Merced — MSC-PR-005

Source: https://www.merced.courts.ca.gov/system/files/forms-and-filings/msc-pr-005-proof-service-personal-service-ada-comp.pdf

MSC-PR-005 PARTY WITHOUT AN ATTORNEY (Name and Address): TELEPHONE NO: FOR COURT USE ONLY

In Pro Per

SUPERIOR COURT OF CALIFORNIA, COUNTY OF MERCED STREET ADDRESS: 627 W. 21st STREET MAILING ADDRESS: 627 W. 21st STREET CITY AND ZIP CODE: MERCED, CA 95340 BRANCH NAME: PROBATE GUARDIANSHIP OF THE PERSON ESTATE OF (NAME):

MINOR CASE NUMBER

PROOF OF SERVICE FOR PERSONAL SERVICE OR BY NOTICE AND ACKNOWLEDMENT OF RECEIPT

I declare that: 1. At the time of service I was at least 18 years of age and not a party to this legal action. 2. I am a resident of or employed in the county where the mailing occurred, if served by mail. 3. My business or residence address is: __________________________________________________________

__________________________________________________________________________________________
4. I served copies of the following paper(s) in the manner shown below:
Petition for Appointment of Guardian of Minor Petition for Appointment of Temporary Guardian
Notice of Hearing for ______________________ UCCJEA
Notice of Hearing for ______________________ Waiver of Notice
Consent of Guardian Nomination of Guardian
Petition for Visitation – Guardianship Petition for Modification of Visitation - Guardianship
Petition for Termination of Guardianship Other:

5. Manner of service:
a. Personal Service. I personally delivered the above papers to:

(1) Name of person served: ___________________________________________________

(2) Address where served: ____________________________________________________

(3) Date served: ____________________________________________________________

(4) Time served: ____________________________________________________________

b. Mailed Service. I placed a sealed envelope containing the papers listed above, along with two copies of a
Notice and Acknowledgement of Receipt and a self-addressed, stamped envelope, deposited with the
United States Postal Service with postage fully prepaid to:

(1) Name of person served: ___________________________________________________

(2) Address to which documents where mailed: ____________________________________

(3) Date documents were mailed: ______________________________________________

(4) City and State where mailing occurred: ________________________________________

I declare under the penalty of perjury under the laws of the State of California that the foregoing is true and correct.

SIGN

DATE: __________ _________________________________ ______________________________________ (Type or Print Name) (Signature of Person who Served Papers)

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For Optional Use PROOF OF SERVICE FOR PERSONAL SERVICE Page 1 of 1 MSC-PR-005 [Rev. Mar 6, 2019] OR BY NOTICE AND ACKNOWLEDGMENT OF RECEIPT