Proof of Service: MERCURY INSURANCE COMPANY VS MICHEL GOMEZ

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,            Attorney or —f"arty without Attorney:                                                                                          For Cour! Use Only
              ROBERT G. SPLINTER, BAR #78284
              23124 NARBONNE AVE.                                               _   _p I
              #105                                                                                                              Superior Court Of California
              LOMITA, CA 90717                                                                                                    “MW 0*’--WWI“
             Telephone No: 310 539-6335


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             Insert name ofCourt, and Judicial District and Branch Court:
                                                                                    6520                                               SEP 1 5 2°”
                                                                                                                           .«.—s ‘R.Cmor,&.:wc1mve Offlcnt/Clerk
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              LOS ANGELES SUPERIOR COURT CENTRAL DISTRICT                                                                             C“    ‘'
             Plaintiff: MERCURY INSURANCE
             Defendant: GOMEZ
                                                                Hearing Date:               Time:         Dept/Div:           Case Number:
               SUMMONS & COMPLAINT                                                                                              17STLC01673
             I . At the time ofservice I was at least I 8 years ofage and not a party to this action.

             2. I served copies of the Summons And Complaint Civil Case Cover Sheet Addendum And Statement Of Location, Statement Of
                 Damages, General Order

             3. a. Party served:                                            OSCAR GOMEZ
                b. Person served:                                           IVAN GOMEZ-CO—OCCUPANT

             4. Address where the party was served:                         516 SOUTH OSAGE AVENUE                                               ‘
                                                                            INGLEWOOD, CA 90301
             5. I served the party:
                b. by substituted service. On: Sat., Sep. 09, 2017 at: 2: 12PM by leaving the copies with or in the presence of:
                                                                    IVAN GOMEZ-CO-OCCUPANT
                  (2) (Home)Competent Member of the Household over 18. I informed him or her of the general nature of the papers.
                  (4) I thereafter mailed (by rst-class, postage prepaid) copies of the documents to the person to be served at the place where the
                      copies were left (Code Civ. Proc., 415.20). I mailed the document on: Mon., Sep. 11,2017 from: LONG BEACH,, CA
                  (5) I attach a declaration of diligence stating actions taken first to attempt personal service.

             6. The "Notice to the Person Served” (on the Summons) was completed asfollows:
               a. as an individual defendant

             7. Person Who Served Papers:                                                                   Recoverable Cost Per CCP 1033.5(a)(4)( B)
                 a. LOYD BALLARD                                                       d. The Feefor Service was:               $79.50
                 b. A & M ATTORNEY SERVICE, INC.                                       e.    I am: (3) registered California process server
                    P.O. BOX 7881                                                                     (1) Owner
                    LONG BEACH,, CA 90807                                                             (ii) Registration No.:      2015313694
                 c. 562 426-8306                                                                      (iii) County:               Los Angeles
                                                                                                      (iv) Expiration Date:       Fri, Jan. 05, 2018




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             8. I declare under penalty ofperjury under the laws of the State of (f'alif0rnia fl!!!                            is true and correct.

                 Date: Mon, Sep. 11, 2017                                                                                                                    .


             RuIeJ§.‘i'§i?ia$§il'§)°ii5°.i§"nE3%} 3007                                                                           ' ' :I              I'           Sp/.1-1592.?