Fill and Sign the Can I Get a Loan or an Advance on My Social Security Benefits Form

SUM-300 ATTORNEY OR PARTY WITHOUT ATTORNEY ( Name, state number, and address ): FOR COURT USE ONLY TELEPHONE NO.: FAX NO.: ATTORNEY FOR (Name) : NAME OF COURT: STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: PLAINTIFF/ PETITIONER: DEFENDANT/ RESPONDENT: DECLARATION OF LOST SUMMONS AFTER SERVICE CASE NUMBER: At the time of service, I was at least eighteen (18) years of age and not a party to this action. On (date) : , I served a copy of a Summons together with (specify documents) : on defendant/cross-defendant/respondent in this pr oceeding, in the manner described below. Name of party served and title, if any: Person with whom a copy of the Summons was left, and title or relationship to party served: Mailing date and type of mail: Address, city, and state ( when required, indicate whethe r address is home or business ): Manner of service: a. Substituted service on a corporation or unincorporated association (including partnership or public entity). By leaving, during usual office hours, copies in the office of the person served, with the perso n who apparently was in charge and thereafter mailing (by first-class mail, postage prepaid) copies to the person served at the place where the copies were left. (Code Civ. Proc., § 415.20(a). b. Place of mailing (specify) : Substituted service on natural pe rson, minor, or incompetent. By leaving copies at the dw elling house, usual place of abode, or usual place of business of t he person served with or in the presence of a competent mem ber of the household or a person apparently in charge of the offi ce or place of business, at least 18 years of age, who was informed of the general nature of the papers, and thereafter mailing (by first-class mail, post age prepaid) copies to the person served at the place where the copies were left. (Code Civ. Proc., § 415. 20(b).) Attached is a separate de claration or affidavit stating acts relied on to establish reasonable dilig ence in first attempting personal service. c. Place of mailing (specify) : Mail and acknowledgmen t of service. By mailing (by first-class mail, postage prepaid) copies to the person served, together with two copies of the notice and acknowledgment pr ovided for in Code of Civil Procedure section 415.30(b) and a return envelope, postage prepaid, addre ssed to the sender. (Code Civ. Proc., § 415.30.) Attached is a completed copy of the notice and acknowledgme nt of receipt mailed to the sender. Place of mailing ( specify ): d. DECLARATION OF LOST SUMMONS AFTER SERVICE Form Adopted for Mandatory Use Judicial Council of California SUM-300 [Rev. January 1, 2007] 1. 2. 3. 4. 5. 6. 7. Personal service. By personally delivering copies to pers on served. (Code Civ. Pr oc., § 415.1 0.) Page 1 0f 2 PLAINTIFF/PETITIONER: CASE NUMBER: DEFENDANT/RESPONDENT: Certified or registered mail service. By mailing to an address outside Californi a (by registered or certified mail with return receipt requested) copies to the person served. (Co de Civ. Proc., § 415.40.) Attached is a signed return receipt or other evidence of actual deliv ery to the person served. Place of mailing ( specify): e. f. Other. Specify other manner of service and authorizing code sections: Continued on Attachment 7f. The following notice appeared on the copy of the Summons served (Code Civ. Proc., § 412.30, 415.10, or 474): a. You are served as an individual defendant. You are served as (or on behalf of) the pe rson sued under the fictitious name of (specify): You are served on behalf of (specify): b. c. under: (5) Code Civ. Proc., § 416.10 (corporation) Code Civ. Proc., § 416.20 (defunct corporation) Code Civ. Proc., § 416.40 (a ssociation/partnership) By personal delivery on ( date): Code Civ. Proc., § 416.60 (minor) Code Civ. Proc., § 416.70 (conservatee) Code Civ. Proc., § 416.90 (individual) (2) (6) (7) (3) (4) This declaration is returned in lieu of the original Summons. Declarant's current address and telephone number are as follows: b. Telephone number: I declare under penalty of perjury under t he laws of the State of California that the foregoing is true and correct. Date: (TYPE OR PRINT NAME) (SIGNATURE OF DECLARANT) DECLARATION OF LOST SUMMONS AFTER SERVICE SUM-300 [Rev. January 1, 2007] (1) 8. 9. a. Address: 10. SUM-300 Page 2 of 2