The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02

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Here is the text we could read:

EA-200

Proof of Personal Service

Clerk stamps date here when form is filed.

Elder or Dependent Adult
Name:

Person From Whom Protection Is Sought or Person
Alleged to Be Preventing Contact
Name:

3 Notice to Server
The server must:
•
•

Be 18 years of age or older.
Not be listed in items , , or
of form EA-100 or be listed in
items , , , or
4 on form EA-300.
3
2
Give a copy of all documents checked in to the person in .
2
4
(You cannot send them by mail.) Then complete and sign this
form and give or mail it to the person in .

•

Fill in court name and street address:

Superior Court of California, County of

Court fills in case number when form is filed.

Case Number:

PROOF OF PERSONAL SERVICE

I gave the person in a copy of the forms checked below:
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.

EA-109, Notice of Court Hearing
EA-110, Temporary Restraining Order
EA-100, Request for Elder or Dependent Adult Abuse Restraining Orders
EA-120, Response to Request for Elder or Dependent Adult Abuse Restraining Orders (blank form)
EA-120-INFO, How Can I Respond to a Request for Elder or Dependent Adult Abuse Restraining Orders?
EA-130, Elder or Dependent Adult Abuse Restraining Order After Hearing
EA-250, Proof of Service of Response by Mail (blank form)
EA-800, Receipt for Firearms, Firearm Parts, and Ammunition (blank form)
EA-300, Request for Elder or Dependent Adult Restraining Order Allowing Contact
EA-309, Notice of Court Hearing to Allow Contact
EA-320, Response to Request for Elder or Dependent Adult Restraining Order Allowing Contact (blank
form)
EA-320-INFO, How Can I Respond to a Request for an Elder or Dependent Adult Restraining Order
Allowing Contact?
EA-330, Elder or Dependent Adult Restraining Order Allowing Contact After Hearing
Other (specify):

m.
n.

I personally gave copies of the documents checked above to the person in :

b. At (time):

a.m.

p.m.

a. On (date):

At this address:

City:

State:

Zip:

Judicial Council of California, www.courts.ca.gov
Rev. January 1, 2023, Optional Form
Welfare and Institutions Code, § 15657.03

Proof of Personal Service
(Elder or Dependent Adult Abuse Prevention)

EA-200, Page 1 of 2

Case Number:

State:

Zip:

Server’s Information
Name:

Address:

City:

Telephone:

Date:

(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.

Type or print server’s name

Server to sign here

Rev. January 1, 2023

Proof of Personal Service
(Elder or Dependent Adult Abuse Prevention)

EA-200, Page 2 of 2

Proof of Personal Service

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the California state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from selfhelp.courts.ca.gov (2023-03)
Page(s): 2
Fields(s): 36
Average fields per page: 18
Reading Level: Grade 6
LIST Grouping(s): Unknown

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

e_page_p_court_box_info was EA-200[0].Page1[0].P1Caption[0].CourtBox[0].CourtInfo_ft[0] (0.53 conf)
e_page_p_caption_case_number was EA-200[0].Page1[0].P1Caption[0].CaseNumber[0].CaseNumber[0] (0.41 conf)
e_page_list_protected_full_name was EA-200[0].Page1[0].List1[0].ProtectedFullName_ft[0] (0.36 conf)
e_page_list_restrained_full_name was EA-200[0].Page1[0].List2[0].RestrainedFullName_ft[0] (0.35 conf)
e_page_list_li__1 was EA-200[0].Page1[0].List4[0].Li4a[0].T49[0] (0.36 conf)
e_page_list_li_b was EA-200[0].Page1[0].List4[0].Li4b[0].T247[0] (0.36 conf)
e_page_list_li_c was EA-200[0].Page1[0].List4[0].Li4c[0].T61[0] (0.36 conf)
e_page_list_li__2 was EA-200[0].Page1[0].List4[0].Li4d[0].T72[0] (0.36 conf)
e_page_list_li__3 was EA-200[0].Page1[0].List4[0].Li4e[0].T83[0] (0.36 conf)
e_page_list_li_f was EA-200[0].Page1[0].List4[0].Li4f[0].T94[0] (0.36 conf)
e_page_list_li_g was EA-200[0].Page1[0].List4[0].Li4g[0].T319[0] (0.36 conf)
e_page_list_li_h was EA-200[0].Page1[0].List4[0].Li4h[0].T215[0] (0.36 conf)
e_page_list_li__4 was EA-200[0].Page1[0].List4[0].Li4i[0].T83[0] (0.36 conf)
e_page_list_li_j was EA-200[0].Page1[0].List4[0].Li4j[0].T94[0] (0.36 conf)
e_page_list_li_k was EA-200[0].Page1[0].List4[0].Li4k[0].T319[0] (0.36 conf)
e_page_list_li_l was EA-200[0].Page1[0].List4[0].Li4l[0].T215[0] (0.36 conf)
e_page_list_li__5 was EA-200[0].Page1[0].List4[0].Li4m[0].T215[0] (0.36 conf)
e_page_list_li_n__1 was EA-200[0].Page1[0].List4[0].Li4n[0].T107[0] (0.36 conf)
e_page_list_li_n__2 was EA-200[0].Page1[0].List4[0].Li4n[0].T108[0] (0.36 conf)
e_page_list_service_date_dt was EA-200[0].Page1[0].List5[0].Li5a[0].ServiceDate_dt[0] (0.39 conf)
e_page_list_b_personal_time was EA-200[0].Page1[0].List5[0].Li5b[0].PersonalTime_ft[0] (0.36 conf)
e_page_list_li_c_service_ft was EA-200[0].Page1[0].List5[0].Li5c[0].ServiceZip_ft[0] (0.38 conf)
e_page_list_c_service_state was EA-200[0].Page1[0].List5[0].Li5c[0].ServiceState_ft[0] (0.38 conf)
e_page_list_c_street_ft was EA-200[0].Page1[0].List5[0].Li5c[0].ServiceStreet_ft[0] (0.36 conf)
e_page_list_li_c_service_city was EA-200[0].Page1[0].List5[0].Li5c[0].ServiceCity_ft[0] (0.37 conf)
e_page_p_header_case_number was EA-200[0].Page2[0].P2Header[0].CaseNumber[0] (0.40 conf)
e_page_list_server_name_ft__1 was EA-200[0].Page2[0].List6[0].ServerName_ft[0] (0.37 conf)
e_page_list_server_street_ft was EA-200[0].Page2[0].List6[0].ServerStreet_ft[0] (0.38 conf)
e_page_list_server_zip_ft was EA-200[0].Page2[0].List6[0].ServerZip_ft[0] (0.41 conf)
e_page_list_server_city_ft was EA-200[0].Page2[0].List6[0].ServerCity_ft[0] (0.32 conf)
e_page_list_server_ft was EA-200[0].Page2[0].List6[0].ServerTelephone_ft[0] (0.43 conf)
e_page_list_server_number_ft was EA-200[0].Page2[0].List6[0].ServerRegNumber_ft[0] (0.35 conf)
e_page_list_server_reg_cty_ft was EA-200[0].Page2[0].List6[0].ServerRegCty_ft[0] (0.39 conf)
e_page_list_server_state_ft was EA-200[0].Page2[0].List6[0].ServerState_ft[0] (0.36 conf)
e_page_list_c_h_dt was EA-200[0].Page2[0].List6[0].CH200SignatureDate_dt[0] (0.42 conf)
e_page_list_server_name_ft__2 was EA-200[0].Page2[0].List6[0].ServerName_ft[1] (0.37 conf)

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Proof of Personal Service

About This Form:

Identified Data Fields:

Create an Interactive Version of this Form:

The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02