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SC-104

Proof of Service

Use this form to serve a person, a business, or a public entity. To learn more
about proof of service, read What Is "Proof of Service"?, Form SC-104B. To
learn more about how to serve a business or entity, read How to Serve a
Business or Public Entity, Form SC-104C.
To serve a business, you must serve one of the following people:
• Owner (for a sole proprietorship)
• Partner (for a partnership) or general partner (for a limited partnership)
• Any officer or general manager (corporation or association)
• Any person authorized for service by the business (corporation, association,

general partnership, limited partnership)

• Any person authorized for service with the Secretary of State (corporation,
association, limited liability company [LLC], limited liability partnership
[LLP], limited partnership)

To serve a public entity, you must first file a claim with that entity, then
serve one of the following people:
• Clerk (of a city or county)
• Chief officer or director (of a public agency)
• Any person authorized for service by the entity
1

If you are serving a person, write the person’s name below:

Clerk stamps date here when form is filed.

Fill in court name and street address:

Superior Court of California, County of

Fill in case number, case name, hearing date,
day, time, and department below:

Case Number:

Case Name:

b. If you are serving a business or entity, write the name of the business
or entity, the person authorized for service, and that person’s job title:

Hearing Date:

Business or Agency Name

Time:

Dept.:

Person Authorized for Service

Job Title

Instructions to Server:
You must be at least 18 years old and not be named in this case. Follow these steps:
• Give a copy of all the documents checked in 3 to the person in 1 , or
• Give a copy of all the documents checked in 3 to one of the following people:
a. A competent adult (at least 18) living with, and at the home of the person in 1 , or

b. An adult (at least 18) who seems to be in charge at the usual workplace of the person in 1 , or

c. An adult (at least 18) who seems to be in charge where the person in 1 usually receives mail
(but not a U.S. Post Office box), if there is no known physical address for the person in 1 .
and mail a copy of the documents left with one of the adults in a, b, or c above to the person in 1 .
THEN
• Complete and sign this form, and

• Give or mail your completed form to the person who asked you to serve these court papers, in time for

the form to be filed with the court at least 5 days before the hearing.

I served the person in 1 a copy of the documents checked below:
a.
b.
c.

SC-100, Plaintiff’s Claim and ORDER to Go to Small Claims Court
SC-120, Defendant’s Claim and ORDER to Go to Small Claims Court
Order for examination (This form must be personally served. Check the form that was served):
Note: The court can issue a civil arrest warrant if the served party does not come to court only if the order for
examination was personally served by a registered process server, sheriff, marshal, or someone appointed by the court.
SC-134, Application and Order to Produce Statement of Assets and to Appear for Examination
(1)
AT-138/EJ-125, Application and Order for Appearance and Examination
(2)
Other

(specify):

Judicial Council of California,
Revised January 1, 2009, Optional Form
Code of Civil Procedure, §§ 116.340, 415.10, 415.20

www.courts.ca.gov

Proof of Service
(Small Claims)

SC-104, Page 1 of 2

Case name:

Fill out “a” or “b” below:
a.

Case Number:

Personal Service: I personally gave copies of the documents checked in 3 to the person in 1
At (time):
On (date):
At this address:

p.m.

a.m.

City:

State:

Zip:

Substituted Service: I personally gave copies of the documents checked in 3 (a, b, or d) to (check one):

A competent adult (at least 18) at the home of, and living with the person in 1 , or
An adult who seems to be in charge where the person in 1 usually works, or
An adult who seems to be in charge where the person in 1 usually receives mail, or has a private
post office box (not a U.S. Post Office box), if there is no known physical address for the person in 1 .

I told that adult, "Please give these court papers to (name of person in 1 )."
I did this on (date):

At (time):

a.m.

p.m.

At this address:

City:

Name or description of the person I gave the papers to:

State:

Zip:

After serving the court papers, I put copies of the documents listed in 3 in an envelope, sealed the envelope,
and put first-class prepaid postage on it. I addressed the envelope to the person in 1 at the address where I
left the copies.
I mailed the envelope on (date):
by leaving it (check one):
a.

At a U.S. Postal Service mail drop, or

from (city, state):

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, or
With someone else I asked to mail the documents to the person in 1 , and I have attached that person s’
completed Form SC-104A.

5 Server s Information

’

Name:

Address:

City:

Fee for service: $

Phone:

State:

Zip:

If you are a registered process server:

County of registration:

Registration number:

I declare under penalty of perjury under California state law that I am at least 18 years old and not named in this
case and that the information above is true and correct.

Date:

Revised January 1, 2009

’
Type or print server s name

Server signs here after serving

Proof of Service
(Small Claims)

SC-104, Page 2 of 2

Proof of Service (Small Claims)

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): 56
Average fields per page: 28
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.

page_right_caption_court_info was SC-104[0].Page1[0].RightCaption[0].CourtInfo[0] (0.53 conf)
c_page_right_case_number was SC-104[0].Page1[0].RightCaption[0].CaseNumber[0] (0.37 conf)
c_page_right_caption_case_name was SC-104[0].Page1[0].RightCaption[0].CaseName[0] (0.37 conf)
c_page_right_caption was SC-104[0].Page1[0].RightCaption[0].Hearindate[0] (0.38 conf)
c_page_right_caption_time was SC-104[0].Page1[0].RightCaption[0].Time[0] (0.38 conf)
c_page_right_caption_dept was SC-104[0].Page1[0].RightCaption[0].Dept[0] (0.38 conf)
c_page_list_lia_full_name was SC-104[0].Page1[0].List1[0].Lia[0].FullName[0] (0.38 conf)
c_page_list_lib_full_name__1 was SC-104[0].Page1[0].List1[0].Lib[0].FullName1[0] (0.38 conf)
c_page_list_lib_full_name__2 was SC-104[0].Page1[0].List1[0].Lib[0].FullName2[0] (0.38 conf)
c_page_list_lia_filed_cb was SC-104[0].Page1[0].List3[0].Lia[0].Filed_cb[0] (0.38 conf)
c_page_list_lib_filing_cb__1 was SC-104[0].Page1[0].List3[0].Lib[0].AmFiling_cb[0] (0.39 conf)
c_page_list_lic_yet_cb was SC-104[0].Page1[0].List3[0].Lic[0].NotYet_cb1[0] (0.36 conf)
c_page_list_lic_sub_listc_li_level__1 was SC-104[0].Page1[0].List3[0].Lic[0].SubListc[0].Li1[0].Level3[0] (0.39 conf)
c_page_list_lic_sub_listc_li_level__2 was SC-104[0].Page1[0].List3[0].Lic[0].SubListc[0].Li2[0].Level3[0] (0.39 conf)
c_page_list_lid_yet_cb was SC-104[0].Page1[0].List3[0].Lid[0].NotYet_cb[0] (0.36 conf)
c_page_list_lid was SC-104[0].Page1[0].List3[0].Lid[0].T1865[0] (0.39 conf)
c_page_px_caption_case_name was SC-104[0].Page2[0].PxCaption[0].CaseName[0] (0.36 conf)
c_page_px_caption_case_number was SC-104[0].Page2[0].PxCaption[0].CaseNumber[0] (0.36 conf)
c_page_list_lia_level was SC-104[0].Page2[0].List4[0].Lia[0].Level31[0] (0.39 conf)
c_page_list_hearing_date_dt was SC-104[0].Page2[0].List4[0].Lia[0].HearingDate_dt1[0] (0.43 conf)
c_page_list_hearing_time_dt was SC-104[0].Page2[0].List4[0].Lia[0].HearingTime_dt1[0] (0.39 conf)
c_page_list_lia_time_def_cb__1 was SC-104[0].Page2[0].List4[0].Lia[0].TimeDef_cb[0] (0.37 conf)
c_page_list_lia_time_def_cb__2 was SC-104[0].Page2[0].List4[0].Lia[0].TimeDef_cb[1] (0.37 conf)
page_list_lia_restrained_street was SC-104[0].Page2[0].List4[0].Lia[0].RestrainedStreet_ft2[0] (0.37 conf)
page_list_lia_restrained_city_ft was SC-104[0].Page2[0].List4[0].Lia[0].RestrainedCity_ft2[0] (0.36 conf)
c_page_list_restrained_state_ft was SC-104[0].Page2[0].List4[0].Lia[0].RestrainedState_ft2[0] (0.40 conf)
c_page_list_lia_restrained_ft was SC-104[0].Page2[0].List4[0].Lia[0].RestrainedZip_ft2[0] (0.34 conf)
c_page_list_lib_level__1 was SC-104[0].Page2[0].List4[0].Lib[0].Level31[0] (0.39 conf)
c_page_list_lib_filing_cb__2 was SC-104[0].Page2[0].List4[0].Lib[0].AmFiling_cb[0] (0.39 conf)
c_page_list_lib_filing_cb__3 was SC-104[0].Page2[0].List4[0].Lib[0].AmFiling_cb[1] (0.39 conf)
c_page_list_lib_filing_cb__4 was SC-104[0].Page2[0].List4[0].Lib[0].AmFiling_cb[2] (0.39 conf)
c_page_list_lib_date_dt__1 was SC-104[0].Page2[0].List4[0].Lib[0].HearingDate_dt3[0] (0.43 conf)
c_page_list_lib_time_dt was SC-104[0].Page2[0].List4[0].Lib[0].HearingTime_dt3[0] (0.39 conf)
c_page_list_lib_time_def_cba__1 was SC-104[0].Page2[0].List4[0].Lib[0].TimeDef_cba[0] (0.37 conf)
c_page_list_lib_time_def_cba__2 was SC-104[0].Page2[0].List4[0].Lib[0].TimeDef_cba[1] (0.37 conf)
page_list_lib_restrained_street was SC-104[0].Page2[0].List4[0].Lib[0].RestrainedStreet_ft3[0] (0.37 conf)
c_page_list_lib_restrained_city was SC-104[0].Page2[0].List4[0].Lib[0].RestrainedCity_ft3[0] (0.36 conf)
c_page_list_lib_restrained_state was SC-104[0].Page2[0].List4[0].Lib[0].RestrainedState_ft3[0] (0.40 conf)
c_page_list_lib_restrained_zip was SC-104[0].Page2[0].List4[0].Lib[0].RestrainedZip_ft3[0] (0.34 conf)
c_page_list_lib_level__2 was SC-104[0].Page2[0].List4[0].Lib[0].Level5_2[0] (0.39 conf)
c_page_list_lib_date_dt__2 was SC-104[0].Page2[0].List4[0].Lib[0].HearingDate_dt4[0] (0.43 conf)
c_page_list_lib_city_dt was SC-104[0].Page2[0].List4[0].Lib[0].HearingCity_dt1[0] (0.40 conf)
c_page_list_lib_threat_cb was SC-104[0].Page2[0].List4[0].Lib[0].SubListb[0].Lia[0].ConductThreat_cb[0] (0.40 conf)
c_page_list_lib_sub_threat was SC-104[0].Page2[0].List4[0].Lib[0].SubListb[0].Lib[0].ConductThreat_cb[0] (0.40 conf)
c_list_lib_sub_threat_cb was SC-104[0].Page2[0].List4[0].Lib[0].SubListb[0].Lic[0].ConductThreat_cb[0] (0.40 conf)
page_list_item_restrained_full_name__1 was SC-104[0].Page2[0].List5[0].item5[0].RestrainedFullName_ft4[0] (0.40 conf)
c_page_list_item_restrained_age__1 was SC-104[0].Page2[0].List5[0].item5[0].RestrainedAge_ft4[0] (0.38 conf)
page_list_item_restrained_street was SC-104[0].Page2[0].List5[0].item5[0].RestrainedStreet_ft4[0] (0.38 conf)
c_page_list_item_restrained_city__1 was SC-104[0].Page2[0].List5[0].item5[0].RestrainedCity_ft4[0] (0.36 conf)
page_list_item_restrained_state was SC-104[0].Page2[0].List5[0].item5[0].RestrainedState_ft[0] (0.40 conf)
c_page_list_item_restrained_zip_ft was SC-104[0].Page2[0].List5[0].item5[0].RestrainedZip_ft[0] (0.31 conf)
c_page_list_item_restrained_city__2 was SC-104[0].Page2[0].List5[0].item5[0].RestrainedCity_ft[0] (0.36 conf)
page_list_item_restrained_full_name__2 was SC-104[0].Page2[0].List5[0].item5[0].RestrainedFullName_ft[0] (0.40 conf)
c_page_list_item_restrained_age__2 was SC-104[0].Page2[0].List5[0].item5[0].RestrainedAge_ft[0] (0.38 conf)
c_page_list_item_sig_date was SC-104[0].Page2[0].List6[0].item6[0].SigDate[0] (0.36 conf)
c_page_list_item_sig_name was SC-104[0].Page2[0].List6[0].item6[0].SigName[0] (0.36 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 (Small Claims)

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