Marin — CR047 / TR047

Source: https://www.marin.courts.ca.gov/system/files/cr047ntr047-proofofservice.pdf

ATTORNEY OR PARTY WITHOUT ATTORNEY: STATE BAR NO.: FOR COURT USE ONLY NAME: STREET ADDRESS: CITY: STATE: ZIP CODE: TELEPHONE NO: EMAIL ADDRESS: ATTORNEY FOR (NAME): MARIN COUNTY SUPERIOR COURT 3501 Civic Center Drive P.O. Box 4988 San Rafael, CA 94913-4988 vs.

DEFENDANT: CASE NUMBER:

PROOF OF PERSONAL SERVICE HEARING DATE:
HEARING TIME:
COURTROOM:

1. I am at least 18 years old, not a party to this action, and not a protected person listed in any of the orders.

2. Name of person served:

3. I served copies of the following documents (specify):

4. I personally delivered copies to the person served a. On (date): ______________________________________ b. At (time): AM PM c. At (address):

5. I am a. not a registered California process server. b. a registered California process server. c. an employee or independent contractor of a registered California process server. d. exempt from registration under Business & Professions Code section 22350(b). e. a California law enforcement officer.

6. My name, address, and telephone number and, if applicable, county of registration and number:

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

8. I am a California law enforcement officer, and I certify that the foregoing is true and correct.

---

DATE

PRINT NAME OF PERSON WHO SERVED PAPERS SIGNATURE OF PERSON WHO SERVED PAPERS

Distribution: Original - Court File

CR047 / TR047 PROOF OF PERSONAL SERVICE Rev. 10/3/17