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PROCESS SERVICE FORM
THIS IS THE INFORMATION WE WILL BE USING TO CREATE 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):
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YOUR NAME:
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TELEPHONE NUMBER:
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FAX NUMBER:
E-MAIL ADDRESS:
STREET ADDRESS + SUITE / APT. / UNIT #:
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CITY:
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STATE:
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ZIP:
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PLEASE ENTER THE PROCESS SERVICE INFORMATION BELOW
*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 back to you, for you to file ) ( P.O.S. = Proof Of Service )
Service Level (Pick One):
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CT Corporation Special Rate
ROUTINE 2-3 days ($49.50)
RUSH 24hrs ($95.00)
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Los Angeles County Rates
ROUTINE 3-5 days ($65.00)
RUSH 48hrs ($95.00)
PRIORITY 24hrs ($125.00)
File P.O.S. with L.A. County Court ?:
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NO, Mail P.O.S. to me, I will File
YES, File P.O.S. for me + $35
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(Los Angeles County Courts Only)
Notarized P.O.S. / Affidavit Required ?
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NO, I Just need a Standard P.O.S.
YES, I Need A Notarized Affidavit + $15
NOT SURE? ( call us 1-800-799-5142 )
CASE NUMBER:
COURT NAME:
PLAINTIFF (S):
DEFENDANT (S):
HEARING DATE (mm/dd/yyyy):
HEARING TIME:
HEARING DEPARTMENT / ROOM #:
NAME OF INDIVIDUAL / COMPANY TO BE SERVED:
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( 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:
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LIST ANY SPECIAL INSTRUCTION / PHYSICAL DESCRIPTIONS:
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HOW WILL YOU BE SENDING US THE DOCUMENTS TO BE SERVED ? PICK ONE:
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FAX: 1-800-605-5144
EMAIL: psa@psasocal.com
USPS/FED-EX/UPS-Mail Service Docs to: 17216 Saticoy Street #358, Van Nuys, CA. 91406______________________
Process Service Associates
Mailing address > 17216 Saticoy Street #358, Van Nuys, CA. 91406
655 S. Flower Street #326, Los Angeles, CA. 90017
http://www.psasocal.com - http://www.los-angeles-process-server.net - psa@psasocal.com
1-800-799-5142 | fax 1-800-605-5144
PLEASE REMEMBER TO CLICK THE SUBMIT BUTTON (BELOW) WHEN FINISHED
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