Madera — Proof of Service: Petition and Petition for Relief per PC1210(e)(1) (MAD-CRM-024)

Source: https://www.madera.courts.ca.gov/system/files/forms-and-filings/mad-crm-024-proof-service-notice-petition-and-petition-relief-under-penal-code-1210e1-rev-07-01-2020.pdf

MAD-CRM-024 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY

TELEPHONE NO.: FAX NO.: E-MAIL ADDRESS: ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF MADERA 200 South G Street Madera, CA 93637 Criminal Division PEOPLE OF THE STATE OF CALIFORNIA

VS.

DEFENDANT: PROOF OF SERVICE PERSONAL SERVICE SERVICE BY MAIL CASE NUMBER:

This is a proof of service of a Notice of Petition and Petition for Relief under Penal Code 1210(e)(1)

DIRECTIONS: A copy of the Petition must be served upon the District Attorney who prosecuted your case AND the Probation Department. After the Petition has been served, the original and a copy of this form (Proof of Service) must be filed with the court.

1. Person serving. I am over the age of 18 and not a party to this action.

Name: Address

Telephone:

2. I served a copy of the Notice of Petition and Petition for Relief under Penal Code 1210(e)(1) as follows:

   (check either a or b below): a. Personal Service: to the person or agency at the address listed below: (1) Name of person or agency served: (2) Address where served: (3) Date served: (4) Time served: b. Service by mail: in the United States mail, in a sealed envelope with postage fully prepaid. The envelope was addressed as follows: (1) Name of person or agency served: (2) Address: (3) Date of mailing: (4) Place of mailing (city and state): I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Date:

SIGN

(Type or print name) (Signature)

Form Adopted for Optional Use PROOF OF SERVICE – NOTICE OF PETITION AND PETITION Page 1 of 1 Madera Superior Court Local Form FOR RELIEF UNDER PENAL CODE 1210(e)(1) MAD-CRM-024 [Rev. 07/01/2020]