Solano — Proof of Service-Sex Offender Registration Termination

Source: https://solano.courts.ca.gov/system/files/cr416.pdf

CR-416 Proof of Service—Sex Offender Clerk stamps date here when form is filed. Registration Termination (Pen. Code, § 290.5) Instructions • This form is for providing proof that a copy of a filed Petition to Terminate Sex Offender Registration (form CR-415) and proof of current registration was served (delivered) to the required law enforcement agencies and district attorney’s offices. Read Information on Filing a Petition to Terminate Sex Offender Registration (form CR-415-INFO) for more information. • The person who serves (delivers) a document or form in this case and Fill in court name and street address: who fills out this form must be at least 18 years old. Superior Court of California, County of • This form is for proof of service by mail or personal delivery. For proof of electronic service, read and follow rule 2.251 of the California Rules of Court, and use Proof of Electronic Service (form POS-050/EFS-050). • File a completed form with the court. Keep a copy of this form for your records. 1 At the time I served the Petition to Terminate Sex Offender Registration Fill in case number: (form CR-415) and proof of current registration, I was at least 18 years Case Number: old. 2 My name is: My mailing address is:

Street City State Zip

3 I served copies of the Petition to Terminate Sex Offender Registration and proof of current registration filed (check one): for myself on behalf of (name of petitioner): 4 I mailed or personally delivered a filed-stamped copy of Petition to Terminate Sex Offender Registration (form CR-415) and proof of current registration to the agencies listed below: a. Registering law enforcement agency Name of agency: Address: Street City State Zip Date of service: Method of service (check one): Mailed the documents to the agency at the address above in a sealed envelope from (city, state): by depositing the envelope with the U.S. Postal Service Delivered in person to (name): at (time): at the address above. b. District attorney (county of registration): County of: Address: Street City State Zip Date of service: Method of service (check one): Mailed the documents to the district attorney’s office at the address above in a sealed envelope from (city, state): by depositing the envelope with the U.S. Postal Service or Delivered in person to (name): at (time): at the address above.

Judicial Council of California, www.courts.ca.gov Proof of Service—Sex Offender CR-416, Page 1 of 2 New July 1, 2021, Optional Form Pen. Code, § 290.5 Registration Termination (Pen. Code, § 290.5)

Case Number:

c. Law enforcement agency (county of conviction, if different than county of registration)
Name of agency:
Address:
Street City State Zip
Date of service:
Method of service (check one):
Mailed the documents to the agency at the address above in a sealed envelope from
(city, state): by depositing the envelope with the U.S. Postal Service
Delivered in person to (name): at (time):
at the address above.

d. District attorney (county of conviction, if different than county of registration)
County of:
Address:
Street City State Zip
Date of service:
Method of service (check one):
Mailed the documents to the district attorney's office at the address above in a sealed envelope from
(city, state): by depositing the envelope with the U.S. Postal Service
Delivered in person to (name): at (time):
at the address above.

Check here if you served copies of the petition and proof of current registration to additional law
enforcement agencies and district attorney's offices. Attach a separate page listing the names,
addresses, date of service, and method of service of each additional copy you served. Write
“CR-416, Item 4” on the top of the page.

5 I declare under penalty of perjury under California state law that the information above is true and correct.

Date:

Type or print server’s name Server signs here after serving

New July 1, 2021 Proof of Service—Sex Offender CR-416, Page 2 of 2 Registration Termination (Pen. Code, § 290.5)

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