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    Pos030 24CV9990822 20240623-013750

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    Sample Proof of service

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    Pos030 24CV9990822 20240623-013750

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    design
    3 views2 pages
    Sample Proof of service

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    POS030_24CV9990822_20240623-013750

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    Sample Proof of service

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    3 views2 pages

    Pos030 24CV9990822 20240623-013750

    Uploaded by

    design
    Sample Proof of service

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    POS-030

    ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
    FOR COURT USE ONLY
    BLA BLA BLA
    Newark
    Newark CA 95054

    TELEPHONE NO.: 4089660000 FAX NO. (Optional):


    E-MAIL ADDRESS (Optional):
    ATTORNEY FOR (Name): Defendant in pro per

    SUPERIOR COURT OF CALIFORNIA, COUNTY OF Alameda


    STREET ADDRESS: Hayward
    MAILING ADDRESS:
    CITY AND ZIP CODE: Hayward
    BRANCH NAME:

    PETITIONER/PLAINTIFF: BLL BLLI


    RESPONDENT/DEFENDANT: BLA BLA BLA ,et al
    CASE NUMBER:
    PROOF OF SERVICE BY FIRST-CLASS MAIL—CIVIL
    24CV9990822

    (Do not use this Proof of Service to show service of a Summons and Complaint.)
    1. I am over 18 years of age and not a party to this action. I am a resident of or employed in the county where the mailing
    took place.
    2. My residence or business address is:

    3. On (date): ____/____/______ I mailed from (city and state): __________________________________


    the following documents (specify):
    ✔ UD-105 and Attachment 3w ✔ Demand for Jury Trial
    UD-104 and UD104(A) The documents are listed in the Attachment to Proof of Service by
    First-Class Mail—Civil (Documents Served) (form POS-030(D)).

    4. I served the documents by enclosing them in an envelope and (check one):


    a. X depositing the sealed envelope with the United States Postal Service with the postage fully prepaid.
    b. placing the envelope for collection and mailing following our ordinary business practices. I am readily familiar with this
    business’s practice for collecting and processing correspondence for mailing. On the same day that correspondence is
    placed for collection and mailing, it is deposited in the ordinary course of business with the United States Postal Service in
    a sealed envelope with postage fully prepaid.
    5. The envelope was addressed and mailed as follows:
    a. Name of person served: BLLLLI
    b. Address of person served:
    Sacramento

    Sacremento

    The name and address of each person to whom I mailed the documents is listed in the Attachment to Proof of Service
    by First-Class Mail—Civil (Persons Served) (POS-030(P)).

    I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

    Date:

    (TYPE OR PRINT NAME OF PERSON COMPLETING THIS FORM) (SIGNATURE OF PERSON COMPLETING THIS FORM)

    Form Approved for Optional Use PROOF OF SERVICE BY FIRST-CLASS MAIL—CIVIL Code of Civil Procedure, §§ 1013, 1013a
    Judicial Council of California www.courtinfo.ca.gov
    POS-030 [New January 1, 2005] (Proof of Service)
    INFORMATION SHEET FOR PROOF OF SERVICE BY FIRST-CLASS MAIL—CIVIL
    (This information sheet is not part of the Proof of Service and does not need to be copied, served, or filed.)

    NOTE: This form should not be used for proof of service of a summons and complaint. For that purpose, use Proof of Service of
    Summons (form POS-010).

    Use these instructions to complete the Proof of Service by First-Class Mail—Civil (form POS-030).

    A person over 18 years of age must serve the documents. There are two main ways to serve documents:
    (1) by personal delivery and (2) by mail. Certain documents must be personally served. You must determine whether
    personal service is required for a document. Use the Proof of Personal Service–Civil (form POS-020) if the documents
    were personally served.

    The person who served the documents by mail must complete a proof of service form for the documents served. You
    cannot serve documents if you are a party to the action.

    INSTRUCTIONS FOR THE PERSON WHO SERVED THE DOCUMENTS

    The proof of service should be printed or typed. If you have Internet access, a fillable version of the Proof of Service
    form is available at www.courtinfo.ca.gov/forms.

    Complete the top section of the proof of service form as follows:

    First box, left side: In this box print the name, address, and telephone number of the person for whom you served the
    documents.

    Second box, left side: Print the name of the county in which the legal action is filed and the court’s address in this box.
    The address for the court should be the same as on the documents that you served.

    Third box, left side: Print the names of the Petitioner/Plaintiff and Respondent/Defendant in this box. Use the same names
    as are on the documents that you served.

    First box, top of form, right side: Leave this box blank for the court’s use.

    Second box, right side: Print the case number in this box. The case number should be the same as the case number on
    the documents that you served.

    Complete items 1–5 as follows:

    1. You are stating that you are over the age of 18 and that you are not a party to this action. You are also stating that
    you either live in or are employed in the county where the mailing took place.

    2. Print your home or business address.

    3. Provide the date and place of the mailing and list the name of each document that you mailed. If you need more
    space to list the documents, check the box in item 3, complete the Attachment to Proof of Service by First-Class
    Mail—Civil (Documents Served) (form POS-030(D)), and attach it to form POS-030.

    4. For item 4:

    Check box a if you personally put the documents in the regular U.S. mail.
    Check box b if you put the documents in the mail at your place of business.

    5. Provide the name and address of each person to whom you mailed the documents. If you mailed the documents to
    more than one person, check the box in item 5, complete the Attachment to Proof of Service by First-Class
    Mail—Civil (Persons Served) (form POS-030(P)), and attach it to form POS-030.

    At the bottom, fill in the date on which you signed the form, print your name, and sign the form. By signing,
    you are stating under penalty of perjury that all the information you have provided on form POS-030 is true
    and correct.

    POS-030 [New January 1, 2005] PROOF OF SERVICE BY FIRST CLASS MAIL—CIVIL


    (Proof of Service)
    For your protection and privacy, please press the Clear
    This Form button after you have printed the form. Print this form Save this form Clear this form

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