POS-050/EFS-050 ATTORNEY OR PARTY WITHOUT ATTORNEY: NAME: FIRM NAME: STREET ADDRESS: CITY: TELEPHONE NO.: E-MAIL ADDRESS: ATTORNEY FOR (name): STATE: FAX NO. : ZIP CODE: STATE BAR NO: FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: CASE NUMBER: PLAINTIFF/PETITIONER: DEFENDANT/RESPONDENT: JUDICIAL OFFICER: PROOF OF ELECTRONIC SERVICE DEPARTMENT: 1. I am at least 18 years old. a. My residence or business address is (specify): b. My electronic service address is (specify): 2. I electronically served the following documents (exact titles): The documents served are listed in an attachment. (Form POS-050(D)/EFS-050(D) may be used for this purpose.) 3. I electronically served the documents listed in 2 as follows: a. Name of person served: On behalf of (name or names of parties represented, if person served is an attorney): b. Electronic service address of person served : c. On (date): The documents listed in item 2 were served electronically on the persons and in the manner described in an attachment. (Form POS-050(P)/EFS-050(P) may be used for this purpose.) Date: I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. (TYPE OR PRINT NAME OF DECLARANT) (SIGNATURE OF DECLARANT) Page 1 of 1 Form Approved for Optional Use Judicial Council of California POS-050/EFS-050 [Rev. February 1, 2017] PROOF OF ELECTRONIC SERVICE (Proof of Service/Electronic Filing and Service) Cal. Rules of Court, rule 2.251 www.courts.ca.gov American LegalNet, Inc. www.FormsWorkFlow.com