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:

CR-106

Proof of Service —
Criminal Record Clearing

Instructions
l

Before using this form, read Information on How to File a Proof of Service
in Criminal Record Clearing Requests (form CR-106-INFO).
This form is only for providing proof that a document or form was served
(delivered) in a case requesting that a court review a criminal record for
dismissal, vacatur, resentencing, reduction, sealing, or other record clearing
remedy.
The person who serves (delivers) a document or form in this case and
who fills out this form must be at least 18 years old.

This form is for proof of service by mail or personal delivery. For proof of
electronic service, use Proof of Electronic Service (form POS-050/EFS-050).

A completed form should be filed with the court. Keep a copy of this form
for your records.

At the time I served the document or form listed below, I was at least 18
years old.

home

business address is:

Clerk stamps date here when form is filed.

Fill in court name and street address:

Superior Court of California, County of

Fill in criminal case number and case name:

Case Number:

Case Name:
People of the State of California

Street

City

State Zip

I mailed or personally delivered the following document or form (fill in the name of the document you are
serving and complete or ):

Service by mail

(a)

(b)

I put one copy of the document or form in an envelope addressed to each agency (and person, if applicable)
listed below, sealed the envelope, and put first-class postage on the envelope.

The envelope or envelopes were addressed as follows:
(1) Name of agency served (and person, if applicable):

Address on envelope:

(2) Name of agency served (and person, if applicable):

Address on envelope:

Street

City

State Zip

Check here if you mailed copies of the document or form to more people or agencies. Attach a
separate page listing the names and addresses on each additional envelope you mailed. Write
“CR-106, Item 4” on the top of the page.

from (city):

(state):

(c)

I mailed the envelope or envelopes on
by depositing the envelope or envelopes (check one):
(1)
(2)

With the U.S. Postal Service.

(date):

At an office or business mail drop where I know the mail is picked up every day and deposited
with the U.S. Postal Service.

Judicial Council of California, www.courts.ca.gov
New January 1, 2020, Optional Form

Proof of Service —
Criminal Record Clearing

CR-106, Page 1 of 2

Case Number:

Service by Personal Delivery

I personally gave one copy of the document or form to each of the following:

(a)

Name of person and agency served:

(1)

Address where you gave the document or form to this person:

Street

City

State

Zip

(2)

Date when you gave the document or form to this person:

(3)

Time when you gave the document or form to this person:

(b)

Name of person and agency served:

(1)

Address where you gave the document or form to this person:

Street

City

State

Zip

(2)

Date when you gave the document or form to this person:

(3)

Time when you gave the document or form to this person:

Check here if you gave copies of the document or form to more people. Attach a separate page
listing the names of each of these people, the address where you gave each of them the document
or form, and the date and time you gave them the document or form. Write “CR-106, Item 5” on
the top of the page.

I declare under penalty of perjury under California state law that the information above is true and correct.

Date:

Type or print server’s name

Server signs here after serving

New January 1, 2020

Proof of Service —
Criminal Record Clearing

CR-106, Page 2 of 2

Proof of Service - Criminal Record Clearing

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): 44
Average fields per page: 22
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.

r_page_right_caption_court_info was CR-106[0].Page1[0].RightCaption[0].CourtInfo[0] (0.54 conf)
r_page_right_caption_case_number was CR-106[0].Page1[0].RightCaption[0].CaseNumber[0] (0.41 conf)
c_r_page_right_caption_tc_case_name_ft was CR-106[0].Page1[0].RightCaption[0].TCCaseName_ft[0] (0.36 conf)
page_area_appellant_lawyer_address was CR-106[0].Page1[0].#area[2].AppellantLawyerMailingAddress[0] (0.40 conf)
page_area_appellant_lawyer_city was CR-106[0].Page1[0].#area[2].AppellantLawyerMailingCity[0] (0.40 conf)
page_area_appellant_lawyer_state was CR-106[0].Page1[0].#area[2].AppellantLawyerMailingState[0] (0.40 conf)
page_area_appellant_lawyer_mailing was CR-106[0].Page1[0].#area[2].AppellantLawyerMailingZip[0] (0.40 conf)
c_r_page_text_field was CR-106[0].Page1[0].TextField6[0] (0.38 conf)
c_r_page_fill_text__1 was CR-106[0].Page1[0].FillText59[0] (0.39 conf)
c_r_page_srv_mailing_address was CR-106[0].Page1[0].SrvMailingAddress1[0] (0.40 conf)
c_r_page_area_srv_mailing_city__1 was CR-106[0].Page1[0].#area[7].SrvMailingCity1[0] (0.40 conf)
c_r_page_area_srv_mailing_state__1 was CR-106[0].Page1[0].#area[7].SrvMailingState1[0] (0.40 conf)
c_r_page_area_srv_mailing_zip__1 was CR-106[0].Page1[0].#area[7].SrvMailingZip1[0] (0.40 conf)
c_r_page_fill_text__2 was CR-106[0].Page1[0].FillText181[0] (0.39 conf)
c_r_page_area_srv_mailing_address__1 was CR-106[0].Page1[0].#area[8].SrvMailingAddress2[0] (0.40 conf)
c_r_page_area_srv_mailing_city__2 was CR-106[0].Page1[0].#area[8].SrvMailingCity2[0] (0.40 conf)
c_r_page_area_srv_mailing_state__2 was CR-106[0].Page1[0].#area[8].SrvMailingState2[0] (0.40 conf)
c_r_page_area_srv_mailing_zip__2 was CR-106[0].Page1[0].#area[8].SrvMailingZip2[0] (0.40 conf)
c_r_page_check_box__1 was CR-106[0].Page1[0].CheckBox33[0] (0.41 conf)
c_r_page_check_boxhome__1 was CR-106[0].Page1[0].CheckBoxhome1[0] (0.41 conf)
c_r_page_check_boxhome__2 was CR-106[0].Page1[0].CheckBoxhome1[1] (0.41 conf)
c_r_page_check_box_b__1 was CR-106[0].Page1[0].CheckBox28b[0] (0.41 conf)
c_r_page_check_box_b__2 was CR-106[0].Page1[0].CheckBox28b[1] (0.41 conf)
c_r_page_fill_text__3 was CR-106[0].Page1[0].FillText72[0] (0.39 conf)
c_r_page_fill_text__4 was CR-106[0].Page1[0].FillText72[1] (0.39 conf)
c_r_page_fill_text__5 was CR-106[0].Page1[0].FillText72[2] (0.39 conf)
c_r_page_caption_case_number was CR-106[0].Page2[0].PxCaption[0].CaseNumber[0] (0.37 conf)
c_r_page_sig_date was CR-106[0].Page2[0].SigDate[0] (0.28 conf)
c_r_page_sig_name was CR-106[0].Page2[0].SigName[0] (0.28 conf)
c_r_page_fill_text__6 was CR-106[0].Page2[0].FillText39[0] (0.39 conf)
c_r_page_fill_text__7 was CR-106[0].Page2[0].FillText72[0] (0.39 conf)
c_r_page_fill_text__8 was CR-106[0].Page2[0].FillText76[0] (0.39 conf)
c_r_page_area_srv_mailing_address__2 was CR-106[0].Page2[0].#area[1].SrvMailingAddress3[0] (0.40 conf)
c_r_page_area_srv_mailing_city__3 was CR-106[0].Page2[0].#area[1].SrvMailingCity3[0] (0.40 conf)
c_r_page_area_srv_mailing_state__3 was CR-106[0].Page2[0].#area[1].SrvMailingState3[0] (0.40 conf)
c_r_page_area_srv_mailing_zip__3 was CR-106[0].Page2[0].#area[1].SrvMailingZip3[0] (0.40 conf)
c_r_page_fill_text__9 was CR-106[0].Page2[0].FillText39[1] (0.39 conf)
c_r_page_fill_text__10 was CR-106[0].Page2[0].FillText72[1] (0.39 conf)
c_r_page_fill_text__11 was CR-106[0].Page2[0].FillText76[1] (0.39 conf)
c_r_page_area_srv_mailing_address__3 was CR-106[0].Page2[0].#area[2].SrvMailingAddress4[0] (0.40 conf)
c_r_page_area_srv_mailing_city__4 was CR-106[0].Page2[0].#area[2].SrvMailingCity4[0] (0.40 conf)
c_r_page_area_srv_mailing_state__4 was CR-106[0].Page2[0].#area[2].SrvMailingState4[0] (0.40 conf)
c_r_page_area_srv_mailing_zip__4 was CR-106[0].Page2[0].#area[2].SrvMailingZip4[0] (0.40 conf)
c_r_page_check_box__2 was CR-106[0].Page2[0].CheckBox33[0] (0.41 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 - Criminal Record Clearing

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