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POS-010 SUPERIOR COURT OF CALIFORNIA, COUNTY OF

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At the time of service I was at least 18 years of age and not a party to this action.
PROOF OF SERVICE OF SUMMONS
Form Adopted for Mandatory Use
Judicial Council of California
POS-010 [Rev. January 1, 2007]
POS-010
PROOF OF SERVICE OF SUMMONS
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
FOR COURT USE ONLY
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
PLAINTIFF/PETITIONER:
DEFENDANT/RESPONDENT:
CASE NUMBER:
ATTORNEY FOR (Name):
TELEPHONE NO.: FAX NO. (Optional):
E–MAIL ADDRESS (Optional):
1.
4. Address where the party was served:
a.
5. I served the party (check proper box)
by personal service. I personally delivered the documents listed in item 2 to the party or person authorized to
receive service of process for the party (1) on (date): (2) at (time):
b.
(business) a person at least 18 years of age apparently in charge at the office or usual place of business
of the person to be served. I informed him or her of the general nature of the papers.
(1)
(home) a competent member of the household (at least 18 years of age) at the dwelling house or usual
place of abode of the party. I informed him or her of the general nature of the papers.
(2)
by substituted service. On (date): at (time): I left the documents listed in item 2 with or
in the presence of (name and title or relationship to person indicated in item 3):
Page 1 of 2
Code of Civil Procedure, § 417.10
Ref. No. or File No.:
a. Party served (specify name of party as shown on documents served):3.
b. Person (other than the party in item 3a) served on behalf of an entity or as an authorized agent (and not a person
under item 5b on whom substituted service was made) (specify name and relationship to the party named in item 3a):
(3)
(physical address unknown) a person at least 18 years of age apparently in charge at the usual mailing
address of the person to be served, other than a United States Postal Service post office box. I informed
him or her of the general nature of the papers.
(Separate proof of service is required for each party served.)
b.
c.
d.
complaint
Alternative Dispute Resolution (ADR) package
Civil Case Cover Sheet (served in complex cases only)
I served copies of: 2.
e.
f.
cross-complaint
other (specify documents):
a.
summons
(5)
(4)
I thereafter mailed (by first-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 documents on
(date): from (city): or a declaration of mailing is attached.
I attach a declaration of diligence stating actions taken first to attempt personal service.
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Person who served papers
The fee for service was: $
not a registered California process server.
exempt from registration under Business and Professions Code section 22350(b).
a registered California process server:
(1)
(2)
(i)
Registration No.:
County:
8.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
9.
Date:
(SIGNATURE )
PROOF OF SERVICE OF SUMMONS
POS-010 [Rev. January 1, 2007]
CASE NUMBER:
PLAINTIFF/PETITIONER:
DEFENDANT/RESPONDENT:
7.
I am a California sheriff or marshal and I certify that the foregoing is true and correct.
e. I am:
(iii)
(ii)
by mail and acknowledgment of receipt of service. I mailed the documents listed in item 2 to the party, to the
address shown in item 4, by first-class mail, postage prepaid,
c.
(2) from (city):
with two copies of the Notice and Acknowledgment of Receipt and a postage-paid return envelope addressed
to me. (Attach completed Notice and Acknowledgement of Receipt.) (Code Civ. Proc., § 415.30.)
(3)
(4)
by other means (specify means of service and authorizing code section):
d.
a.
b.
(1) on (date):
to an address outside California with return receipt requested. (Code Civ. Proc., § 415.40.)
Additional page describing service is attached.
6. The "Notice to the Person Served" (on the summons) was completed as follows:
as an individual defendant.
as the person sued under the fictitious name of (specify):
(NAME OF PERSON WHO SERVED PAPERS/SHERIFF OR MARSHAL)
or
a. Name:
b. Address:
c. Telephone number:
d.
Page 2 of 2
(3)
416.10 (corporation)
416.60 (minor)
416.30 (joint stock company/association)
416.70 (ward or conservatee)
416.90 (authorized person)
d.
under the following Code of Civil Procedure section:
other:
415.95 (business organization, form unknown)
415.46 (occupant)
416.20 (defunct corporation)
On behalf of (specify):
416.40 (association or partnership)
416.50 (public entity)
c.
as occupant.
employee independent contractor.
owner
5.
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POS-010 SUPERIOR COURT OF CALIFORNIA, COUNTY OF

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Completed 10 March 2021

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