MC-040
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
FAX NO. (Optional):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
TELEPHONE NO.:
E-MAIL ADDRESS (Optional):
ATTORNEY FOR (Name):
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
Form Approved for Optional Use
Judicial Council of California
MC-040 [Rev. January 1, 2013]
NOTICE OF CHANGE OF ADDRESS OR OTHER
CONTACT INFORMATION
Page 1 of 2
PLAINTIFF/PETITIONER:
NOTICE OF CHANGE OF ADDRESS OR OTHER
Please take notice that, as of (date):
plaintiff (name):
a.
The new address or other contact information for (name):
All notices and documents regarding the action should be sent to the above address.
Date:
(SIGNATURE OF PARTY OR ATTORNEY)
(TYPE OR PRINT NAME)
b.
d.
f.
g.
Street:
City:
State and zip code:
Fax number (if available):
E-mail address (if available):
e. Telephone number:
DEFENDANT/RESPONDENT:
is as follows:
FOR COURT USE ONLY
CASE NUMBER:
JUDICIAL OFFICER:
DEPT.:
has changed his or her address for service of notices and documents or other contact information in the above-captioned
action.
1.
3.
defendant (name):
petitioner (name):
respondent (name):
other (describe):
a.
b.
c.
d.
e.
the following self-represented party or
the attorney for:
2.
A list of additional parties represented is provided in Attachment 1.
c.
Mailing address (if different from above):
CONTACT INFORMATION
Cal. Rules of Court, rules 2.200 and 8.816
www.courts.ca.gov
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(NOTE: This page may be used for proof of service by first-class mail of the Notice of Change of Address or Other Contact
Information. Please use a different proof of service, such as Proof of Service—Civil (form POS-040), if you serve this notice
by a method other than first class-mail, such as by fax or electronic service. You cannot serve the Notice of Change of
Address or Other Contact Information if you are a party in the action. The person who served the notice must complete this
proof of service.)
CASE NUMBER:
PROOF OF SERVICE BY FIRST-CLASS MAIL
I served a copy of the Notice of Change of Address or Other Contact Information by enclosing it in a sealed envelope addressed
to the persons at the addresses listed in item 5 and (check one):
At the time of service, I was at least 18 years old and not a party to this action.
NOTICE OF CHANGE OF ADDRESS OR OTHER CONTACT INFORMATION
The Notice of Change of Address or Other Contact Information was placed in the mail:
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 DECLARANT)
(SIGNATURE OF DECLARANT)
NOTICE OF CHANGE OF ADDRESS
MC-040 [Rev. January 1, 2013]
Page 2 of 2
4.
a.
b.
1.
3.
deposited the sealed envelope with the United States Postal Service with postage fully prepaid.
at (city and state):
b.
a. on (date):
The envelope was addressed and mailed as follows:
5.
a. Name of person served:
Street address:
City:
State and zip code:
c. Name of person served:
Street address:
City:
State and zip code:
b.
Name of person served:
Street address:
City:
State and zip code:
d.
Name of person served:
Street address:
City:
State and zip code:
Names and addresses of additional persons served are attached. (You may use form POS-030(P).)
MC-040
OR OTHER CONTACT INFORMATION
I am a resident of or employed in the county where the mailing took place. My residence or business address is (specify):
2.
placed the sealed envelope for collection and for 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
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.
PLAINTIFF/PETITIONER:
DEFENDANT/RESPONDENT:
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