Orange — Alternative Writ of Mandate -DUI

Source: https://www.occourts.org/system/files/selfhelp/shc-app-07.pdf

SUPERIOR COURT OF CALIFORNIA Self-Help Services COUNTY OF ORANGE www.occourts.org/self-help

ALTERNATIVE WRIT OF MANDATE - DUI

SELF-HELP FORM PACKET

SHC-APP-07 (Rev. 7/01/2026)

www.occourts.org/self-help

CM-010 ATTORNEY OR PARTY WITHOUT ATTORNEY STATE BAR NUMBER: FOR COURT USE ONLY NAME:

FIRM NAME:

STREET ADDRESS:

CITY: STATE: ZIP CODE:

TELEPHONE NO.: FAX NO.:

EMAIL ADDRESS:

ATTORNEY FOR (name):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

CASE NAME:

CIVIL CASE COVER SHEET Complex Case Designation CASE NUMBER:
Unlimited Limited Counter Joinder
(Amount (Amount

demanded demanded is Filed with first appearance by defendant JUDGE: exceeds $35,000) $35,000 or less) (Cal. Rules of Court, rule 3.402) DEPT.:

Items 1–6 below must be completed (see instructions on page 2 and examples on page 3).

1. Check one box below for the case type that best describes this case:

Auto Tort Contract Provisionally Complex Civil Litigation Auto (22) Breach of contract/warranty (06) (Cal. Rules of Court, rules 3.400–3.404) Uninsured motorist (46) Song-Beverly Act: Motor Vehicle Antitrust/Trade regulation (03) Lemon Law (49) Asbestos Construction defect (10) Rule 3.740 collections (09) Asbestos (04) Mass tort (40) Other collections (09) Securities litigation (28) Other PI/PD/WD (Personal Injury/Property Insurance coverage (18) Environmental/Toxic tort (30) Damage/Wrongful Death) Tort Other contract (37) Comprehensive groundwater adjudication (47) Product liability (24) Real Property Insurance coverage claims arising from the Medical malpractice (45) Eminent domain/Inverse above listed provisionally complex case types Other PI/PD/WD (23) condemnation (14) (41) Wrongful eviction (33) Non-PI/PD/WD (Other) Tort Enforcement of Judgment Other real property (26) Business tort/Unfair business practice (07) Enforcement of judgment (20) Unlawful Detainer Civil rights (08) Commercial (31) Miscellaneous Civil Complaint Defamation (13) Residential (32) RICO (27) Fraud (16) Drugs (38) Other complaint (not specified above) (42) Intellectual property (19) Judicial Review Miscellaneous Civil Petition Professional negligence (25) Asset forfeiture (05) Other non-PI/PD/WD tort (35) Partnership and corporate governance (21) Petition re arbitration award (11) Employment Other petition (not specified above) (43) Writ of mandate (02) Wrongful termination (36) Other judicial review (39) Other employment (15) Employment Development Department (EDD)

EDD decision review (48)

Judicial Council of California, courts.ca.gov Rev. July 1, 2026, Mandatory Form Civil Case Cover Sheet CM-010, Page 1 of 3 Cal. Rules of Court, rules 2.30, 3.220, 3.400–3.403, 3.740 Cal. Stds. Jud. Admin., std. 3.10

CM-010 2. Is this case complex under rule 3.400 of the California Rules of Court? Yes No If the case is complex, mark the factors requiring exceptional judicial management:

a. Large number of separately represented parties
b. Extensive motion practice raising difficult or novel issues that will be time-consuming to resolve
c. Substantial amount of documentary evidence
d. Large number of witnesses
e. Coordination with related actions pending in one or more courts in other counties, states, or countries, or in a federal court
f. Substantial postjudgment judicial supervision

3. Remedies sought (check all that apply): a. monetary

   b. nonmonetary; declaratory or injunctive relief

   c. punitive

4. Number of causes of action (specify):

5. Is this case a class action suit? Yes No

6. If there are any known related cases, file and serve a notice of related case. (You may use form CM-015.)

Date:

Type or print name Signature of party or attorney for party

NOTICE

Plaintiff must file this cover sheet with the first paper filed in the action or proceeding (except small claims cases or cases filed under the Probate

Code, Family Code, or Welfare and Institutions Code). (Cal. Rules of Court, rule 3.220.) Failure to file may result in sanctions.

File this cover sheet in addition to any cover sheet required by local court rule.

If this case is complex under rule 3.400 et seq. of the California Rules of Court, or a collections case under rule 3.740, you must serve a copy of this cover sheet on all other parties to the action or proceeding. (Cal. Rules of Court, rule 3.220.)

Unless this is a collections case under rule 3.740 or a complex case, this cover sheet will be used for statistical purposes only.

INSTRUCTIONS ON HOW TO COMPLETE THE COVER SHEET

To Plaintiffs and Others Filing First Papers. If you are filing a first paper (for example, a complaint) in a civil case, you must complete and file, along with your first paper, the Civil Case Cover Sheet contained on pages 1 and 2. This information will be used to compile statistics about the types and numbers of cases filed. You must complete items 1 through 6 on the sheet. In item 1, you must check one box for the case type that best describes the case. If the case fits both a general and a more specific type of case listed in item 1, check the more specific one. If the case has multiple causes of action, check the box that best indicates the primary cause of action. To assist you in completing the sheet, examples of the cases that belong under each case type in item 1 are provided on page 3 of this form. A cover sheet must be filed only with your initial paper. Failure to file a cover sheet with the first paper filed in a civil case may subject a party, its counsel, or both to sanctions under rules 2.30 and 3.220 of the California Rules of Court. To Parties in Rule 3.740 Collections Cases. A "collections case" under rule 3.740 of the California Rules of Court is defined as an action for recovery of money owed in a sum stated to be certain that is not more than $35,000, exclusive of interest and attorney's fees, arising from a transaction in which property, services, or money was acquired on credit. A collections case does not include an action seeking the following: (1) tort damages, (2) punitive damages, (3) recovery of real property, (4) recovery of personal property, or (5) a prejudgment writ of attachment. The identification of a case as a rule 3.740 collections case on this form means that it will be exempt from the general time-for-service requirements and case management rules, unless a defendant files a responsive pleading. A rule 3.740 collections case will be subject to the requirements for service and obtaining a judgment in rule 3.740. To Parties in Complex Cases. In complex cases only, parties must also use the Civil Case Cover Sheet to designate whether the case is complex. If a plaintiff believes the case is complex under rule 3.400 of the California Rules of Court, this must be indicated by completing the appropriate boxes in items 1 and 2. If a plaintiff designates a case as complex, the cover sheet must be served with the complaint on all parties to the action. A defendant may file and serve no later than the time of its first appearance a joinder in the plaintiff's designation, a counter-designation that the case is not complex, or, if the plaintiff has made no designation, a designation that the case is complex. SEE PAGE 3 FOR INFORMATION PURPOSES ONLY.

Rev. July 1, 2026 Civil Case Cover Sheet CM-010, Page 2 of 3

CM-010

CASE TYPES AND EXAMPLES

The list below provides explanations and examples for the case type checkboxes listed in item 1 on this form. The lists of examples below are not meant to be exhaustive, and some case types may have causes of action not listed here.

Auto Tort Contract Provisionally Complex Civil Litigation (Cal. Auto (22)–Personal Injury/Property Damage/ Breach of Contract/Warranty (06) Rules of Court, rules 3.400–3.404) Wrongful Death Breach of Rental/Lease Contract (not Antitrust/Trade Regulation (03) Uninsured Motorist (if the case involves an unlawful detainer or wrongful eviction) Construction Defect (10) uninsured motorist claim subject to Contract/Warranty Breach–Seller Plaintiff Mass Tort (40) arbitration, check this item instead of Auto) (not fraud) Securities Litigation (28) (46) Negligent Breach of Contract/Warranty Environmental/Toxic Tort (30) Other Breach of Contract/Warranty Comprehensive Groundwater Adjudication Asbestos Song-Beverly Act: Motor Vehicle Lemon Law (47) Asbestos (04) (check this item if the case involves a Song- Insurance Coverage Claims (arising from Asbestos Property Damage Beverly Act claim regarding a motor provisionally complex case type listed Asbestos Personal Injury/Wrongful Death vehicle) (49) above) (41) Other PI/PD/WD (Personal Injury/ Rule 3.740 Collections (as defined in Cal. Enforcement of Judgment Property Damage/Wrongful Death) Tort Rules of Court, rule 3.740(a)) (09) Enforcement of Judgment (20) Product Liability (not asbestos or Other Collections (e.g., money owed, open Abstract of Judgment (Out of County) environmental/toxic tort) (24) book accounts, promissory note) (09) Confession of Judgment (non-domestic Medical Malpractice (45) Insurance Coverage (not provisionally relations) Medical Malpractice–Physicians & complex) (18) Sister-State Judgment Surgeons Auto Subrogation Administrative Agency Award Other Professional Health Care Other Coverage Petition/Certification of Entry of Judgment Malpractice Other Contract (37) on Unpaid Taxes Other PI/PD/WD (23) Contractual Fraud Other Enforcement of Judgment Case Premises Liability (e.g., slip and fall) Other Contract Dispute Intentional Bodily Injury/PD/WD (e.g., Miscellaneous Civil Complaint Real Property assault, vandalism) RICO (27) Eminent Domain/Inverse Condemnation (14) Intentional Infliction of Emotional Distress Other Complaint (not specified above) (42) Wrongful Eviction (33) Negligent Infliction of Emotional Distress Declaratory Relief Only Other Real Property (e.g., quiet title) (26) Other PI/PD/WD Injunctive Relief Only (non-harassment) Writ of Possession of Real Property Mechanic's Lien Non-PI/PD/WD (Other) Tort Mortgage Foreclosure Other Commercial Complaint Case Business Tort/Unfair Business Practice (07) Quiet Title (non-tort/non-complex) Civil Rights (e.g., discrimination, false arrest) Other Real Property (not unlawful Other Civil Complaint (non-tort/ (not civil harassment) (08) detainer) non-complex) Defamation (e.g., slander, libel) (13) Unlawful Detainer Fraud (other than contract) (16) Mis

Complaint (non-tort/ (not civil harassment) (08) detainer) non-complex) Defamation (e.g., slander, libel) (13) Unlawful Detainer Fraud (other than contract) (16) Miscellaneous Civil Petition Commercial (31) Intellectual Property (19) Partnership and Corporate Governance (21) Residential (32) Professional Negligence (25) Other Petition (not specified above) (43) Drugs (if the case involves illegal drugs, check Legal Malpractice Civil Harassment this item; otherwise, choose Commercial or Other Professional Malpractice Workplace Violence Residential) (38) (not medical) Elder/Dependent Adult Abuse Other Non-PI/PD/WD Tort (35) Judicial Review Election Contest Asset Forfeiture (05) Petition for Name Change Employment Petition re Arbitration Award (11) Petition for Relief From Government Wrongful Termination (36) Writ of Mandate (02) Claim Requirement Other Employment (15) Writ–Administrative Mandamus Other Civil Petition Writ–Mandamus on Limited Court Case Matter Writ–Other Limited Court Case Review Other Judicial Review (39) Review of Health Officer Order Notice of Appeal–Labor Commissioner Appeals

Employment Development Department (EDD)

EDD Decision Review (if the case involves an Employment Development Department decision, check this item instead of wrongful termination or other employment) (48)

Rev. July 1, 2026 Civil Case Cover Sheet CM-010, Page 3 of 3

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name & Address): FOR COURT USE ONLY

Telephone No.: Fax No. (Optional): E-Mail Address (Optional): ATTORNEY FOR (Name): Bar No:

SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE CENTRAL JUSTICE CENTER: 700 Civic Center Dr. West, Santa Ana, CA 92701

PETITIONER:

RESPONDENT: Director of the Department of Motor Vehicles

PETITION FOR ALTERNATIVE WRIT OF MANDATE CASE NUMBER:
CCP § 1094.5 AND VEHICLE CODE § 13559 TO SET
ASIDE SUSPENSION OF DRIVING PRIVILEGE - DUI
STAY REQUESTED
Unlimited Civil

Mark all boxes that apply

1. Petitioner (full name), ,
   is a resident of the County of Orange, State of California at the time this Petition is filed.

2. Respondent, Director of the Department of Motor Vehicles, is the Chief Executive Officer of the Department of Motor Vehicles, a government agency of the State of California, hereafter referred to as “the DMV”.

3. On (date) , per Vehicle Code 13382(a) and/or 23612(e), the arresting officer served the petitioner with an Administrative Per Se Order of Suspension/Revocation Temporary License Endorsement, a copy of which is attached to this petition.

4. Prior to the suspension of petitioner’s driver’s license, petitioner was the holder of a valid California driver’s
   license number issued by the DMV.

5. On (date) , in the County of Orange, State of California, petitioner was detained by a Peace Officer of the

   California Highway Patrol.
   Police Department.
   County Sheriff’s Department.
   Other (describe) .

   and, after arrest for violation of Vehicle Code § 23152 or 23153, was administered a chemical test for blood alcohol concentration. not administered a chemical test for blood alcohol concentration.

Approved for Optional Use PETITION FOR ALTERNATIVE WRIT OF MANDATE CCP 1094.5(g) L-0115 (Rev. July 1, 2008) CCP § 1094.5 AND VEHICLE CODE § 13559 TO SET ASIDE SUSPENSION OF DRIVING PRIVILEGE – DUI

PETITIONER: CASE NUMBER:

RESPONDENT: Director of the Department of Motor Vehicles

6. Per Vehicle Code § 13380, the Officer then filed a sworn statement (Form DS-367) with the DMV stating
   that there was reasonable cause to believe petitioner had been driving a motor vehicle in violation of
   Vehicle Code § 23152 or 23153, the petitioner was arrested and petitioner

   took a chemical test with a result of % and % blood alcohol concentration.
   did not take or complete a chemical test.

7. A copy of the Officer’s DS-367 Statement – Vehicle Code §§ 23152 and 13352 is attached to this petition.

8. On (date) , petitioner requested an administrative hearing. The hearing was granted and held on (date) .

9. A certified copy of the transcript of the administrative hearing has been ordered from the DMV and

   has been lodged with the Court. will be lodged with the Court as soon as it is received by petitioner.

10. On (date) , the DMV issued an Order of Suspension which stated that petitioner’s privilege to drive a motor vehicle was suspended for year(s), from (date) through (date) . The suspension was under the authority of Vehicle Code § 13353.3. A copy of the Order of Suspension is attached to this petition.

11. This petition is further based on the following evidence and matters from the record of the administrative hearing [attach additional pages if necessary].

12. Petitioner is beneficially interested in this action because petitioner is a party directly affected by the action of Respondent in suspending his or her privilege to operate a motor vehicle.

Approved for Optional Use PETITION FOR ALTERNATIVE WRIT OF MANDATE CCP 1094.5(g) L-0115 (Rev. July 1, 2008) CCP § 1094.5 AND VEHICLE CODE § 13559 TO SET ASIDE SUSPENSION OF DRIVING PRIVILEGE – DUI

PETITIONER: CASE NUMBER:

RESPONDENT: Director of the Department of Motor Vehicles

13. Petitioner needs his or her license

    to drive to and from and in connection with his or her employment, as well as personal needs. to engage in business for his or her livelihood.

    Unless the Order of the DMV is stayed, he or she will suffer irreparable damage and injury.

14. As required by California Rule of Court, rule 3.1142, a copy of petitioner’s driving record from the DMV is attached to this petition.

15. Petitioner does not have a speedy and adequate remedy at law because there is no appeal from respondent’s order suspending the privilege to operate a motor vehicle. Petitioner’s only method of review of that order is by writ of mandate in this Court.

16. Petitioner’s privilege to operate a motor vehicle is not suspended or revoked for any reason other than

    those stated in this petition.

Petitioner prays that:

1. An alternative writ of mandate issue under the seal of the Court commanding respondent Director of the

DMV to set aside and revoke the DMV’s suspension of petitioner’s driving privilege or to show cause before the Court at a time and place to be specified by the Court why it has not done so, and why a peremptory writ should not issue.

2. Pending the hearing and final judgment of the Court in this matter, the DMV be ordered to stay the operation of the order suspending Petitioner’s driving privilege.

3. Other (Describe):

4. For such and further relief as the Court may deem proper.

Dated:

(Type or Print Name) (Signature of Petitioner)

VERIFICATION

STATE OF CALIFORNIA) COUNTY OF ORANGE) ss.

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

Executed on (date) at , California.

(Signature of Petitioner)

Approved for Optional Use PETITION FOR ALTERNATIVE WRIT OF MANDATE CCP 1094.5(g) L-0115 (Rev. July 1, 2008) CCP § 1094.5 AND VEHICLE CODE § 13559 TO SET ASIDE SUSPENSION OF DRIVING PRIVILEGE – DUI

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name & Address): FOR COURT USE ONLY

Telephone No.: Fax No. (Optional): E-Mail Address (Optional): ATTORNEY FOR (Name): Bar No:

SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE CENTRAL JUSTICE CENTER: 700 Civic Center Dr. West, Santa Ana, CA 92701

PETITIONER:

RESPONDENT: Director of the Department of Motor Vehicles

ALTERNATIVE WRIT OF MANDATE ORDER CASE NUMBER:
AND ORDER TO SHOW CAUSE - DUI
Unlimited Civil

To the Director of the Department of Motor Vehicles and the Department of Motor Vehicles, hereafter referred to as “the DMV”:

You are ordered to set aside and revoke the DMV’s suspension of the petitioner’s driving privilege commencing (date) through (date) or, in the alternative, to show cause why you have not done so and appear for hearing on a Writ of Mandate on (date) at (time) or as soon thereafter as the matter may be heard in Department of the above entitled Court.

Petitioner is ordered to serve on respondent written notice of the time and place of the hearing with a copy of the petition, the papers on which the petition is based and this Order at least 16 court days prior to the date of the hearing if service is personal, and an additional 5 calendar days if service is by mail.

Dated: Judge/Commissioner

ALTERNATIVE WRIT OF MANDATE ORDER

L89 (New January 1, 2006) AND ORDER TO SHOW CAUSE - DUI CCP 1094.5(g)

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name & Address): FOR COURT USE ONLY

Telephone No.: Fax No. (Optional): E-Mail Address (Optional): ATTORNEY FOR (Name): Bar No:

SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE CENTRAL JUSTICE CENTER: 700 Civic Center Dr. West, Santa Ana, CA 92701

PETITIONER:

RESPONDENT: Director of the Department of Motor Vehicles

ORDER STAYING SUSPENSION - DUI CASE NUMBER:
Unlimited Civil

The suspension of petitioner’s license is stayed until the ruling on the petition for Writ of Mandate.

The following conditions apply to this Order:

Petitioner is not to consume any alcoholic beverages within 12 hours prior to driving.

Petitioner is only to drive to and from school or work.

Other:

Dated: Judge/Commissioner

Approved for Optional Use ORDER STAYING SUSPENSION – DUI CCP 1094.5(g) L-0274 (Rev. July 1, 2008)

POS-040 ATTORNEY OR PARTY WITHOUT ATTORNEY: STATE BAR NO: FOR COURT USE ONLY NAME:

FIRM NAME:

STREET ADDRESS:

CITY: STATE: ZIP CODE:

TELEPHONE NO.: FAX NO. :

E-MAIL ADDRESS:

ATTORNEY FOR (name):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME: CASE NUMBER: Plaintiff/Petitioner:

Defendant/Respondent: JUDICIAL OFFICER: PROOF OF SERVICE—CIVIL Check method of service (only one): By Personal Service By Mail By Overnight Delivery DEPARTMENT: By Messenger Service By Fax

Do not use this form to show service of a summons and complaint or for electronic service. See USE OF THIS FORM on page 3.

1. At the time of service I was over 18 years of age and not a party to this action.

2. My residence or business address is:

3. The fax number from which I served the documents is (complete if service was by fax):

4. On (date): I served the following documents (specify):

5. I served the documents on the person or persons below, as follows: a. Name of person served:

   b. (Complete if service was by personal service, mail, overnight delivery, or messenger service.)

   Business or residential address where person was served:

   c. (Complete if service was by fax.)

   Fax number where person was served:

   The names, addresses, and other applicable information about persons served is on the Attachment to Proof of Service— Civil (Persons Served) (form POS-040(P)).

6. 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 5. (1) For a party represented by an attorney, delivery was made (a) to the attorney personally; or (b) by leaving the documents at the attorney's office, in an envelope or package clearly labeled to identify the attorney being served, with a receptionist or an individual in charge of the office; or (c) if there was no person in the office with whom the notice or papers could be left, by leaving them in a conspicuous place in the office between the hours of nine in the morning and five in the evening. (2) For a party, delivery was made to the party or by leaving the documents at the party's residence with some person not younger than 18 years of age between the hours of eight in the morning and eight in the evening.

Form Approved for Optional Use PROOF OF SERVICE—CIVIL Code of Civil Procedure, §§ 1011, 1013, 1013a,Judicial Council of California 2015.5; Cal. Rules of Court, rule 2.306 POS-040 [Rev. January 1, 2020] (Proof of Service) www.courts.ca.gov

POS-040 CASE NAME: CASE NUMBER:

6. b. By United States mail. I enclosed the documents in a sealed envelope or package addressed to the persons at the addresses in item 5 and (specify one): (1) (2) 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 5. I 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 5 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 5. 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.

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

Date:

(TYPE OR PRINT NAME OF DECLARANT) (SIGNATURE OF DECLARANT)

(If item 6d 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 5. (1) For a party represented by an attorney, delivery was made (a) to the attorney personally; or (b) by leaving the documents at the attorney's office, in an envelope or package clearly labeled to identify the attorney being served, with a receptionist or an individual in charge of the office; or (c) if there was no person in the office with whom the notice or papers could be left, by leaving them in a conspicuous place in the office between the hours of nine in the morning and five in the evening. (2) For a party, delivery was made to the party or by leaving the documents at the party's residence with some person not younger than 18 years of age between the hours of eight in the morning and eight 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.

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:

(NAME OF DECLARANT) (SIGNATURE OF DECLARANT)

POS-040 [Rev. January 1, 2020] PROOF OF SERVICE—CIVIL Page 2 of 3 (Proof of Service)

POS-040 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

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, or (5) fax.

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).

Also, this proof of service form should not be used to show proof of electronic service. For that purpose, use Proof of Electronic Service (form POS-050).

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 form is available at www.courts.ca.gov/forms.htm. 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 for whom you served the documents. 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 plaintiff/petitioner and defendant/respondent 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 1–6:

1. You are stating that you are over the age of 18.
2. Print your home or business address.
3. If service was by fax service, print the fax number from which service was made.
4. List each document that you served. If you need more space, check the box in item 4, complete the Attachment to Proof of Service—Civil (Documents Served) (form POS-040(D)), and attach it to form POS-040.
5. Provide the names, addresses, and other applicable information about the persons served. If more than one person was served, check the box on item 5, complete the Attachment to Proof of Service—Civil (Persons Served) (form POS-040(P)), and attach it to form POS-040.
6. 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 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 form POS-040 is true and correct.

POS-040 [Rev.January 1, 2020] PROOF OF SERVICE—CIVIL Page 3 of 3 (Proof of Service)