WV 250 Proof Of Service Response By Mail & WV250

User Manual: & WV250

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WV-250, Page 1 of 1
Proof of Service of Response by Mail
(Workplace Violence Prevention)
WV-250 Proof of Service of
Response by Mail
Judicial Council of California, www.courts.ca.gov
Revised January 1, 2012, Optional Form
Code of Civil Procedure, § 527.8
I am 18 years of age or older and not a party to this proceeding. I am live or am employed in the county where
the mailing took place. I mailed the petitioner or the petitioner’s lawyer a copy of:
a. Form WV-120, Response to Petition for Workplace Violence Restraining Order (completed)
b. Other (specify):
I placed copies of the documents listed above in a sealed envelope and mailed them as described below:
Clerk stamps date here when form is filed.
PROOF OF SERVICE BY MAIL
5
Fill in court name and street address:
Superior Court of California, County of
Case Number:
Fill in case number:
Name:
1Petitioner (Employer)
2Employee in Need of Protection
Name:
3Respondent (Person From Whom Protection Is Sought)
Name:
The server must:
Be 18 years of age or older.
Mail a copy of all documents
checked in below to the petitioner or
the petitioner’s lawyer.
•
•
Notice to Server
•
4
5
Not be the respondent.
Complete and sign this form and give it
to the respondent.
•
Be a resident of or employed in the
county where the mailing took place.
•
6
Server’s Information
Name:
Address:
Zip:
State:City:
Telephone:
(If you are a registered process server):
Registration number:
County of registration:
7
I declare under penalty of perjury under the laws of the State of California that the information above is true and
correct.
Date:
Type or print server’s name Server to sign here
Zip:
State:
City:
Mailed to (name):
On (date):Mailed from: City: State:
To this address:
a.
c.
b.
To keep other people from
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.
Save This Form
Print This Form
Clear This Form

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