service or statement of delivery or mailing is required. Use Part 1 and Part 3 for delivery by mail.
Use Part 2 and Part 3 for personal delivery.
 

Part 1:

Delivery by U.S. Mail: Proof of Service by Mail
I declare that I am over the age of eighteen years and not a party to this action.
My address is ________________________________. On __________________,
(date)
I served the attached _____________________________________ by placing
(name of document)
a true copy enclosed in a sealed envelope with postage fully prepaid in the U.S. mail,
addressed as follows:
________________________________________
________________________________________
________________________________________
 

Part 2:

Personal Delivery:
I declare that on ____________________, I personally delivered the attached
(date)
________________________________ to _______________________________,
(name of document)
(name of recipient)
at _______________________________________.
(location)
 

Part 3:

I declare under penalty of perjury that the foregoing is true and correct and that
this declaration was executed on ____________________________ at
(date)
_Feb 17, 2009.
(city)
_________________________________
_____________________________
(type or print name)