If you are being served on behalf of a corporation, an unincorporated association (including a partnership), or other entity, this
form must be signed by you in the name of such entity or by a person authorized to receive service of process on behalf of such
entity. In all other cases, this form must be signed by you personally or by a person authorized by you to acknowledge receipt of
summons. If you return this form to the sender, service of a summons is deemed complete on the day you sign the
acknowledgment of receipt below.
(SIGNATURE OF SENDER—MUST NOT BE A PARTY IN THIS CASE)
ACKNOWLEDGMENT OF RECEIPT
This acknowledges receipt of (to be completed by sender before mailing):
1.
2.
(To be completed by recipient):
(SIGNATURE OF PERSON ACKNOWLEDGING RECEIPT, WITH TITLE IF
ACKNOWLEDGMENT IS MADE ON BEHALF OF ANOTHER PERSON OR ENTITY)
Form Adopted for Mandatory Use
Judicial Council of California
POS-015 [Rev. January 1, 2005]
NOTICE AND ACKNOWLEDGMENT OF RECEIPT — CIVIL
Code of Civil Procedure,
§§ 415.30, 417.10
www.courtinfo.ca.gov
Page 1 of 1
TO (insert name of party being served):
Date of mailing:
(TYPE OR PRINT NAME)
A copy of the summons and of the complaint.
Other
(specify):
Date this form is signed:
(TYPE OR PRINT YOUR NAME AND NAME OF ENTITY, IF ANY,
ON WHOSE BEHALF THIS FORM IS SIGNED)
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
BRANCH NAME:
CITY AND ZIP CODE:
STREET ADDRESS:
MAILING ADDRESS:
Plaintiff/Petitioner:
Defendant/Respondent:
FOR COURT USE ONLY
CASE NUMBER:
NOTICE AND ACKNOWLEDGMENT OF RECEIPT—CIVIL
POS-015
ATTORNEY OR PARTY WITHOUT ATTORNEY:
STATE: ZIP CODE:CITY:
STREET ADDRESS:
FIRM NAME:
NAME:
STATE BAR NO:
TELEPHONE NO.: FAX NO. :
E-MAIL ADDRESS:
ATTORNEY FOR (Name):
NOTICE
The summons and other documents identified below are being served pursuant to section 415.30 of the California Code of Civil
Procedure. Your failure to complete this form and return it within 20 days from the date of mailing shown below may subject you
(or the party on whose behalf you are being served) to liability for the payment of any expenses incurred in serving a summons
on you in any other manner permitted by law.
For your protection and privacy, please press the Clear
This Form button after you have printed the form.
