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:

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):

POS-010

FOR COURT USE ONLY

a.

b.

c.

d.

e.

f.

b.

a.

b.

FAX NO. (Optional):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:

TELEPHONE NO.:

E-MAIL ADDRESS (Optional):

      ATTORNEY FOR (Name):

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

        PLAINTIFF/PETITIONER:

DEFENDANT/RESPONDENT:

PROOF OF SERVICE OF SUMMONS

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

(Separate proof of service is required for each party served.)

2.  I served copies of:

summons

complaint

Alternative Dispute Resolution (ADR) package

Civil Case Cover Sheet (served in complex cases only)

cross-complaint

other (specify documents):

3.  a. Party served (specify name of party as shown on documents served):

CASE NUMBER:

Ref. No. or File No.:

Person (other than the party in item 3a) served on behalf of an entity or as an authorized agent (and not a person 
under item 5b on whom substituted service was made) (specify name and relationship to the party named in item 3a):

4.  Address where the party was served:

5.  I served the party (check proper box)

by personal service. I personally delivered the documents listed in item 2 to the party or person authorized to 
receive service of process for the party (1) on (date):

(2) at (time):

by substituted service. On (date):
in the presence of (name and title or relationship to person indicated in item 3):

at (time):

I left the documents listed in item 2 with or

(1)

(2)

(3)

(4)

(5)

(business) a person at least 18 years of age apparently in charge at the office or usual place of business 
of the person to be served. I informed him or her of the general nature of the papers.

(home) a competent member of the household (at least 18 years of age) at the dwelling house or usual 
place of abode of the party. I informed him or her of the general nature of the papers.

(physical address unknown) a person at least 18 years of age apparently in charge at the usual mailing 
address of the person to be served, other than a United States Postal Service post office box. I informed 
him or her of the general nature of the papers.

I thereafter mailed (by first-class, postage prepaid) copies of the documents to the person to be served 
at the place where the copies were left (Code Civ. Proc., § 415.20). I mailed the documents on
(date):

from (city):

a declaration of mailing is attached.

or

I attach a declaration of diligence stating actions taken first to attempt personal service.

Form Adopted for Mandatory Use 
Judicial Council of California 
POS-010  [Rev. January 1, 2007]

PROOF OF SERVICE OF SUMMONS

Page 1 of 2

Code of Civil Procedure, § 417.10

        PLAINTIFF/PETITIONER:

 DEFENDANT/RESPONDENT:

CASE NUMBER:

POS-010

5. c.

by mail and acknowledgment of receipt of service. I mailed the documents listed in item 2 to the party, to the 
address shown in item 4, by first-class mail, postage prepaid,

(1) on (date):

(2) from (city):

(3)

(4)

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

to an address outside California with return receipt requested. (Code Civ. Proc., § 415.40.)

d.

                            (specify means of service and authorizing code section):
by other means

Additional page describing service is attached.

6. The "Notice to the Person Served" (on the summons) was completed as follows:

a.

b.

c.

d.

as an individual defendant.

as the person sued under the fictitious name of (specify):

as occupant.

On behalf of (specify):

under the following Code of Civil Procedure section:

416.10 (corporation)

416.20 (defunct corporation)

415.95 (business organization, form unknown)

416.60 (minor)

416.30 (joint stock company/association)

416.70 (ward or conservatee)

416.40 (association or partnership)

416.90 (authorized person)

416.50 (public entity)

415.46 (occupant)

other:

7. Person who served papers

a. Name:

b. Address:

c. Telephone number:

d. The fee for service was: $

e.

I am:

(1) 

(2) 

(3) 

8.

9.

Date:

not a registered California process server.

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

a registered California process server:

(i) 

owner

employee

independent contractor.

(ii)  Registration No.:

(iii)  County:

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 or marshal and I certify that the foregoing is true and correct.

(NAME OF PERSON WHO SERVED PAPERS/SHERIFF OR MARSHAL)

(SIGNATURE)

POS-010 [Rev. January 1, 2007]

PROOF OF SERVICE OF SUMMONS

Page 2 of 2

Proof of Service of Summons

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): 85
Average fields per page: 42
Reading Level: Grade 9
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.

po_page_p_caption_case_number was POS-010[0].Page1[0].P1Caption[0].CaseNumber1[0].CaseNumber[0] (0.58 conf)
po_page_p_caption_atty_party_info_text_field was POS-010[0].Page1[0].P1Caption[0].AttyPartyInfo[0].TextField1[0] (0.37 conf)
po_page_caption_party_info_phone was POS-010[0].Page1[0].P1Caption[0].AttyPartyInfo[0].Phone[0] (0.40 conf)
po_page_p_caption_atty_party_info_fax was POS-010[0].Page1[0].P1Caption[0].AttyPartyInfo[0].Fax[0] (0.40 conf)
po_page_caption_party_info_email was POS-010[0].Page1[0].P1Caption[0].AttyPartyInfo[0].Email[0] (0.40 conf)
po_page_p_caption_atty_party_info_nmae was POS-010[0].Page1[0].P1Caption[0].AttyPartyInfo[0].Nmae[0] (0.40 conf)
po_page_caption_court_info_county was POS-010[0].Page1[0].P1Caption[0].CourtInfo[0].CrtCounty[0] (0.41 conf)
po_page_caption_court_info_street was POS-010[0].Page1[0].P1Caption[0].CourtInfo[0].CrtStreet[0] (0.41 conf)
po_page_caption_court_info_add was POS-010[0].Page1[0].P1Caption[0].CourtInfo[0].CrtMailingAdd[0] (0.43 conf)
po_page_caption_court_info_city was POS-010[0].Page1[0].P1Caption[0].CourtInfo[0].CrtCityZip[0] (0.35 conf)
po_page_caption_court_info_branch was POS-010[0].Page1[0].P1Caption[0].CourtInfo[0].CrtBranch[0] (0.41 conf)
po_page_caption_title_party_name__1 was POS-010[0].Page1[0].P1Caption[0].TitlePartyName[0].Party1[0] (0.37 conf)
po_page_caption_title_party_name__2 was POS-010[0].Page1[0].P1Caption[0].TitlePartyName[0].Party2[0] (0.37 conf)
po_page_p_case_number_req was POS-010[0].Page1[0].P1Caption[0].CaseNumber2[0].reqNumber[0] (0.39 conf)
po_page_list_lia_check_box__1 was POS-010[0].Page1[0].List2[0].Lia[0].CheckBox1[0] (0.37 conf)
po_page_list_lib_check_box__1 was POS-010[0].Page1[0].List2[0].Lib[0].CheckBox2[0] (0.37 conf)
po_page_list_lic_check_box__1 was POS-010[0].Page1[0].List2[0].Lic[0].CheckBox3[0] (0.37 conf)
po_page_list_lid_check_box__1 was POS-010[0].Page1[0].List2[0].Lid[0].CheckBox4[0] (0.37 conf)
po_page_list_lie_check_box was POS-010[0].Page1[0].List2[0].Lie[0].CheckBox5[0] (0.37 conf)
po_page_list_lif_limited was POS-010[0].Page1[0].List2[0].Lif[0].limited124[0] (0.39 conf)
po_page_list_lif_text_field was POS-010[0].Page1[0].List2[0].Lif[0].TextField66[0] (0.40 conf)
po_page_list_lia_fill_text was POS-010[0].Page1[0].List3[0].Lia[0].FillText1[0] (0.40 conf)
po_page_list_lib_limited was POS-010[0].Page1[0].List3[0].Lib[0].limited2[0] (0.39 conf)
po_page_list_lib_text_field__1 was POS-010[0].Page1[0].List3[0].Lib[0].TextField16[0] (0.40 conf)
po_page_list_item_fill_text was POS-010[0].Page1[0].List4[0].item4[0].FillText18[0] (0.41 conf)
po_page_list_lia_ch was POS-010[0].Page1[0].List5[0].Lia[0].Ch1[0] (0.38 conf)
po_page_list_sub_l_fill__1 was POS-010[0].Page1[0].List5[0].Lia[0].SubLista[0].LI1[0].FillText20[0] (0.39 conf)
po_page_list_sub_l_fill__2 was POS-010[0].Page1[0].List5[0].Lia[0].SubLista[0].LI2[0].FillText21[0] (0.39 conf)
po_page_list_lib_ch was POS-010[0].Page1[0].List5[0].Lib[0].Ch1[0] (0.38 conf)
po_page_list_lib_fill_text__1 was POS-010[0].Page1[0].List5[0].Lib[0].FillText15[0] (0.40 conf)
po_page_list_lib_fill_text__2 was POS-010[0].Page1[0].List5[0].Lib[0].FillText16[0] (0.40 conf)
po_page_list_lib_fill_text__3 was POS-010[0].Page1[0].List5[0].Lib[0].FillText26[0] (0.40 conf)
po_page_list_lib_sub_li_ch__1 was POS-010[0].Page1[0].List5[0].Lib[0].SubListb[0].Li1[0].Ch3[0] (0.35 conf)
po_page_list_lib_sub_li_ch__2 was POS-010[0].Page1[0].List5[0].Lib[0].SubListb[0].Li2[0].Ch4[0] (0.35 conf)
po_page_list_lib_sub_li_ch__3 was POS-010[0].Page1[0].List5[0].Lib[0].SubListb[0].Li3[0].Ch5[0] (0.35 conf)
po_page_list_lib_sub_li_ch__4 was POS-010[0].Page1[0].List5[0].Lib[0].SubListb[0].Li4[0].Ch6[0] (0.35 conf)
po_page_list_lib_fill_text__4 was POS-010[0].Page1[0].List5[0].Lib[0].SubListb[0].Li4[0].FillText28[0] (0.39 conf)
po_page_list_lib_fill_text__5 was POS-010[0].Page1[0].List5[0].Lib[0].SubListb[0].Li4[0].FillText266[0] (0.39 conf)
po_page_list_lib_sub_li_ch__5 was POS-010[0].Page1[0].List5[0].Lib[0].SubListb[0].Li4[0].Ch6[1] (0.35 conf)
po_page_list_lib_sub_li_ch__6 was POS-010[0].Page1[0].List5[0].Lib[0].SubListb[0].Li5[0].Ch7[0] (0.35 conf)
po_page_caption_title_party_name__3 was POS-010[0].Page2[0].PxCaption[0].TitlePartyName[0].Party1[0] (0.39 conf)
po_page_caption_title_party_name__4 was POS-010[0].Page2[0].PxCaption[0].TitlePartyName[0].Party2[0] (0.39 conf)
po_page_px_caption_case_number was POS-010[0].Page2[0].PxCaption[0].CaseNumber[0].CaseNumber[0] (0.38 conf)
po_page_list_lic_ch was POS-010[0].Page2[0].List5[0].Lic[0].Ch1[0] (0.38 conf)
po_page_list_lic_sub_listc_lii_fill_text__1 was POS-010[0].Page2[0].List5[0].Lic[0].SubListc[0].Lii1[0].FillText50[0] (0.39 conf)
po_page_list_lic_sub_listc_lii_fill_text__2 was POS-010[0].Page2[0].List5[0].Lic[0].SubListc[0].Lii2[0].FillText51[0] (0.39 conf)
po_page_list_lic_sub_listc_lii_check_box__1 was POS-010[0].Page2[0].List5[0].Lic[0].SubListc[0].Lii3[0].CheckBox24[0] (0.40 conf)
po_page_list_lic_sub_listc_lii_check_box__2 was POS-010[0].Page2[0].List5[0].Lic[0].SubListc[0].Lii4[0].CheckBox25[0] (0.40 conf)
po_page_list_lid_ch was POS-010[0].Page2[0].List5[0].Lid[0].Ch1[0] (0.38 conf)
po_page_list_lid_fill_text was POS-010[0].Page2[0].List5[0].Lid[0].FillText56[0] (0.40 conf)
po_page_list_lid_check_box__2 was POS-010[0].Page2[0].List5[0].Lid[0].CheckBox31[0] (0.37 conf)
po_page_list_lia_check_box__2 was POS-010[0].Page2[0].List6[0].Lia[0].CheckBox40[0] (0.37 conf)
po_page_list_lib_check_box__2 was POS-010[0].Page2[0].List6[0].Lib[0].CheckBox41[0] (0.37 conf)
po_page_list_lib_text_field__2 was POS-010[0].Page2[0].List6[0].Lib[0].TextField40[0] (0.40 conf)
po_page_list_lic_check_box__2 was POS-010[0].Page2[0].List6[0].Lic[0].CheckBox43[0] (0.37 conf)
po_page_list_lid_check_box__3 was POS-010[0].Page2[0].List6[0].Lid[0].CheckBox45[0] (0.37 conf)
po_page_list_lid_specify was POS-010[0].Page2[0].List6[0].Lid[0].specify[0] (0.39 conf)
po_page_list_lid_check_box__4 was POS-010[0].Page2[0].List6[0].Lid[0].CheckBox55[0] (0.37 conf)
po_page_list_lid_check_box__5 was POS-010[0].Page2[0].List6[0].Lid[0].CheckBox56[0] (0.37 conf)
po_page_list_lid_check_box__6 was POS-010[0].Page2[0].List6[0].Lid[0].CheckBox57[0] (0.37 conf)
po_page_list_lid_check_box__7 was POS-010[0].Page2[0].List6[0].Lid[0].CheckBox58[0] (0.37 conf)
po_page_list_lid_check_box__8 was POS-010[0].Page2[0].List6[0].Lid[0].CheckBox59[0] (0.37 conf)
po_page_list_lid_check_box__9 was POS-010[0].Page2[0].List6[0].Lid[0].CheckBox60[0] (0.37 conf)
po_page_list_lid_check_box__10 was POS-010[0].Page2[0].List6[0].Lid[0].CheckBox61[0] (0.37 conf)
po_page_list_lid_check_box__11 was POS-010[0].Page2[0].List6[0].Lid[0].CheckBox62[0] (0.37 conf)
po_page_list_lid_check_box__12 was POS-010[0].Page2[0].List6[0].Lid[0].CheckBox63[0] (0.37 conf)
po_page_list_lid_check_box__13 was POS-010[0].Page2[0].List6[0].Lid[0].CheckBox64[0] (0.37 conf)
po_page_list_lid_check_box__14 was POS-010[0].Page2[0].List6[0].Lid[0].CheckBox65[0] (0.37 conf)
po_page_list_lid was POS-010[0].Page2[0].List6[0].Lid[0].other[0] (0.39 conf)
po_page_list_lia_field was POS-010[0].Page2[0].List7[0].Lia[0].Field1[0] (0.38 conf)
po_page_list_lib_field was POS-010[0].Page2[0].List7[0].Lib[0].Field2[0] (0.38 conf)
po_page_list_lic_field was POS-010[0].Page2[0].List7[0].Lic[0].Field3[0] (0.38 conf)
po_page_list_lid_decimal_field was POS-010[0].Page2[0].List7[0].Lid[0].DecimalField11[0] (0.36 conf)
po_page_list_lie_sub_li_ch__1 was POS-010[0].Page2[0].List7[0].Lie[0].subListe[0].Li1[0].Ch30[0] (0.37 conf)
po_page_list_lie_sub_li_ch__2 was POS-010[0].Page2[0].List7[0].Lie[0].subListe[0].Li2[0].Ch31[0] (0.37 conf)
po_page_list_lie_sub_li_ch__3 was POS-010[0].Page2[0].List7[0].Lie[0].subListe[0].Li3[0].Ch32[0] (0.37 conf)
po_page_list_lie_sub_li_ch__4 was POS-010[0].Page2[0].List7[0].Lie[0].subListe[0].Li3[0].Ch33[0] (0.37 conf)
po_page_list_lie_sub_li_ch__5 was POS-010[0].Page2[0].List7[0].Lie[0].subListe[0].Li3[0].Ch34[0] (0.37 conf)
po_page_list_lie_sub_li_ch__6 was POS-010[0].Page2[0].List7[0].Lie[0].subListe[0].Li3[0].Ch35[0] (0.37 conf)
po_page_list_lie_sub_liste_li_field__1 was POS-010[0].Page2[0].List7[0].Lie[0].subListe[0].Li3[0].Field12[0] (0.37 conf)
po_page_list_lie_sub_liste_li_field__2 was POS-010[0].Page2[0].List7[0].Lie[0].subListe[0].Li3[0].Field13[0] (0.37 conf)
po_page_list_item_declare__1 was POS-010[0].Page2[0].List8[0].item8[0].declare1[0] (0.35 conf)
po_page_list_item_declare__2 was POS-010[0].Page2[0].List9[0].item9[0].declare1[0] (0.35 conf)
po_page_sign_sig_date was POS-010[0].Page2[0].Sign[0].SigDate[0] (0.36 conf)
po_page_sign_sig_name was POS-010[0].Page2[0].Sign[0].SigName[0] (0.36 conf)

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

Suggested Screen 0:

po_page_p_caption_case_number
po_page_p_caption_atty_party_info_text_field
po_page_caption_party_info_phone
po_page_p_caption_atty_party_info_fax
po_page_caption_party_info_email
po_page_p_caption_atty_party_info_nmae
po_page_caption_court_info_county
po_page_caption_court_info_street
po_page_caption_court_info_add
po_page_caption_court_info_city
po_page_caption_court_info_branch
po_page_caption_title_party_name__1
po_page_caption_title_party_name__2
po_page_p_case_number_req
po_page_list_lia_check_box__1
po_page_list_lib_check_box__1
po_page_list_lic_check_box__1
po_page_list_lid_check_box__1
po_page_list_lie_check_box
po_page_list_lif_limited
po_page_list_lif_text_field
po_page_list_lia_fill_text
po_page_list_lib_limited
po_page_list_lib_text_field__1
po_page_list_item_fill_text
po_page_list_lia_ch
po_page_list_sub_l_fill__1
po_page_list_sub_l_fill__2
po_page_list_lib_ch
po_page_list_lib_fill_text__1
po_page_list_lib_fill_text__2
po_page_list_lib_fill_text__3
po_page_list_lib_sub_li_ch__1
po_page_list_lib_sub_li_ch__2
po_page_list_lib_sub_li_ch__3
po_page_list_lib_sub_li_ch__4
po_page_list_lib_fill_text__4
po_page_list_lib_fill_text__5
po_page_list_lib_sub_li_ch__5
po_page_list_lib_sub_li_ch__6
po_page_caption_title_party_name__3
po_page_caption_title_party_name__4
po_page_px_caption_case_number
po_page_list_lic_ch
po_page_list_lic_sub_listc_lii_fill_text__1
po_page_list_lic_sub_listc_lii_fill_text__2
po_page_list_lic_sub_listc_lii_check_box__1
po_page_list_lic_sub_listc_lii_check_box__2
po_page_list_lid_ch
po_page_list_lid_fill_text
po_page_list_lid_check_box__2
po_page_list_lia_check_box__2
po_page_list_lib_check_box__2
po_page_list_lib_text_field__2
po_page_list_lic_check_box__2
po_page_list_lid_check_box__3
po_page_list_lid_specify
po_page_list_lid_check_box__4
po_page_list_lid_check_box__5
po_page_list_lid_check_box__6
po_page_list_lid_check_box__7
po_page_list_lid_check_box__8
po_page_list_lid_check_box__9
po_page_list_lid_check_box__10
po_page_list_lid_check_box__11
po_page_list_lid_check_box__12
po_page_list_lid_check_box__13
po_page_list_lid_check_box__14
po_page_list_lid
po_page_list_lia_field
po_page_list_lib_field
po_page_list_lic_field
po_page_list_lid_decimal_field
po_page_list_lie_sub_li_ch__1
po_page_list_lie_sub_li_ch__2
po_page_list_lie_sub_li_ch__3
po_page_list_lie_sub_li_ch__4
po_page_list_lie_sub_li_ch__5
po_page_list_lie_sub_li_ch__6
po_page_list_lie_sub_liste_li_field__1
po_page_list_lie_sub_liste_li_field__2
po_page_list_item_declare__1
po_page_list_item_declare__2
po_page_sign_sig_date
po_page_sign_sig_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

About This Form:

Identified Data Fields:

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