CH 250 Proof Of Service Response By Mail Ch250

User Manual: CH-250

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CH-250, Page 1 of 1
Proof of Service of Response by Mail
(Civil Harassment Prevention)
CH-250 Proof of Service of Response by
Mail
Judicial Council of California, www.courts.ca.gov
Rev. January 1, 2012, Optional Form
Code of Civil Procedure, § 527.6
The server must:
Be 18 years of age or older.
Mail a copy of all documents
checked in to the person in .
Complete and sign this form and give
it to the person in .
•
•
Notice to Server
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 a copy of all documents checked below:
a. Form CH-120, Response to Request for Civil Harassment Restraining Orders
I declare under penalty of perjury under the laws of the State of California that the information above is true and
correct.
b. Other (specify):
Clerk stamps date here when form is filed.
•
PROOF OF SERVICE BY MAIL
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4
14
2
1
Fill in court name and street address:
Superior Court of California, County of
Case Number:
Fill in case number:
Server’s Information
Name:
Address:
Zip:
State:City:
Telephone:
(If you are a registered process server):
Registration number:
County of registration:
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Date:
Type or print server’s name Server to sign here
Live or be employed in the county
where the mailing took place.
Name:
1
2Person From Whom Protection Is Sought
Your Name:
Person Seeking Protection
•
I placed copies of the documents checked above in a sealed envelope and mailed them as described below:
5
Zip:
State:
City:
Mailed to (name):
On (date):Mailed from: City: State:
Not be listed in items or of Form
CH-100.1
To this address:
a.
c.
b.
•
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seeing what you entered on
your form, please press the
Clear This Form button at the
end of the form when finished.
For your protection and privacy, please press the Clear This Form
button after you have printed the form.
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