Page 2 of 2Rev. 11/17 PROOF OF SERVICE OF SUMMONS
Respondent: Case Number:
4. Address where the respondent was served:
5. I served the respondent (check one and ll in date(s)):
by personally delivering the copies to the respondent on (date)
requested, on (date)
substitute service (publication) pursuant to San Manuel Rules of Civil Procedure 28.2.2 (b) by prominently
Reservation for three (3) weeks and in a newspaper of general circulation in the vicinity of the Reservation for
three (3) weeks. In such case, the deadline for return of proof of service shall be not less than thirty (30) days
from the date of publication.
Date(s) of posting and publication:
Note: Service by publication must be pre-approved by the presiding judge pursuant to a court order.
6. Person serving (name, address and phone number):
7. The fee for service (if applicable) was: $
I declare under penalty of perjury under the laws of the San Manuel Band of Mission Indians that the foregoing is
true and correct.
Type or Print Name of Person who Served Papers