Preview
orm iy! Proof of Service een
FILE
Use this form to serve a person, a business, or a public entity. To learn more SUPERIOR COURT
about proof of service, read What Is "Proof of Service"?, Form SC-104B. To
learn more about how to serve a business or entity, read How to Serve a 20I5NOY 17 AM 8: 06
Business or Public Entity, Form SC-104C.
To serve a business, you must serve one of the following people:
+ 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) Fill in court name snd street address:
* Any person authorized for service with the Secretary of State (corporation, | StPerior Court of California, County of
association, limited lability company [LLC], limited liability parmership San Joaquin
[LLP], limited partnership) 222 E. Weber Ave
To serve a public entity, you must first file a claim with that entity, then Stockton, CA 95202
serve one of the following people:
* Clerk (of a city or county)
* Chief officer or director (of a public agency) ay in ease number, case name. hearing date,
* Any person authorized for service by the entity os ae me
@ a. Ifyou are serving a person, write the person’s name below: .
Arshell Edwards . STK-CV-SC-2015-0009958
Case Name:
b. If you are serving a business or entity, write the name of the business
or entity, the person authorized for service, and that person’s job title: Big Valley Ford Lincoln y.
Dusinass or Agney Name Hearing Date: 1517-2015
Person Authorized for Service Job Title Time: 1:30PM Dept: J2
@) 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 receives 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 (4).
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.
3) I served the person in (@ a copy of the documents checked below: : ) CO
a. SC-100, Plaintiff's Claim and ORDER to Go to Small Claims Court
bo SC-120, Defendant’s Claim and ORDER to Go to Small Claims Court
c. L] 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.
() O SC-134, Application and Order to Produce Statement of Assets and to Appear for Examination
(2) 0 AT-138/EJ-125, Application and Order for Appearance and Examination
d. C1 Other (specifi):
Judicial Councit of Catitarnc -courtinto.ca.gov i SC-104, Page 1 of 2
Rovised “awary 1, 2009, Optional Ferm Proof of Service 9 >
Code of Givi Procedure, §§ 146,340, 415.10, 415.20 (Small Claims)Case Number:
STK-CV-SC-2015-0009958
Case name:
Fill out “a” or “b” below:
a. Personal Service: I personally gave copies of the documents checked in ® to the person in @:
On (date); 10-6-2015 At (time): 130 am. Mp.m.
At this address: 8075 Saratoga Way
City; Stockton State__CA zip: _95209
b. [1 Substituted Service: I personally gave copies of the documents checked in @ @, b, or d) to (check one):
C1 A competent adult (at least 18) at the home of, and living with the person in@) or
CO An adult who seems to be in charge where the person in) usually works, or
1 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): Olam. 0 p.m.
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);___——=——sfrom (City, state):
by leaving it (check one):
a.) AtaU.S. Postal Service mail drop, or
b.0 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.
6) Server's Information
Name: Floyd Baker Phone:
Address: P.O. Box 1375
City: Merced State: CA Zip:95340
Fee for service: $ 60.00
If you are a registered process server:
County of registration: Merced Registration number: 98
6) I declare under penalty of perjury under California state law that I am at least 18 years old and not named in this
case and that the information above is true and correct.
Date; 1-6-2015
Floyd Baker Dv Tloryot Kee
Type or print server's name Server signs here after serving
|
Rsed Janay 1, 2003 Proof of Service SC-104, Page 2 of 2
(Small Claims)
Preview
orm iy! Proof of Service een FILE Use this form to serve a person, a business, or a public entity. To learn more SUPERIOR COURT about proof of service, read What Is "Proof of Service"?, Form SC-104B. To learn more about how to serve a business or entity, read How to Serve a 20I5NOY 17 AM 8: 06 Business or Public Entity, Form SC-104C. To serve a business, you must serve one of the following people: + 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) Fill in court name snd street address: * Any person authorized for service with the Secretary of State (corporation, | StPerior Court of California, County of association, limited lability company [LLC], limited liability parmership San Joaquin [LLP], limited partnership) 222 E. Weber Ave To serve a public entity, you must first file a claim with that entity, then Stockton, CA 95202 serve one of the following people: * Clerk (of a city or county) * Chief officer or director (of a public agency) ay in ease number, case name. hearing date, * Any person authorized for service by the entity os ae me @ a. Ifyou are serving a person, write the person’s name below: . Arshell Edwards . STK-CV-SC-2015-0009958 Case Name: b. If you are serving a business or entity, write the name of the business or entity, the person authorized for service, and that person’s job title: Big Valley Ford Lincoln y. Dusinass or Agney Name Hearing Date: 1517-2015 Person Authorized for Service Job Title Time: 1:30PM Dept: J2 @) 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 receives 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 (4). 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. 3) I served the person in (@ a copy of the documents checked below: : ) CO a. SC-100, Plaintiff's Claim and ORDER to Go to Small Claims Court bo SC-120, Defendant’s Claim and ORDER to Go to Small Claims Court c. L] 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. () O SC-134, Application and Order to Produce Statement of Assets and to Appear for Examination (2) 0 AT-138/EJ-125, Application and Order for Appearance and Examination d. C1 Other (specifi): Judicial Councit of Catitarnc -courtinto.ca.gov i SC-104, Page 1 of 2 Rovised “awary 1, 2009, Optional Ferm Proof of Service 9 > Code of Givi Procedure, §§ 146,340, 415.10, 415.20 (Small Claims)Case Number: STK-CV-SC-2015-0009958 Case name: Fill out “a” or “b” below: a. Personal Service: I personally gave copies of the documents checked in ® to the person in @: On (date); 10-6-2015 At (time): 130 am. Mp.m. At this address: 8075 Saratoga Way City; Stockton State__CA zip: _95209 b. [1 Substituted Service: I personally gave copies of the documents checked in @ @, b, or d) to (check one): C1 A competent adult (at least 18) at the home of, and living with the person in@) or CO An adult who seems to be in charge where the person in) usually works, or 1 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): Olam. 0 p.m. 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);___——=——sfrom (City, state): by leaving it (check one): a.) AtaU.S. Postal Service mail drop, or b.0 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. 6) Server's Information Name: Floyd Baker Phone: Address: P.O. Box 1375 City: Merced State: CA Zip:95340 Fee for service: $ 60.00 If you are a registered process server: County of registration: Merced Registration number: 98 6) I declare under penalty of perjury under California state law that I am at least 18 years old and not named in this case and that the information above is true and correct. Date; 1-6-2015 Floyd Baker Dv Tloryot Kee Type or print server's name Server signs here after serving | Rsed Janay 1, 2003 Proof of Service SC-104, Page 2 of 2 (Small Claims)