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:

•

•

•

1

2

4

APP-109

Proof of Service 
(Appellate Division)

Instructions

This form is only for providing proof that a document has been served  
(delivered) in a proceeding in the superior court appellate division. If you 
are serving a document electronically, please use Proof of Electronic 
Service (Appellate Division) (form APP-109E).

The person who serves (delivers) a document in this case and who fills out  
this form:

Must be at least 18 years old

Must NOT be a party in this case

Before you fill out this form, read What Is Proof of Service? (form  
APP-109-INFO) to understand your responsibilities.

At the time I served the documents listed in      , I was at least 18 years old.

4

Clerk stamps date here when form is filed.

You fill in the name and street address of the court 
that issued the decision that is being challenged in 
this case:

Superior Court of California, County of

I am not a party in the case identified in the box on the right side of  
this page.

3

My  

home

business address is:

You fill in the number and name of the trial court 
case in which the decision being challenged was 
issued:

Trial Court Case Number:

Street

City

State Zip

Trial Court Case Name:

I mailed or personally delivered the following document, as indicated  
below (check or fill in the name of the document you are serving and  
check and complete either a or b).

Notice of Appeal/Cross Appeal (Limited Civil Case)

Notice Designating Record on Appeal (Limited Civil Case)

You fill in the appellate division case number (if 
you know it):

Appellate Division Case Number:

Proposed Statement on Appeal (  

Limited Civil Case 

Misdemeanor

Infraction)

Appellant’s Opening Brief

Respondent’s Brief

Appellant’s Reply Brief

Abandonment of Appeal (Limited Civil Case)

Petition for Writ (Misdemeanor, Infraction, or Limited Civil Case)

Other (write in the name of the document):

a.

Service by Mail

(1)

I put one copy of the document identified        in an envelope addressed to each person listed in (2), 
sealed the envelope, and put first-class postage on the envelope.

4

Judicial Council of California, www.courts.ca.gov 
Rev. January 1, 2017, Optional Form

Proof of Service 
(Appellate Division)

APP-109 Page 1 of 2

Appellate Division 

Case Name: 

Appellate Division Case Number:

(2)

The envelope or envelopes were addressed as follows:

(a)

Name of person served:
Address on envelope:

(b)

(Name of person served:

Address on envelope:

Street

Street

City

City

State Zip

State Zip

Check here if you mailed copies of the document identified in       to more people. Attach a  
separate page listing the names and addresses on each additional envelope you mailed. Write  
“APP-109, Item 4a” on the top of the page.

4

(3)

I mailed the envelope or envelopes on                                      from  
(state):
                         by depositing the envelope or envelopes (check one):

(date):

(city):

With the U.S. Postal Service or

(a) 

(b) 

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.

b.

Service by Personal Delivery

(1)

(a)

Name of person served:

I personally gave one copy of the document identified in       to each of the following people:

4

(b)

(Address where you gave the documents to this person:

Street
Date when you gave the documents to this person:

City

(c)

State Zip

(d)

Time when you gave the documents to this person:

(2)

(a)

Name of person served:

(b)

(Address where you gave the documents to this person:

Street
Date when you gave the documents to this person:

City

(c)

State Zip

(d)

Time when you gave the documents to this person:

Check here if you gave copies of the document identified in       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, and the date and time you gave them the document. Write “APP-109, Item 4b” on the 
top  of the page.

4

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

5

Date:

Type or print server’s name

Server signs here after serving

Rev. January 1, 2017

APP-109 Page 2 of 2

Proof of Service 
(Appellate Division)

Proof of Service (Appellate Division)

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): 60
Average fields per page: 30
Reading Level: Grade 6
LIST Grouping(s): CO-07-00-00-00, CO-00-00-00-00.

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.

topmost_subform_page_check_box__1 was topmostSubform[0].Page1[0].CheckBox16[0] (0.60 conf)
topmost_subform_page_check_bx__1 was topmostSubform[0].Page1[0].CheckBx16[0] (0.39 conf)
topmost_subform_page_check_box__2 was topmostSubform[0].Page1[0].CheckBox27[0] (0.39 conf)
topmost_subform_page_check_box__3 was topmostSubform[0].Page1[0].CheckBox32[0] (0.39 conf)
topmost_subform_page_check_box__4 was topmostSubform[0].Page1[0].CheckBox37[0] (0.39 conf)
topmost_subform_page_check_box__5 was topmostSubform[0].Page1[0].CheckBox62[0] (0.39 conf)
topmost_subform_page_check_bx__2 was topmostSubform[0].Page1[0].CheckBx62[0] (0.39 conf)
topmost_subform_page_check_b was topmostSubform[0].Page1[0].CheckB62[0] (0.39 conf)
topmost_subform_page_check_box__6 was topmostSubform[0].Page1[0].CheckBox47[0] (0.39 conf)
topmost_subform_page_check_box__7 was topmostSubform[0].Page1[0].CheckBox42[0] (0.39 conf)
topmost_subform_page_check_box__8 was topmostSubform[0].Page1[0].CheckBox57[0] (0.39 conf)
topmost_subform_page_check_box__9 was topmostSubform[0].Page1[0].CheckBox77[0] (0.39 conf)
topmost_subform_page_check_box__10 was topmostSubform[0].Page1[0].CheckBox82[0] (0.39 conf)
topmost_subform_page_check_box__11 was topmostSubform[0].Page1[0].CheckBox87[0] (0.39 conf)
topmost_subform_page_fill_text__1 was topmostSubform[0].Page1[0].FillText38[0] (0.44 conf)
topmost_subform_page_check_box__12 was topmostSubform[0].Page1[0].CheckBox1[0] (0.39 conf)
appellant_lawyer_address was topmostSubform[0].Page1[0].#area[0].AppellantLawyerMailingAddress[0] (0.40 conf)
area_appellant_lawyer_city was topmostSubform[0].Page1[0].#area[0].AppellantLawyerMailingCity[0] (0.40 conf)
area_appellant_lawyer_state was topmostSubform[0].Page1[0].#area[0].AppellantLawyerMailingState[0] (0.40 conf)
page_area_appellant_lawyer was topmostSubform[0].Page1[0].#area[0].AppellantLawyerMailingZip[0] (0.40 conf)
topmost_subform_page_right_side_header_gp_court_info_ft was topmostSubform[0].Page1[0].RightSideHeader_gp[0].CourtInfo_ft[0] (0.38 conf)
topmost_subform_page_right_side_header_gp_tc_case_number_ft was topmostSubform[0].Page1[0].RightSideHeader_gp[0].TCCaseNumber_ft[0] (0.40 conf)
topmost_page_right_side_name was topmostSubform[0].Page1[0].RightSideHeader_gp[0].TCCaseName_ft[0] (0.46 conf)
right_header_app_div_number was topmostSubform[0].Page1[0].RightSideHeader_gp[0].AppDivCaseNumber_ft[0] (0.33 conf)
topmost_subform_page_fill_text__2 was topmostSubform[0].Page2[0].FillText35[0] (0.44 conf)
topmost_subform_page_fill_text__3 was topmostSubform[0].Page2[0].FillText43[0] (0.44 conf)
topmost_subform_page_fill_text__4 was topmostSubform[0].Page2[0].FillText35[1] (0.44 conf)
topmost_subform_page_fill_text__5 was topmostSubform[0].Page2[0].FillText59[0] (0.44 conf)
topmost_subform_page_fill_text__6 was topmostSubform[0].Page2[0].FillText181[0] (0.44 conf)
topmost_subform_page_check_box__13 was topmostSubform[0].Page2[0].CheckBox218[0] (0.39 conf)
topmost_subform_page_check_box__14 was topmostSubform[0].Page2[0].CheckBox17[0] (0.39 conf)
topmost_subform_page_check_box__15 was topmostSubform[0].Page2[0].CheckBox17[1] (0.39 conf)
topmost_subform_page_check_box__16 was topmostSubform[0].Page2[0].CheckBox28[0] (0.39 conf)
topmost_subform_page_fill_text__7 was topmostSubform[0].Page2[0].FillText39[0] (0.44 conf)
topmost_subform_page_fill_text__8 was topmostSubform[0].Page2[0].FillText72[0] (0.44 conf)
topmost_subform_page_fill_text__9 was topmostSubform[0].Page2[0].FillText76[0] (0.44 conf)
topmost_subform_page_check_box__17 was topmostSubform[0].Page2[0].CheckBox33[0] (0.39 conf)
topmost_subform_page_fill_text__10 was topmostSubform[0].Page2[0].FillText7615[0] (0.44 conf)
topmost_subform_page_fill_text__11 was topmostSubform[0].Page2[0].FillText76139[0] (0.44 conf)
topmost_area_mailing_address__1 was topmostSubform[0].Page2[0].#area[4].SrvMailingAddress1[0] (0.42 conf)
topmost_subform_page_area_srv_mailing_city__1 was topmostSubform[0].Page2[0].#area[4].SrvMailingCity1[0] (0.42 conf)
topmost_subform_page_area_srv_mailing_state__1 was topmostSubform[0].Page2[0].#area[4].SrvMailingState1[0] (0.42 conf)
topmost_subform_page_area_srv_mailing_zip__1 was topmostSubform[0].Page2[0].#area[4].SrvMailingZip1[0] (0.42 conf)
topmost_area_mailing_address__2 was topmostSubform[0].Page2[0].#area[5].SrvMailingAddress2[0] (0.42 conf)
topmost_subform_page_area_srv_mailing_city__2 was topmostSubform[0].Page2[0].#area[5].SrvMailingCity2[0] (0.42 conf)
topmost_subform_page_area_srv_mailing_state__2 was topmostSubform[0].Page2[0].#area[5].SrvMailingState2[0] (0.42 conf)
topmost_subform_page_area_srv_mailing_zip__2 was topmostSubform[0].Page2[0].#area[5].SrvMailingZip2[0] (0.42 conf)
topmost_area_mailing_address__3 was topmostSubform[0].Page2[0].#area[6].SrvMailingAddress3[0] (0.42 conf)
topmost_subform_page_area_srv_mailing_city__3 was topmostSubform[0].Page2[0].#area[6].SrvMailingCity3[0] (0.42 conf)
topmost_subform_page_area_srv_mailing_state__3 was topmostSubform[0].Page2[0].#area[6].SrvMailingState3[0] (0.42 conf)
topmost_subform_page_area_srv_mailing_zip__3 was topmostSubform[0].Page2[0].#area[6].SrvMailingZip3[0] (0.42 conf)
topmost_subform_page_fill_text__12 was topmostSubform[0].Page2[0].FillText39[1] (0.44 conf)
topmost_subform_page_fill_text__13 was topmostSubform[0].Page2[0].FillText72[1] (0.44 conf)
topmost_subform_page_fill_text__14 was topmostSubform[0].Page2[0].FillText76[1] (0.44 conf)
topmost_area_mailing_address__4 was topmostSubform[0].Page2[0].#area[7].SrvMailingAddress4[0] (0.42 conf)
topmost_subform_page_area_srv_mailing_city__4 was topmostSubform[0].Page2[0].#area[7].SrvMailingCity4[0] (0.42 conf)
topmost_subform_page_area_srv_mailing_state__4 was topmostSubform[0].Page2[0].#area[7].SrvMailingState4[0] (0.42 conf)
topmost_subform_page_area_srv_mailing_zip__4 was topmostSubform[0].Page2[0].#area[7].SrvMailingZip4[0] (0.42 conf)
page_header_app_div_name was topmostSubform[0].Page2[0].Header[0].AppDivCaseName_ft[0] (0.36 conf)
page_header_app_div_number was topmostSubform[0].Page2[0].Header[0].AppDivCaseNumber_ft[0] (0.37 conf)

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

Suggested Screen 0:

topmost_subform_page_check_box__1
topmost_subform_page_check_bx__1
topmost_subform_page_check_box__2
topmost_subform_page_check_box__3
topmost_subform_page_check_box__4
topmost_subform_page_check_box__5
topmost_subform_page_check_bx__2
topmost_subform_page_check_b
topmost_subform_page_check_box__6
topmost_subform_page_check_box__7
topmost_subform_page_check_box__8
topmost_subform_page_check_box__9
topmost_subform_page_check_box__10
topmost_subform_page_check_box__11
topmost_subform_page_fill_text__1
topmost_subform_page_check_box__12
appellant_lawyer_address
area_appellant_lawyer_city
area_appellant_lawyer_state
page_area_appellant_lawyer
topmost_subform_page_right_side_header_gp_court_info_ft
topmost_subform_page_right_side_header_gp_tc_case_number_ft
topmost_page_right_side_name
right_header_app_div_number
topmost_subform_page_fill_text__2
topmost_subform_page_fill_text__3
topmost_subform_page_fill_text__4
topmost_subform_page_fill_text__5
topmost_subform_page_fill_text__6
topmost_subform_page_check_box__13
topmost_subform_page_check_box__14
topmost_subform_page_check_box__15
topmost_subform_page_check_box__16
topmost_subform_page_fill_text__7
topmost_subform_page_fill_text__8
topmost_subform_page_fill_text__9
topmost_subform_page_check_box__17
topmost_subform_page_fill_text__10
topmost_subform_page_fill_text__11
topmost_area_mailing_address__1
topmost_subform_page_area_srv_mailing_city__1
topmost_subform_page_area_srv_mailing_state__1
topmost_subform_page_area_srv_mailing_zip__1
topmost_area_mailing_address__2
topmost_subform_page_area_srv_mailing_city__2
topmost_subform_page_area_srv_mailing_state__2
topmost_subform_page_area_srv_mailing_zip__2
topmost_area_mailing_address__3
topmost_subform_page_area_srv_mailing_city__3
topmost_subform_page_area_srv_mailing_state__3
topmost_subform_page_area_srv_mailing_zip__3
topmost_subform_page_fill_text__12
topmost_subform_page_fill_text__13
topmost_subform_page_fill_text__14
topmost_area_mailing_address__4
topmost_subform_page_area_srv_mailing_city__4
topmost_subform_page_area_srv_mailing_state__4
topmost_subform_page_area_srv_mailing_zip__4
page_header_app_div_name
page_header_app_div_number

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 (Appellate Division)

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