4. I served the documents on the persons below, as follows:
a. Name of person served:–––––
–––––
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––––– –––––
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–– POS-
040
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address) FOR COURT USE ONLY
TELEPHONE NO. FAX NO.
(Optional):
E-MAIL ADDRESS (Optional):
ATTORNEY FOR
(Name) :
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
CITY AND ZIP
CODE
BRANCH
NAME
PETITIONER/PLAINTIF
F
RESPONDENT/DEFENDAN
T CASE
NUMBER
PROOF OF SERVICE-
CIVIL
Check method of service (only one):
By Personal service By
Mail By Overnight Delivery JUD
GE
By Messenger service By
Facsimile By E-Mail/Electronic
Transmission DEP
T.
(Do not use this Proof of Service to show service of a Summons and Complaint.)
1. At the time of service I was over 18 years of age and not a party to this action.
2. My address is (specify one):
a
. Busines
s: b
. Residenc
e:
3. On
( date ): I served the following documents
( specify ):
The documents are listed in the Attachment to Proof of Service-Civil (Documents Served) (form POS-040(D)).
b. Address of person served:
c. Fax number or e-mail address of person served, if service was by fax or e-mail:
d. Time of service, if personal service was used:
The names, addresses, and other applicable information about the persons served is on the Attachment to Proof of
Service Civil (Persons Served) (form POS-040(P)).
5. The documents were served by the following means (specify):
a
. By personal service. I personally delivered the documents to the persons at the addresses listed in item 4.
(1) For a party represented by an attorney, delivery was made to the attorney or at the attorney's office by leaving the
documents in an envelope or package clearly labeled to identify the attorney being served with a receptionist or an
individual in charge of the office. (2) For a party, delivery was made to the party or by leaving the documents at the
party's residence with some person not less than 18 years of age between the hours of eight in the morning and six in
the evening.
Form Approved for Optional
Judicial Council of California
POS-040 [New January 1,
2005] PROOF OF SERVICE-
CIVIL
(Proof of Service) Code of
Civ.Proc. §§
1011,1013, 1013a,
2015.5electronic form ã 2005
WWW.LawCA.com
Law Publishers
I served the envelope or package, as stated above, on (date):
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:
–––––
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––
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–––––
–––––CASE
NAME CASE
NUMBER:
5
b. By United States
mail I enclosed the documents in a sealed envelope or package addressed to the persons at the
addresses in item 4 and (specify
one):
(
1
) deposited the sealed envelope with the United States Postal Service, with the postage fully prepaid.
(
2
) placed the 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
United States Postal Service, in a sealed envelope with postage fully prepaid.
I am a resident or employed in the county where the mailing occurred. The envelope or package was placed in the mail at
(city and state):
c
. By overnight delivery. I enclosed the documents in an envelope or package provided by an overnight delivery
carrier and addressed to the persons at the addresses in item 4. 1 placed the envelope or package for collection
and overnight delivery at an office or a regularly utilized drop box of the overnight delivery carrier.
d
. By messenger service. I served the documents by placing them in an envelope or package addressed to the persons
at the addresses listed in item 4 and providing them to a professional messenger service for service. (A declaration by
the messenger must accompany this Proof of Service or be contained in the Declaration of Messenger below.)
e
. By fax transmission . Based on an agreement of the parties to accept service by fax transmission, I faxed the
documents to the persons at the fax numbers listed in item 4. No error was reported by the fax machine that I used. A
copy of the record of the fax transmission, which I printed out, is attached.
f
. By e-mail or electronic transmission. Based on a court order or an agreement of the parties to accept service by e-
mail or electronic transmission, I caused the documents to be sent to the persons at the e-mail addresses listed
in item 4. I did not receive, within a reasonable time after the transmission, any electronic message or other indication
that the transmission was unsuccessful.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Dat
e:
(SIGNATURE OF
DECLARANT)(TYPE OR PRINT NAME OF DECLARANT)
(If item 5d above is checked, the declaration below must be completed or a separate declaration from a messenger must be attached.)
DECLARATION OF MESSENGER
By personal service. I personally delivered the envelope or package received from the declarant above to the persons at
the addresses listed in item 4. (1) For a party represented by an attorney, delivery was made to the attorney or at the
attorney's office by leaving the documents in an envelope or package, which was clearly labeled to identify the attorney being
served, with a receptionist or an individual in charge of the office. (2) For a party, delivery was made to the party or by leaving
the documents at the party's residence with some person not less than 18 years of age between the hours of eight in the
morning and six in the evening.
At the time of service, I was over 18 years of age. I am not a party to the above-referenced legal proceeding.
(NAME OF
DECLARANT) (SIGNATURE OF
DECLARANT)
POS-040 [New January 1,
2005] PROOF OF SERVICE-
CIVIL
(Proof of Service) electronic form ã 2005
WWW.LawCA.com
Law Publishers
INFORMATION SHEET FOR PROOF OF SERVICE-CIVIL
(This information sheet is not part of the official proof of service form and does not need to be copied, served, or filed.)
USE OF THIS FORM
Note: This proof of service form should not be used to show proof of service of a summons and complaint. For that
purpose, use Proof of Service of Summons (form POS-010).
This form is designed to be used to show proof of service of documents by (1) personal service, (2) mail, (3) overnight
delivery, (4) messenger service, (5) facsimile, or (6) e-mail/electronic transmission.
Certain documents must be personally served. For example, an order to show cause and temporary restraining order
generally must be served by personal delivery. You must determine whether a document must be personally delivered
or can be served by mail or another method.
GENERAL INSTRUCTIONS
A person must be over 18 years of age to serve the documents. The person who served the documents must complete
the Proof of Service. A party to the action cannot serve the documents.
The Proof of Service should be typed or printed. If you have Internet access, a fillable version of this proof of service
f o r m i s a v a i l a b l e a t w w w. L a w C A . c o m
Complete the top section of the proof of service form as follows:
First box, left side: In this box print the name, address, and telephone number of the person forwhom you served the
document
s.
Second box, left side: Print the name of the county in which the legal action is filed and the court's address in this box.
The address for the court should be the same as the address on the documents that you served.
Third box, left side: Print the names of the Petitioner/Plaintiff and Respondent/Defendant in this box. Use the same
names as are on the documents that you served.
Fourth box, left side: Check the method of service that was used. You should check only one method of service and
should show proof of only one method on the form. If you served a party by several methods, use a separate form to
show each method of
service.
First box, top of form, right side: Leave this box blank for the court's use.
Second box, right side: Print the case number in this box. The case number should be the same as the case number
on the documents that you served.
Third box, right side: State the judge and department assigned to the case, if known.
Complete items 1-
5.
You are stating that you are over the age of 18 and that you are not a party to this action.
Print your home or business address.
List each document that you served. If you need more space, check the box in item 3, complete the Attachment to
Proof of Service-Civil (Documents Served) (form POS-040(D)), and attach it to form POS-040.
Provide the names, addresses, and other applicable information about the persons served. If more than one person
was served, check the box on item 4, complete the Attachment to Proof of Service-Civil (Persons Served) (form
POS-040(P)), and attach it to form POS-040.
Check the box before the method of service that was used, and provide any additional information that is required.
The law may require that documents be served in a particular manner (such as by personal delivery) for certain
purposes. Service by fax transmission or e-mail generally requires the prior agreement of the parties.
You must sign and date the proof of service form. By signing, you are stating under penalty of perjury that the
information that you have provided on POS-040 is true and correct.
POS-040 [New January 1,
2005] PROOF OF SERVICE-
CIVIL
(Proof of Service) electronic form ã 2005
WWW.LawCA.com
Law Publishers
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