Fillable Proof of Service of Summons May 28, 2019 (California)

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Proof of Service of Summons May 28, 2019 (California)

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Superior Court of California, County of Sacramento
Family Law & Probate
Proof of Service of Summons Page 1 of 1
Cover Sheet:
Proof of Service of Summons
Effective Date:
May 28, 2019
Last Revision Date:
October 29, 2020
Purpose:
This form is to be completed and filed once the Summons and
Petition has been served on the Respondent in a Family Law case.
Assistance:
Parties who are acting as their own attorneys may receive help from
the Self Help Center to complete these forms. You may contact the
Self Help Center through the Court’s website, by creating an e-
Correspondence account.
Required Forms:
All forms are Judicial Council forms, unless otherwise indicated:
Proof of Service of Summons, FL-115
Optional Forms:
This form is needed only if the respondent is willing to accept
service:
Notice and Acknowledgment of Receipt, FL-117
Filing Fee:
None
Copies:
Make two copies of the completed forms. The Court will file and
keep the original and will endorse and return the copies to you.
Before You File:
Service must be done by someone over the age of eighteen who is
not a party to the case.
Filing:
All forms must be typewritten or printed in blue or black ink. (See
California Rules of Court, Rules 2.100-2.119)
Mail or place completed forms in the court drop-box located at the
Family Court at 3341 Power Inn Road, Sacramento, CA 95826.
Drop box hours are 8:00 am to 5:00 pm Monday through Friday,
excluding Court holidays.
Next Steps:
Judgment is not automatic. There are additional steps that must be
taken to obtain a Judgment.
At the time of service I was at least 18 years of age and not a party to this action. I served the respondent with copies of:
PROOF OF SERVICE OF SUMMONS
(Family Law—Uniform Parentage—Custody and Support)
Form Approved for Optional Use
Judicial Council of California
FL-115 [Rev. January 1, 2015]
FL-115
1.
and
a.
(1)
(2)
(3)
(7)
b.
c.
–or–
–or–
(5)
(6)
(4)
a.
I served the respondent by the following means (check proper boxes):
on (date): at (time):
b.
(1)
(2)
(name):
d.
Page 1 of 2
(8)
Code of Civil Procedure, § 417.10
www.courts.ca.gov
who is (specify title or relationship to respondent):
PROOF OF SERVICE OF SUMMONS
FOR COURT USE ONLY
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
TELEPHONE NO.: FAX NO.:
E-MAIL ADDRESS:
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
BRANCH NAME:
CITY AND ZIP CODE:
STREET ADDRESS:
MAILING ADDRESS:
PETITIONER:
RESPONDENT:
CASE NUMBER:
Family Law—Marriage/Domestic Partnership: Petition—Marriage/Domestic Partnership (form FL-100), Summons (form
FL-110), and blank Response—Marriage/Domestic Partnership (form FL-120)
Uniform Parentage: Petition to Establish Parental Relationship (form FL-200), Summons (form FL-210), and blank
Response to Petition to Establish Parental Relationship (form FL-220)
Custody and Support: Petition for Custody and Support of Minor Children (form FL-260), Summons (form FL-210), and
blank Response to Petition for Custody and Support of Minor Children (form FL-270)
Completed and blank Declaration Under
Uniform Child Custody Jurisdiction and
Enforcement Act (form FL-105)
Completed and blank Declaration of
Disclosure (form FL-140)
Completed and blank Schedule of Assets
and Debts (form FL-142)
Completed and blank Income and
Expense Declaration (form FL-150)
Completed and blank Financial Statement
(Simplified) (form FL-155)
Completed and blank Property
Declaration (form FL-160)
Request for Order (form FL-300), and blank
Responsive Declaration to Request for Order (form
FL-320)
2WKHUVSHFLI\
2.
3.
Personal service. I personally delivered the copies to the respondent (Code Civ. Proc., § 415.10)
Substituted service. I left the copies with or in the presence of
(Business) a person at least 18 years of age who was apparently in charge at the office or usual place of
business of the respondent. I informed him or her of the general nature of the papers.
(Home) a competent member of the household (at least 18 years of age) at the home of the respondent. I
informed him or her of the general nature of the papers.
on (date):
A declaration of diligence is attached, stating the actions taken to first attempt personal service.
I thereafter mailed additional copies (by first class, postage prepaid) to the respondent at the place where the
copies were left (Code Civ. Proc., § 415.20b) on
(date):
at (time):
Address where respondent was served:
Sacramento
William R. Ridgeway Family Relations Courthouse
Sacramento, CA 95826
3341 Power Inn Road
3341 Power Inn Road
Person who served papers
The fee for service was (specify): $
a.
b.
c.
(1)
Registration no.:
County:
5.
6.
PROOF OF SERVICE OF SUMMONS
(Family Law—Uniform Parentage—Custody and Support)
FL-115 [Rev. January 1, 2015]
4.
This person is
(2)
c.
(1)
(2)
(specify code section):
d.
–or–
Name:
Telephone number:
d.
Page 2 of 2
CASE NUMBER:
RESPONDENT:
PETITIONER:
FL-115
3.
Mail and acknowledgment service. I mailed the copies to the respondent, addressed as shown in item 2, by
first-class mail, postage prepaid, on
Other
with two copies of the Notice and Acknowledgment of Receipt (form FL-117) and a postage-paid return
envelope addressed to me. (Attach completed Notice and Acknowledgment of Receipt (form FL-117).)
(Code Civ. Proc., § 415.30.)
to an address outside California (by registered or certified mail with return receipt requested). (Attach signed
return receipt or other evidence of actual delivery to the respondent.) (Code Civ. Proc., §§ 415.40, 417.20.)
Continued on Attachment 3d.
Address:
exempt from registration under Business and Professions Code section 22350(b).
not a registered California process server.
a registered California process server:
an employee or an independent contractor
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
I am a California sheriff, marshal, or constable, and I certify that the foregoing is true and correct.
Date:
(NAME OF PERSON WHO SERVED PAPERS)
(SIGNATURE OF PERSON WHO SERVED PAPERS)
(date):
from (city):
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signature
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I agree I received the following:
NOTICE AND ACKNOWLEDGMENT OF RECEIPT
(Family Law)
Form Approved for Optional Use
Judicial Council of California
FL-117 [Rev. January 1, 2015]
FL-117
a.
b.
c.
Page 1 of 1
Code of Civil Procedure, § 415.30, 417.10
www.courts.ca.gov
NOTICE AND ACKNOWLEDGMENT OF RECEIPT
FOR COURT USE ONLY
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
TELEPHONE NO.: FAX NO.:
E-MAIL ADDRESS:
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
BRANCH NAME:
CITY AND ZIP CODE:
STREET ADDRESS:
MAILING ADDRESS:
PETITIONER:
RESPONDENT:
CASE NUMBER:
Family Law: Petition—Marriage/Domestic Partnership (form FL-100), Summons (form FL-110), and blank Response—
Marriage/Domestic Partnership (form FL-120)
Uniform Parentage: Petition to Establish Parental Relationship (form FL-200), Summons (form FL-210), and blank
Response to Petition to Establish Parental Relationship (form FL-220)
Custody and Support: Petition for Custody and Support of Minor Children (form FL-260), Summons (form FL-210), and
blank Response to Petition for Custody and Support of Minor Children (form FL-270)
ACKNOWLEDGMENT OF RECEIPT
NOTICE
The documents identified below are being served on you by mail with this acknowledgment form. You must personally sign, or a
person authorized by you must sign, this form to acknowledge receipt of the documents.
If the documents described below include a summons and you fail to complete and return this acknowledgment form to the sender
within 20 days of the date of mailing, you will be liable for the reasonable expenses incurred after that date in serving you or
attempting to serve you with these documents by any other methods permitted by law. If you return this form to the sender, service
of a summons is deemed complete on the date you sign the acknowledgment of receipt below. This is not an answer to the action.
If you do not agree with what is being requested, you must submit a completed Response form to the court within 30 calendar days.
To (name of individual being served):
Recipient signed this acknowledgment on (specify date):
Date of mailing (specify):
(TYPE OR PRINT SENDER'S NAME)
(SIGNATURE OF SENDER—MUST NOT BE A PARTY IN THIS CASE
AND MUST BE 18 YEARS OR OLDER)
(SIGNATURE OF PERSON ACKNOWLEDGING RECEIPT)
(TYPE OR PRINT NAME OF PERSON ACKNOWLEDGING RECEIPT)
(1)
(2)
(3)
(7)
(4)
d.
(8)
Completed and blank Declaration Under Uniform
Child Custody Jurisdiction and Enforcement Act
(form FL-105)
Completed and blank Declaration of Disclosure
(form FL-140)
Completed and blank Schedule of Assets and
Debts (form FL-142)
Completed and blank Property Declaration (form
FL-160)
Request for Order (form FL-300), and blank
Responsive Declaration to Request for Order
(form FL-320)
2WKHUVSHFLI\
(6)
Completed and blank Financial Statement
(Simplified) (form FL-155)
Completed and blank Income and Expense
Declaration (form FL-150)
(5)
4.
2.
1.
3.
5.
6.
(Sender completes items 1 through 4 and signs before mailing. Recipient completes items 5 and 6, signs, then returns)
Sacramento
William R. Ridgeway Family Relations Courthouse
Sacramento, CA 95826
3341 Power Inn Road
3341 Power Inn Road
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Proof of Service of Summons May 28, 2019 (California)

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Completed 13 November 2020

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