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Here is the text we could read:

CH-250

Proof of Service by Mail

1 Name of Person Asking for Protection:

2 Name of Person to Be Restrained:

Clerk stamps date here when form is filed.

3 Notice to Server
The server must:
• Be 18 years of age or over.
• Not be listed in items      ,     ,             
                                                                                        Request for Civil 
Harassment Restraining Orders.

2 or 3 of form CH-100,

1

• Mail a copy of all documents checked in                                       .          

4

to the person in 5 .

Fill in court name and street address:

Superior Court of California, County of

4

I (the server) am 18 years of age or over and live in or am employed 
in the county where the mailing took place. I mailed a copy of all 
documents checked below to the person in      :5

Fill in case number:

Case Number:

CH-120, Response to Request for Civil Harassment Restraining Orders
CH-130, Civil Harassment Restraining Order After Hearing

a.
b.

c.

Other (specify):

5

I placed copies of the documents checked above in a sealed envelope and mailed them as described below:

a. Name of person served:

b. To this address: 

City:

c. Mailed on (date):

d. Mailed from (city):

6 Server s Information

’

Name:
Address:

City:
Telephone:

Date:

State:

Zip:

(state):

State:

Zip:

If you are a registered process server:
County of registration:

Registration number:

7

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

Judicial Council of California,    
Rev. September 1, 2022, Optional Form             
Code of Civil Procedure, § 527.6 

Proof of Service by Mail  (CLETS)  
(Civil Harassment Prevention)

CH-250,  Page 1 of 1

Proof of Service of Response by Mail

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): 1
Fields(s): 27
Average fields per page: 27
Reading Level: Grade 5
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.

c_h_page_right_court_info was CH-250[0].Page1[0].Right_Caption[0].Court[0].CourtInfo_ft[0] (0.52 conf)
c_h_page_right_n_number was CH-250[0].Page1[0].Right_Caption[0].CN[0].CaseNumber_ft[0] (0.39 conf)
c_h_page_list_item__1 was CH-250[0].Page1[0].List1[0].item1[0].T40[0] (0.38 conf)
c_h_page_list_item__2 was CH-250[0].Page1[0].List2[0].item2[0].T145[0] (0.38 conf)
c_h_page_list_lia_tr_cb was CH-250[0].Page1[0].List4[0].Lia[0].TRO_cb[0] (0.33 conf)
c_h_page_list_lib_tr_cb was CH-250[0].Page1[0].List4[0].Lib[0].TRO_cb1[0] (0.33 conf)
c_h_page_list_lic_tr_cb was CH-250[0].Page1[0].List4[0].Lic[0].TRO_cb2[0] (0.33 conf)
c_h_page_list_lic_field__1 was CH-250[0].Page1[0].List4[0].Lic[0].Field1[0] (0.40 conf)
c_h_page_list_lic_field__2 was CH-250[0].Page1[0].List4[0].Lic[0].Field2[0] (0.40 conf)
c_h_page_list_lia_name_ft was CH-250[0].Page1[0].List5[0].Lia[0].MailedToName_ft[0] (0.41 conf)
c_h_page_list_lib_street was CH-250[0].Page1[0].List5[0].Lib[0].MailedToStreet_ft[0] (0.41 conf)
c_h_page_list_lib_city_ft was CH-250[0].Page1[0].List5[0].Lib[0].MailedToCity_ft[0] (0.41 conf)
c_h_page_list_lib_state was CH-250[0].Page1[0].List5[0].Lib[0].MailedToState_ft[0] (0.39 conf)
c_h_page_list_lib_zip_ft was CH-250[0].Page1[0].List5[0].Lib[0].MailedToZip_ft[0] (0.35 conf)
c_h_page_list_lic_mailed_date_dt was CH-250[0].Page1[0].List5[0].Lic[0].MailedDate_dt[0] (0.42 conf)
c_h_page_list_lid__1 was CH-250[0].Page1[0].List5[0].Lid[0].T73[0] (0.40 conf)
c_h_page_list_lid__2 was CH-250[0].Page1[0].List5[0].Lid[0].T78[0] (0.40 conf)
c_h_page_item_server_name was CH-250[0].Page1[0].List6[0].item6[0].ServerName_ft1[0] (0.36 conf)
c_h_page_list_item_server was CH-250[0].Page1[0].List6[0].item6[0].ServerStreet_ft[0] (0.38 conf)
c_h_page_list_item_city was CH-250[0].Page1[0].List6[0].item6[0].ServerCity_ft[0] (0.36 conf)
c_h_page_list_item_state was CH-250[0].Page1[0].List6[0].item6[0].ServerState_ft[0] (0.38 conf)
c_h_page_list_item_server_ft was CH-250[0].Page1[0].List6[0].item6[0].ServerZip_ft[0] (0.30 conf)
c_h_page_list_item_phone was CH-250[0].Page1[0].List6[0].item6[0].ServerPhone_ft[0] (0.33 conf)
c_h_list_item_server_county was CH-250[0].Page1[0].List6[0].item6[0].ServerCounty_ft[0] (0.34 conf)
c_h_page_item_reg_number was CH-250[0].Page1[0].List6[0].item6[0].ServerRegNumber_ft[0] (0.36 conf)
c_h_page_item_date_dt was CH-250[0].Page1[0].List7[0].item7[0].SignatureDate_dt[0] (0.37 conf)
c_h_page_list_item_print was CH-250[0].Page1[0].List7[0].item7[0].Print[0] (0.38 conf)

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

Proof of Service of Response by Mail

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