Fillable Printable Proof of Service Form - California

Proof of Service Form - California

PROOF OF SERVICE

I declare that I am a resident of or employed in the County of ,

State of _________________. I am over the age of 18 years. The name and address of my

residence or business is

On , I served the

(Date) (Description of document(s))

(Description of document(s) continued)

on the parties listed below (include name, address and, where applicable, fax number) b y (check

the applicable method or methods):

___ placing a true copy thereof enclosed in a sealed envelope for collection and delivery

by the United States Postal Service or private delivery service following ordinary business

practices with postage or other costs prepaid;

___ personal delivery;

___ facsimile transmission in accordance with the requirements of PERB Regulations

32090 and 32135(d).

(Include here the name, address and, where applicable, fax number of the Respondent and any other parties served.)

I declare under penalty of perjury that the foregoing is true and correct and that this

declaration was executed on , at .

(Date) (City) (State)

(Type or print name) (Signature)