COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. :
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, if attorney, 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:
PLAINTIFF: ........ DEFENDANT: EMPLOYEE:
Defendant(s) : ..............................................
THE PEOPLE OF THE STATE OF NEW YORK TO
PROOF OF SERVICE BY PERSONAL DELIVERY OF COMPLETED RESPONSE (Workplace Violence) PERSONAL SERVICE
County of 1. I am over the age of 18 and not a party day of legal action. , 20 to this in room , on the , at o'clock in the noon, and at any recessed 2. I served a copy of the following documents (check the box before the titlethis action on the you served): or adjourned date, to testify and give evidence as a witness in of each document part of the
a. b. Completed Response to Petition of Employer for Injunction Prohibiting Violence or Threats of Violence Against Employee (Workplace Violence) (form WV-110) Other (specify):
Instructions to Defendant: If the court orders personal service, you must have someone else personally serve the plaintiff. You GREETINGS: cannot serve these papers yourself. After having the plaintiff personally served with any of the documents identified in item 2, have the person who served the documents complete this Proof of Service By excuses being laid aside, you Response of you attend before WE COMMAND YOU, that all business and Personal Delivery of Completed and each (Workplace Violence). Give the completed Proof to the clerk for filing. An unsigned copy of the Proof should be attached to and served with the the Honorable at the Court document. located at
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 your failure to comply.
3. a. Name:
Witness, Honorable Court in County, c. Time:
b. Date: d. Address:
, one of the Justices of the day of , 20
(Attorney must sign above and type name below)
4. My residence or business address is (specify): 5. My telephone number is (specify):
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-132 [Rev. January 1, 2005]
Telephone No.: Facsimile No.: E-Mail Address: PROOF OF SERVICE BY PERSONAL DELIVERY OF COMPLETED RESPONSE Tel. No.: Mobile
(SIGNATURE) Page 1 of 1 Code of Civil Procedure, §§ 527.8 and 527.9 www.courtinfo.ca.gov
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