Process Service Form

PSA - PROCESS SERVICE FORM

THIS IS THE INFORMATION WE WILL BE USING TO MAKE YOUR PROOF OF SERVICE / AFFIDAVIT
PLEASE BE ACCURATE
ENTER 1) YOUR CONTACT INFO. 2) PROCESS SERVICE INFO. 3) CLICK - [SUBMIT]

YOUR FIRM / COMPANY NAME (IF ANY):

* YOUR NAME:

* TELEPHONE NUMBER:

FAX NUMBER:

E-MAIL ADDRESS:

* STREET ADDRESS + SUITE / APT. / UNIT #:

* CITY:

* STATE:

* ZIP:

PLEASE ENTER THE PROCESS SERVICE INFORMATION BELOW

*note ( after service is complete, we can file the Proof Of Service for you at any 'Los Angeles County Branch Court' for an add $35,
/or/ we mail the Proof Of Service/Affidavit to you, for you to file ( P.O.S. = Proof Of Service )

* Service Level (Pick One) :

* File P.O.S. with L.A. County Court ?:

* Notarized P.O.S. / Affidavit Required ?:

CASE NUMBER:

COURT NAME:

PLAINTIFF (S):

DEFENDANT (S):

HEARING DATE ( 01/01/2006):

HEARING TIME:

HEARING DEPARTMENT / ROOM # :

* NAME OF INDIVIDUAL / COMPANY TO BE SERVED:

( IF SERVING A COMPANY ) NAME OF AGENT FOR SERVICE:

( HOME ) STREET ADDRESS + SUITE / APT. / UNIT #:

CITY:

STATE:

ZIP:

( BUSINESS ) STREET ADDRESS + SUITE / APT. / UNIT #:

CITY:

STATE:

ZIP:

* LIST ALL DOCUMENTS TO BE SERVED:

LIST ANY SPECIAL INSTRUCTIONS / PHYSICAL DESCRIPTIONS:

* HOW WILL YOU BE SENDING US THE DOCUMENTS TO BE SERVED ? PICK ONE :

Process Service Associates
17216 Saticoy Street #358, Van Nuys, CA. 91406
http://www.psasocal.com / psa@psasocal.com
1-800-799-5142 fax 818-810-6440

PLEASE REMEMBER TO CLICK THE SUBMIT BUTTON WHEN FINISHED

* Indicates Response Required