Declaration of Service
I declare that I am a resident of or employed in the county where the mailing took place. I am over the age of
eighteen years and I am not a party to this case, my business or residence address is:
On
, I served this Additional Panel Request form, the original, or a true and correct copy of the
original, which is attached, on each of the persons or firms named below, by placing it in a sealed envelope,
addressed to the person or firm named below, and by:
A depositing the sealed envelope with the U. S. Postal Service with the postage fully prepaid.
B
placing the sealed envelope for collection and 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 that correspondence is placed for collection and mailing, it is deposited in the ordinary course
of business with the U. S. Postal Service in a sealed envelope with postage fully prepaid.
C
placing the sealed envelope for collection and overnight delivery at an office or a regularly utilized drop
box of the overnight delivery carrier.
D
placing the sealed envelope for pick up by a professional messenger service for service. (Messenger must
return to you a completed declaration of personal service.)
E personally delivering the sealed envelope to the person or firm named below at the address shown below.
Person or firm served
Zip Code
State
City
Street Address
Method of
Service
Street Address
Zip Code
State
City
Person or firm served
Method of
Service
Street Address
Zip Code
State
City
Person or firm served
Method of
Service
City
State
Zip Code
Street Address
Person or firm served
Method of
Service
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Signature _____________________________________________
Type or print name
, California.
atDate:
QME form 31.7(10/2013)
