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

LIT Lab Home | About The Explorer | Find & Compare | Explore: California Lists

Here is the text we could read:

EA-250

Proof of Service of
Response by Mail

1 Elder or Dependent Adult Seeking Protection

2 Person From Whom Protection Is Sought

Full Name:

Your Full Name:

3 Notice to Server
The server must:
• Be 18 years of age or older.
• Live or be employed in the county
where the mailing took place.
• Not be listed in items , , or

6
2

of form EA-100 or in items , ,
3
or on form EA-300.

• Mail a copy of all documents checked

in .

4 to the person in .1

• Complete and sign this form and give

it to the person in .2

4 PROOF OF SERVICE BY MAIL

Clerk stamps date here when form is filed.

Fill in court name and street address:

Superior Court of California, County of

Court fills in case number when form is filed.

Case Number:

I am 18 years of age or older and not a party to this proceeding. I live or am employed in the county where the
mailing took place. I mailed the person in 1 a copy of all documents checked below:
a.
b.
c.

Form EA-120, Response to Request for Elder or Dependent Adult Abuse Restraining Orders (completed)
Form EA-320, Response to Request for Elder or Dependent Adult Restraining Order Allowing Contact
Other (specify):

I placed copies of the documents above in a sealed envelope and mailed them as described below:
a. Mailed to (name):

b. To this address:

City:
c. On (date)

6 Server s Information

’

Name:
Address:

City:

Date:

Mailed from (city):

State:

Zip:

Telephone:

State:

Zip:

(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

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

www.courts.ca.gov

Proof of Service of Response by Mail
(Elder or Dependent Adult Abuse Prevention)

EA-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): 26
Average fields per page: 26
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.

e_page_county_court_info was EA-250[0].Page1[0].Courtinfo[0].county[0].CourtInfo_ft[0] (0.51 conf)
e_page_case_number_ft was EA-250[0].Page1[0].Courtinfo[0].CaseNumber[0].CaseNumber_ft[0] (0.37 conf)
page_list_item_protected_full_name was EA-250[0].Page1[0].List1[0].item1[0].ProtectedFullName_ft[0] (0.36 conf)
page_list_item_restrained_full_name was EA-250[0].Page1[0].List2[0].item2[0].RestrainedFullName_ft[0] (0.35 conf)
e_page_list_lia_name_caption was EA-250[0].Page1[0].List4[0].Lia[0].FieldName_cb_NoCaption12[0] (0.40 conf)
e_page_list_lib_name_caption was EA-250[0].Page1[0].List4[0].Lib[0].FieldName_cb_NoCaption13[0] (0.40 conf)
e_page_list_lic_form_cb was EA-250[0].Page1[0].List4[0].Lic[0].OtherForm_cb[0] (0.37 conf)
e_page_list_lic_form_ft was EA-250[0].Page1[0].List4[0].Lic[0].OtherForm_ft[0] (0.37 conf)
e_page_list_lia_name_ft was EA-250[0].Page1[0].List5[0].Lia[0].MailedToName_ft[0] (0.43 conf)
e_page_list_lib_street_ft was EA-250[0].Page1[0].List5[0].Lib[0].MailedToStreet_ft[0] (0.42 conf)
e_page_list_lib_city_ft was EA-250[0].Page1[0].List5[0].Lib[0].MailedToCity_ft[0] (0.40 conf)
e_page_list_lib_mailed_state was EA-250[0].Page1[0].List5[0].Lib[0].MailedToState_ft[0] (0.41 conf)
e_page_list_lib_zip_ft was EA-250[0].Page1[0].List5[0].Lib[0].MailedToZip_ft[0] (0.37 conf)
e_page_list_lic_mailed_date_dt was EA-250[0].Page1[0].List5[0].Lic[0].MailedDate_dt[0] (0.43 conf)
e_page_list_mailed_city_ft was EA-250[0].Page1[0].List5[0].Lic[0].MailedFromCity_ft[0] (0.37 conf)
e_page_list_mailed_state_ft was EA-250[0].Page1[0].List5[0].Lic[0].MailedFromState_ft[0] (0.43 conf)
e_page_list_item_server_name was EA-250[0].Page1[0].List6[0].item6[0].ServerName_ft[0] (0.37 conf)
e_page_list_item_server_street was EA-250[0].Page1[0].List6[0].item6[0].ServerStreet_ft[0] (0.38 conf)
e_page_list_item_server_city was EA-250[0].Page1[0].List6[0].item6[0].ServerCity_ft[0] (0.32 conf)
e_page_list_item_server_state was EA-250[0].Page1[0].List6[0].item6[0].ServerState_ft[0] (0.36 conf)
e_page_list_item_server_ft was EA-250[0].Page1[0].List6[0].item6[0].ServerZip_ft[0] (0.41 conf)
e_page_list_item_server_county was EA-250[0].Page1[0].List6[0].item6[0].ServerCounty_ft[0] (0.36 conf)
page_list_item_server_reg_number was EA-250[0].Page1[0].List6[0].item6[0].ServerRegNumber_ft[0] (0.35 conf)
e_page_list_item_date_dt was EA-250[0].Page1[0].List6[0].item6[0].SignatureDate_dt[0] (0.39 conf)
e_page_list_item_text_field was EA-250[0].Page1[0].List6[0].item6[0].TextField2[0] (0.37 conf)
e_page_list_item_server_phone was EA-250[0].Page1[0].List6[0].item6[0].ServerPhone_ft[0] (0.38 conf)

Create an Interactive Version of this Form:

The Weaver creates a draft guided interview from a template form, like the one provided here. You can use the link below to open this form in the Weaver. To learn more, read "Weaving" your form into a draft interview.

Launch Form in Weaver

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