Amador — WV-260

Source: https://amador.courts.ca.gov/system/files/forms-and-filings/wv260.pdf

Clerk stamps date here when form is filed. Proof of Service of Order WV-260 After Hearing by Mail

You may serve Form WV-130, Workplace Violence Restraining Order After Hearing, on the respondent by mail if the respondent was not at the hearing and: • Before the hearing, the respondent was personally served with Form WV-110, Temporary Restraining Order, and proof of service of Form WV-110 was presented to the court at the hearing; and • The judge’s orders in Form WV-130 are the same as in Form WV-110 except for the expiration date. Fill in court name and street address: Superior Court of California, County of 1 Petitioner (Employer) Name: 2 Employee (Protected Person) Name: Fill in case number: 3 Respondent (Restrained Person) Case Number: Name: PROOF OF SERVICE BY MAIL 4 I am 18 years of age or older and live or am employed in the county where the mailing took place. I am not the petitioner, the employee, or any person listed in item 4 of Form WV-130. I mailed the respondent a copy of: a. Form WV-130, Workplace Violence Restraining Order After Hearing b. Other (specify):

5 I placed copies of the documents above in a sealed envelope and mailed them as described below: a. Mailed to (name): b. To this address: City: State: Zip: c. On (date): Mailed from: City: State: 6 Server’s Information Name: Telephone: Address: City: State: Zip: (If you are a registered process server): County of registration: Registration number: I declare under penalty of perjury under the laws of the State of California that the information above is true and correct. Date:

Type or print server ’s name Server to sign here

www.courts.ca.govJudicial Council of California,

Rev. January 1, 2012, Optional Form Proof of Service of Order After Hearing by Mail WV-260, Page 1 of 1 Code of Civil Procedure, § 527.8 (Workplace Violence Prevention) For your protection and privacy, please press the Clear This Form button after you have printed the form. Print this form Save this form Clear this form