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Here is the text we could read:

PARTY WITHOUT ATTORNEY  or  ATTORNEY             STATE BAR NO.:

FOR COURT USE ONLY

FL-115

STATE:

ZIP CODE:

FAX NO.:

SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:

NAME:

FIRM NAME:

STREET ADDRESS:

CITY:

TELEPHONE NO.:

E-MAIL ADDRESS:

ATTORNEY FOR (name):

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PETITIONER:

RESPONDENT:

a.

b.

c.

d.

a.

b.

PROOF OF SERVICE OF SUMMONS

CASE NUMBER:

1. At the time of service I was at least 18 years of age and not a party to this action. I served the respondent with copies of:

Family Law: Petition—Marriage/Domestic Partnership (form             ), Summons (form             ), and blank Response—
Marriage/Domestic Partnership (form              )

–or–

–or–

and

Uniform Parentage: Petition to Determine Parental Relationship (form            ), Summons (form             ), and blank 
Response to Petition to Determine Parental Relationship (form             )

Custody and Support: Petition for Custody and Support of Minor Children (form             ), Summons (form             ), and 
blank Response to Petition for Custody and Support of Minor Children (form             )

(1)

(2)

(3)

(4)

Completed and blank Declaration Under 
Uniform Child Custody Jurisdiction and 
Enforcement Act (UCCJEA) (form             )

Completed and blank Declaration of 
Disclosure (form              )
Completed and blank Schedule of Assets 
and Debts (form              )

Completed and blank Income and 
Expense Declaration (form             )

(5)

(6)

(7)

(8)

Completed and blank Financial Statement 
(Simplified) (form             )

Completed and blank Property 
Declaration (form             )

Request for Order (form              ), and blank 
Responsive Declaration to Request for Order 
(form              )
Other (specify):

2. Address where respondent was served:

3.

I served the respondent by the following means (check proper boxes):

Personal service. I personally delivered the copies to the respondent (Code Civ. Proc., § 415.10)
on (date):
Substituted service. I left the copies with or in the presence of (name):

at (time):

who is (specify title or relationship to respondent):

(1)

(2)

(Business) a person at least 18 years of age who was apparently in charge at the office or usual place of 
business of the respondent. I informed the person of the general nature of the papers.
(Home) a competent member of the household (at least 18 years of age) at the home of the respondent. I 
informed the person of the general nature of the papers.

on (date):

at (time):

I thereafter mailed additional copies (by first class, postage prepaid) to the respondent at the place where the 
copies were left (Code Civ. Proc., § 415.20b) on  (date):

A declaration of diligence is attached, stating the actions taken to first attempt personal service.

Form Approved for Optional Use 
Judicial Council of California 
FL-115  [Rev. January 1, 2021]

PROOF OF SERVICE OF SUMMONS  
(Family Law—Uniform Parentage—Custody and Support)

Page 1 of 2

Code of Civil Procedure, § 417.10 

PETITIONER:

RESPONDENT:

CASE NUMBER:

FL-115

3. c.

Mail and acknowledgment service. I mailed the copies to the respondent, addressed as shown in item 2, by 
first-class mail, postage prepaid, on (date):

from (city):

(1)

(2)

with two copies of the Notice and Acknowledgment of Receipt (form FL-117) and a postage-paid return 
envelope addressed to me. (Attach completed Notice and Acknowledgment of Receipt (form             ).) 
(Code Civ. Proc., § 415.30.)

to an address outside California (by registered or certified mail with return receipt requested). (Attach signed 
return receipt or other evidence of actual delivery to the respondent.) (Code Civ. Proc., §§ 415.40, 417.20.)

d.

Other (specify code section):

Continued on Attachment 3d.

4. Person who served papers

Name:
Address:

Telephone number:

This person is

exempt from registration under Business and Professions Code section 22350(b).

an employee or

an independent contractor

not a registered California process server.
a registered California process server:

(1) Registration no.:
(2) County:
(3) The fee for service was (specify):  $

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

–or–

I am a California sheriff, marshal, or constable, and I certify that the foregoing is true and correct.

a.

b.
c.

5.

6.

Date:

(NAME OF PERSON WHO SERVED PAPERS)

(SIGNATURE OF PERSON WHO SERVED PAPERS)

FL-115  [Rev. January 1, 2021]

PROOF OF SERVICE OF SUMMONS  
(Family Law—Uniform Parentage—Custody and Support)

Page 2 of 2

Proof of Service of Summons (Family Law-Uniform Parentage-Custody and Support)

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): 70
Average fields per page: 35
Reading Level: Grade 8
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.

f_l_page_case_number_ft__1 was FL-115[0].Page1[0].Page1[0].CaseNumber[0].CaseNumber_ft[0] (0.53 conf)
f_l_page_add_info_party_ft was FL-115[0].Page1[0].Page1[0].AddInfo[0].PartyAttyAddInfo_ft[0] (0.35 conf)
f_l_page_add_info_phone_ft__1 was FL-115[0].Page1[0].Page1[0].AddInfo[0].Phone_ft[0] (0.35 conf)
f_l_page_add_info_phone_ft__2 was FL-115[0].Page1[0].Page1[0].AddInfo[0].Phone_ft[1] (0.35 conf)
f_l_page_add_info_phone_ft__3 was FL-115[0].Page1[0].Page1[0].AddInfo[0].Phone_ft[2] (0.35 conf)
f_l_page_add_info_phone_ft__4 was FL-115[0].Page1[0].Page1[0].AddInfo[0].Phone_ft[3] (0.35 conf)
f_l_page_add_info_phone_ft__5 was FL-115[0].Page1[0].Page1[0].AddInfo[0].Phone_ft[4] (0.35 conf)
f_l_page_add_info_phone_ft__6 was FL-115[0].Page1[0].Page1[0].AddInfo[0].Phone_ft[5] (0.35 conf)
f_l_page_add_info_phone_ft__7 was FL-115[0].Page1[0].Page1[0].AddInfo[0].Phone_ft[6] (0.35 conf)
f_l_page_add_info_email_ft was FL-115[0].Page1[0].Page1[0].AddInfo[0].Email_ft[0] (0.41 conf)
f_l_page_add_info_atty_ft was FL-115[0].Page1[0].Page1[0].AddInfo[0].AttyFor_ft[0] (0.37 conf)
f_l_page_add_info_phone_ft__8 was FL-115[0].Page1[0].Page1[0].AddInfo[0].Phone_ft[7] (0.35 conf)
l_page_court_info_county_ft was FL-115[0].Page1[0].Page1[0].CourtInfo[0].CrtCounty_ft[0] (0.37 conf)
f_l_page_court_info_branch was FL-115[0].Page1[0].Page1[0].CourtInfo[0].Branch_ft[0] (0.42 conf)
f_l_page_court_info_city_zip_ft was FL-115[0].Page1[0].Page1[0].CourtInfo[0].CityZip_ft[0] (0.43 conf)
l_page_court_info_street_ft was FL-115[0].Page1[0].Page1[0].CourtInfo[0].Street_ft[0] (0.36 conf)
l_page_court_info_add_ft was FL-115[0].Page1[0].Page1[0].CourtInfo[0].MailingAdd_ft[0] (0.39 conf)
f_l_page_title_party_name_petitioner_tf was FL-115[0].Page1[0].Page1[0].TitlePartyName[0].Petitioner_tf[0] (0.35 conf)
f_l_page_title_party_name_respondent_tf was FL-115[0].Page1[0].Page1[0].TitlePartyName[0].Respondent_tf[0] (0.35 conf)
f_l_page_list_check__1 was FL-115[0].Page1[0].Page1[0].List1[0].LI1[0].Check1[0] (0.38 conf)
f_l_page_list_check__2 was FL-115[0].Page1[0].Page1[0].List1[0].LI2[0].Check1[0] (0.38 conf)
f_l_page_list_check__3 was FL-115[0].Page1[0].Page1[0].List1[0].LI3[0].Check1[0] (0.38 conf)
f_l_page_list_check_box__1 was FL-115[0].Page1[0].Page1[0].List1[0].LI4[0].CheckBox1[0] (0.37 conf)
f_l_page_list_check_box__2 was FL-115[0].Page1[0].Page1[0].List1[0].LI4[0].List1[0].LI1[0].CheckBox1[0] (0.36 conf)
f_l_page_list_check_box__3 was FL-115[0].Page1[0].Page1[0].List1[0].LI4[0].List1[0].LI2[0].CheckBox1[0] (0.36 conf)
f_l_page_list_check_box__4 was FL-115[0].Page1[0].Page1[0].List1[0].LI4[0].List1[0].LI3[0].CheckBox1[0] (0.36 conf)
f_l_page_list_check_box__5 was FL-115[0].Page1[0].Page1[0].List1[0].LI4[0].List1[0].LI4[0].CheckBox1[0] (0.36 conf)
f_l_page_list_check_box__6 was FL-115[0].Page1[0].Page1[0].List1[0].LI4[0].List1[0].LI5[0].CheckBox1[0] (0.36 conf)
f_l_page_list_check_box__7 was FL-115[0].Page1[0].Page1[0].List1[0].LI4[0].List1[0].LI6[0].CheckBox1[0] (0.36 conf)
f_l_page_list_check_box__8 was FL-115[0].Page1[0].Page1[0].List1[0].LI4[0].List1[0].LI7[0].CheckBox1[0] (0.36 conf)
f_l_page_list_check_box__9 was FL-115[0].Page1[0].Page1[0].List1[0].LI4[0].List1[0].LI8[0].CheckBox1[0] (0.36 conf)
f_l_page_list_text_field was FL-115[0].Page1[0].Page1[0].List1[0].LI4[0].List1[0].LI8[0].TextField[0] (0.35 conf)
f_l_page_list_address_served_tf was FL-115[0].Page1[0].Page1[0].List2[0].LI1[0].AddressWhereServed_tf[0] (0.33 conf)
f_l_page_list_check_box__10 was FL-115[0].Page1[0].Page1[0].List3[0].LI1[0].CheckBox1[0] (0.37 conf)
f_list_date_personal_completed was FL-115[0].Page1[0].Page1[0].List3[0].LI1[0].DatePersonalServiceCompleted_dt[0] (0.42 conf)
f_list_time_personal_dt was FL-115[0].Page1[0].Page1[0].List3[0].LI1[0].TimePersonalServiceCompleted_dt[0] (0.37 conf)
f_l_page_list_check_box__11 was FL-115[0].Page1[0].Page1[0].List3[0].LI2[0].CheckBox1[0] (0.37 conf)
f_l_page_list_copies_left_name_tf was FL-115[0].Page1[0].Page1[0].List3[0].LI2[0].CopiesLeftWith_Name_tf[0] (0.37 conf)
f_l_page_list_relationship_respondent_tf was FL-115[0].Page1[0].Page1[0].List3[0].LI2[0].List1[0].RelationshipToRespondent_tf[0] (0.37 conf)
f_l_page_list_check_box__12 was FL-115[0].Page1[0].Page1[0].List3[0].LI2[0].List1[0].LI1[0].CheckBox1[0] (0.36 conf)
f_l_page_list_check_box__13 was FL-115[0].Page1[0].Page1[0].List3[0].LI2[0].List1[0].LI2[0].CheckBox1[0] (0.36 conf)
f_l_list_service_dt was FL-115[0].Page1[0].Page1[0].List3[0].LI2[0].List1[0].LI2[0].DateofSubstitutedService_dt[0] (0.39 conf)
f_l_page_list_timeof_substituted_service_tf was FL-115[0].Page1[0].Page1[0].List3[0].LI2[0].List1[0].LI2[0].TimeofSubstitutedService__tf[0] (0.39 conf)
f_page_list_date_mailed_dt was FL-115[0].Page1[0].Page1[0].List3[0].LI2[0].List1[0].LI2[0].DateCopiesMailed_dt[0] (0.39 conf)
f_l_page_party_respondent_tf was FL-115[0].Page2[0].Page2[0].Party[0].Respondent_tf[0] (0.37 conf)
f_l_page_party_petitioner_tf was FL-115[0].Page2[0].Page2[0].Party[0].Petitioner_tf[0] (0.37 conf)
f_l_page_case_number_ft__2 was FL-115[0].Page2[0].Page2[0].CaseNumber[0].CaseNumber_ft[0] (0.38 conf)
f_l_page_list_check_box__14 was FL-115[0].Page2[0].Page2[0].List3[0].LI3[0].CheckBox1[0] (0.37 conf)
f_page_list_mail_dt was FL-115[0].Page2[0].Page2[0].List3[0].LI3[0].DateofMail_AcknowledgmentService_dt[0] (0.37 conf)
f_l_page_list_city_summons_mailed_tf was FL-115[0].Page2[0].Page2[0].List3[0].LI3[0].CityFromWhichSummonsMailed_tf[0] (0.44 conf)
f_l_page_list_check_box__15 was FL-115[0].Page2[0].Page2[0].List3[0].LI3[0].List1[0].LI2[0].CheckBox2[0] (0.36 conf)
f_l_page_list_checkbox was FL-115[0].Page2[0].Page2[0].List3[0].LI3[0].List1[0].LI1[0].Checkbox1[0] (0.37 conf)
f_l_page_list_check_box__16 was FL-115[0].Page2[0].Page2[0].List3[0].LI4[0].CheckBox1[0] (0.37 conf)
f_l_page_list_specify_code was FL-115[0].Page2[0].Page2[0].List3[0].LI4[0].SpecifyCodeSectio[0] (0.35 conf)
f_l_page_list_item_dattch was FL-115[0].Page2[0].Page2[0].List3[0].LI4[0].item3dattch[0] (0.37 conf)
f_l_page_list_server_tf was FL-115[0].Page2[0].Page2[0].List4[0].NameofServer_tf[0] (0.36 conf)
f_l_page_list_servers_address_tf was FL-115[0].Page2[0].Page2[0].List4[0].ServersAddress_tf[0] (0.38 conf)
f_l_list_servers_number was FL-115[0].Page2[0].Page2[0].List4[0].ServersTelephoneNumber_tf[0] (0.42 conf)
f_l_page_list_check_box__17 was FL-115[0].Page2[0].Page2[0].List4[0].LI1[0].CheckBox1[0] (0.37 conf)
f_l_page_list_check_box__18 was FL-115[0].Page2[0].Page2[0].List4[0].LI2[0].CheckBox1[0] (0.37 conf)
f_l_page_list_check_box__19 was FL-115[0].Page2[0].Page2[0].List4[0].LI3[0].CheckBox1[0] (0.37 conf)
f_l_page_list_check_b__1 was FL-115[0].Page2[0].Page2[0].List4[0].LI3[0].CheckB1[0] (0.37 conf)
f_l_page_list_check_b__2 was FL-115[0].Page2[0].Page2[0].List4[0].LI3[0].CheckB1[1] (0.37 conf)
f_l_page_list_servers_county was FL-115[0].Page2[0].Page2[0].List4[0].LI3[0].List1[0].LI2[0].ServersCounty_tf[0] (0.39 conf)
f_l_page_list_service_tf was FL-115[0].Page2[0].Page2[0].List4[0].LI3[0].List1[0].LI3[0].FeeforService_tf[0] (0.37 conf)
f_l_servers_registration_number was FL-115[0].Page2[0].Page2[0].List4[0].LI3[0].List1[0].LI1[0].ServersRegistrationNumber_tf[0] (0.40 conf)
f_l_page_list_check_box__20 was FL-115[0].Page2[0].Page2[0].List5[0].LI1[0].CheckBox1a[0] (0.37 conf)
f_l_page_list_check_box__21 was FL-115[0].Page2[0].Page2[0].List6[0].LI1[0].CheckBox1a[0] (0.37 conf)
f_l_page_sig_sub_date was FL-115[0].Page2[0].Page2[0].SigSub[0].SigDate[0] (0.38 conf)
f_l_page_sig_sub_name was FL-115[0].Page2[0].Page2[0].SigSub[0].Name[0] (0.36 conf)

We've done our best to group similar variables togther to avoid overwhelming the user.

Suggested Screen 0:

f_l_page_case_number_ft__1
f_l_page_add_info_party_ft
f_l_page_add_info_phone_ft__1
f_l_page_add_info_phone_ft__2
f_l_page_add_info_phone_ft__3
f_l_page_add_info_phone_ft__4
f_l_page_add_info_phone_ft__5
f_l_page_add_info_phone_ft__6
f_l_page_add_info_phone_ft__7
f_l_page_add_info_email_ft
f_l_page_add_info_atty_ft
f_l_page_add_info_phone_ft__8
l_page_court_info_county_ft
f_l_page_court_info_branch
f_l_page_court_info_city_zip_ft
l_page_court_info_street_ft
l_page_court_info_add_ft
f_l_page_title_party_name_petitioner_tf
f_l_page_title_party_name_respondent_tf
f_l_page_list_check__1
f_l_page_list_check__2
f_l_page_list_check__3
f_l_page_list_check_box__1
f_l_page_list_check_box__2
f_l_page_list_check_box__3
f_l_page_list_check_box__4
f_l_page_list_check_box__5
f_l_page_list_check_box__6
f_l_page_list_check_box__7
f_l_page_list_check_box__8
f_l_page_list_check_box__9
f_l_page_list_text_field
f_l_page_list_address_served_tf
f_l_page_list_check_box__10
f_list_date_personal_completed
f_list_time_personal_dt
f_l_page_list_check_box__11
f_l_page_list_copies_left_name_tf
f_l_page_list_relationship_respondent_tf
f_l_page_list_check_box__12
f_l_page_list_check_box__13
f_l_list_service_dt
f_l_page_list_timeof_substituted_service_tf
f_page_list_date_mailed_dt
f_l_page_party_respondent_tf
f_l_page_party_petitioner_tf
f_l_page_case_number_ft__2
f_l_page_list_check_box__14
f_page_list_mail_dt
f_l_page_list_city_summons_mailed_tf
f_l_page_list_check_box__15
f_l_page_list_checkbox
f_l_page_list_check_box__16
f_l_page_list_specify_code
f_l_page_list_item_dattch
f_l_page_list_server_tf
f_l_page_list_servers_address_tf
f_l_list_servers_number
f_l_page_list_check_box__17
f_l_page_list_check_box__18
f_l_page_list_check_box__19
f_l_page_list_check_b__1
f_l_page_list_check_b__2
f_l_page_list_servers_county
f_l_page_list_service_tf
f_l_servers_registration_number
f_l_page_list_check_box__20
f_l_page_list_check_box__21
f_l_page_sig_sub_date
f_l_page_sig_sub_name

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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 Summons (Family Law-Uniform Parentage-Custody and Support)

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