listed in @ in an envelope, sealed the envelope,
and put first-class prepaid postage on it. I addressed the envelope to the person in @ at the address where I
left the copies.
I mailed the envelope on (date): from (city, state):
by leaving it (check one):
a.[] AtaUsS. Postal Service mail drop, or
b.O Atan office or business mail drop where I know the mail is picked up every day and deposited with the
USS. Postal Service, or
c.L With someone else I asked to mail the documents to the person in @, and I have attached that person’s
completed Form SC-104A.
® Server's Information
Name: Nuha Abusamra Phone: (949) 463-7107
Address: 3501 Anza Street #2
City: San Francisco State:__Ca Zip: 94121
Fee for service: $ “a
If you are a registered process server:
County of registration:
Registration number:
©) I declare under penalty of perjury under California state law that I am at least 18 ye:
case and that the information above is true and correct.
Date: 01/27/16
old and not named in this
Nuha Abusamra »
Type or print server’s name Server sis
Revised January 1, 2009 Proof of Service SC-104, Page 2 of 2
(Small Claims)
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OA SUPERIOR COURT OF CALIFORNIA COUNTY OF SAN FRANCISCO Document Scanning Lead Sheet Feb-02-2016 9:31 am | Case Number: CSM-16-851486 Filing Date: Feb-02-2016 9:28 Filed by: ELIAS BUTT Juke Box: 001 Image: 05257178 PROOF OF SERVICE ON CLAIM AYESHA KHALID VS. JORGE CASTRILLO 001005257178 Instructions: Please place this sheet on top of the document to be scanned.fom Tt7.} Proof of Service ie stamps dale ere when form meee Use this form to serve a person, a business, or a public entity. To learn more 3 3 wi os about proof of service, read What Is "Proof of Service"?, Form SC-104B. To F I D learn more about how to serve a business or entity, read How to Serve a Sy erie Coun of ca fornia Business or Public Entity, Form SC-104C. To serve a business, you must serve one of the following people: FEB +2 PAN8 * Owner (for a sole proprietorship) + Partner (for a partnership) or general partner (for a limited partnership) + Any officer or general manager (corporation or association) + Any person authorized for service by the business (corporation, association, general partnership, limited partnership) , + Any person authorized for service with the Secretary of State (corporation, association, limited liability company [LLC], limited liability partnership [LLP], limited partnership) To serve a public entity, you must first file a claim with that entity, then serve one of the following people: * Clerk (of a city or county) a — a + Chief officer or director (of a public agency) in case number, case name, hearing date, + Any person authorized for service by the entity Gay, time, andi department below: If you are serving a person, write the person’s name below Case Number: a. ‘ou. : you are semving 2 person Pe CSM-16-851486 Jorge Castrillo Name: b. If you are serving a business or entity, write the name of the business orn ive Castrillo or entity, the person authorized for service, and that person’s job title: Superior Court of California, County of Small Claims Superior Court 400 McAllister, Room 103 San Francisco, California 94102 Business of Agency Name Hearing Date: March 04, 2016 ‘Person Authorized for Service Job Title Time: 3:30pm Dept: 506 @) Instructions to Server: You must be at least 18 years old and not be named in this case. Follow these steps: * Give a copy of all the documents checked in ® to.the person in ®, or * Give a copy of all the documents checked in@ to one of the following people: a. A competent adult (at least 18) living with, and at the home of the person in @, or b. An adult (at least 18) who seems to be in charge at the usual workplace of the person in@), or c. An adult (at least 18) who seems to be in charge where the person in @usually reteives mail (but not a U.S. Post Office box), if there is no known physical address for the person in@. and mail a copy of the documents left with one of the adults in a, b, or c above to the person in@). THEN * Complete and sign this form, and + Give or mail your completed form to the person who asked you to serve these court papers, in time for the form to be filed with the court at least 5 days before the hearing. @) I served the person in @ a copy of the documents checked below: : Q a. [Z] SC-100, Plaintiff's Claim and ORDER to Go to Small Claims Court b. 10 sc-120, Defendant's Claim and ORDER to Go to Small Claims Court c. (0 Order for examination (This form must be personally served. Check the form that was served): Note: The court can issue a civil arrest warrant if the served party does not come to court only if the order for examination was personally served by a registered process server, sheriff, marshal, or someone appointed by the court. () Cl sc-134, Application and Order to Produce Statement of Assets and to Appear for Examination (2) DD AT-138/EJ-125, Application and Order for Appearance and Examination d. © Other (specify): Judicial Council of Califofnia, www.courtinfo.ca.gov. Proof of Service SC-104, Page 1 ¥ Revised January 1, 2009, Optional Form - Code of Civil Procedure, §§ 116.340, 415.10, 415.20 (Small Claims)Case name: Khalid vs Castrillo Case Number: CSM-16-851486 Fill out “a” or “b” below: a. Personal Service: I personally gave copies of the documents checked in © to the person in@: On (date): 01/27/16 At (time): 9:36 Oam. Mpm. At this address; 3501 Anza Street #4 City; San Francisco State:__Ca__ ip, _94121 b. (1 Substituted Service: I personally gave copies of the documents checked in@) (a, b, or d) to (check one): (1 A competent adult (at least 18) at the home of, and living with the person in@ , or O An adult who seems to be in charge where the person in@) usually works, or An adult who seems to be in charge where the person in@)usually receives mail, or has a private post office box (not a U.S. Post Office box), if there is no known physical address for the person in). I told that adult, "Please give these court papers to (name of person in| @." I did this on (date): At (time): Oam. O pm. At this address: City: State: Zip: Name or description of the person I gave the papers to: After serving the court papers, I put copies of the documents listed in @ in an envelope, sealed the envelope, and put first-class prepaid postage on it. I addressed the envelope to the person in @ at the address where I left the copies. I mailed the envelope on (date): from (city, state): by leaving it (check one): a.[] AtaUsS. Postal Service mail drop, or b.O Atan office or business mail drop where I know the mail is picked up every day and deposited with the USS. Postal Service, or c.L With someone else I asked to mail the documents to the person in @, and I have attached that person’s completed Form SC-104A. ® Server's Information Name: Nuha Abusamra Phone: (949) 463-7107 Address: 3501 Anza Street #2 City: San Francisco State:__Ca Zip: 94121 Fee for service: $ “a If you are a registered process server: County of registration: Registration number: ©) I declare under penalty of perjury under California state law that I am at least 18 ye: case and that the information above is true and correct. Date: 01/27/16 old and not named in this Nuha Abusamra » Type or print server’s name Server sis Revised January 1, 2009 Proof of Service SC-104, Page 2 of 2 (Small Claims)