COURT COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
Index No. Calendar No.
FOR COURT USE ONLY
: Plaintiff(s) : : : :
TELEPHONE NO.: ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME:
Defendant(s) : ......................................................
THE PEOPLE OF THE STATE OF NEW YORK TO
PROOF OF SERVICE BY MAIL OF COMPLETED RESPONSE (Workplace Violence)
Instructions to Defendant: After having the plaintiff served by mail with any of the documents identified in item 2, have the person who mailed the documents complete this Proof of Service by Mail. Give the completed Proof to the clerk for filing. You cannot serve these papers. An unsigned copy of the Proof of Completed Response (Workplace Violence) should be attached to GREETINGS: and served with the document. 1. I am over the age of 18 and not a party to this legal action. I am a resident of or employed in the county where the mailing the Honorable at the Court occurred. My residence or business address is (specify):
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before ,
located at County of in room , on the day , 20 , at o'clock in the noon, and at any recessed 2. I served a copy of the following documents: of a or adjourned date, to testifyPetition of Employer for Injunction Prohibiting ViolencetheThreats of Violence Against Completed Response to and give evidence as a witness in this action on or part of the
b Employee (Workplace Violence) (form WV-110) Other (specify):
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of true failure to comply. 3. I deposited a yourcopy of each of the foregoing documents in the United States mail, in a sealed envelope with postage fully prepaid.
The envelope was addressed and mailed as follows: a. Name of person served: Witness, Honorable b. Court in Address:
, one of the Justices of the , 20
c. Date of mailing:
(Attorney must sign above and type name below)
d. Place of mailing (city and state):
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Office and P.O. Address
(TYPE OR PRINT NAME)
Form Approved for Optional Use Judicial Council of California WV-131 [Rev. January 1, 2005]
Telephone No.: (SIGNATURE) Facsimile No.: E-Mail Address: PROOF OF SERVICE BY MAIL OF COMPLETED RESPONSE Mobile Tel. No.:
Page 1 of 1 Code of Civil Procedure, § 527.8 www.courtinfo.ca.gov
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