Madera Superior Court Form Adopted for Optional Use MAD-CRM-0024 (Rev. 3/19/19) PROOF OF SER VICE Page 1 of 1 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, Address, Telephone No.) ATTORNEY FOR (Name): FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF MADERA Madera 226 200 S. G St., Madera, CA 93637 Traffic 226 200 S. G St., Madera, CA 93637 PEOPLE OF THE STATE OF CALIFORNIA VS. Defendant: PROOF OF SERVICE PERSONAL SERVICE SERVICE BY MAIL Case Number: This is a proof of service of a Notice of Petition and Petition for Relief under Penal Code 1210(e)(1) DIRECTIONS: A copy of this Petition must be se rved upon the District Attorney or City Attorney who prosecute d your case. Mail the front and back of each page of this document to the District Attorney or City Attorney who prosecuted the case. When the petition has been served, the original may then b e filed with the court. 1. Person serving. I am over the age of 18 and not a party to this action. Name: Address Telephone: 2. I served a copy of the Notice of Petition and Petition for Relief under Penal Code 1210(e)(1) as follows (check either a or b below): a. Personal Service: I personally delivered the Notice of Petition and Petition for Relief under Penal Code 1210(e)(1) to the person at the address listed below: (1) Name of person served: (2) Address where served: (3) Date served: (4) Time served: b. Service by mail: I deposited the Notice of Petition and Petition for Relief under Penal Code 1210(e)(1) in the United States mail, in a sealed envelope with postage fully prepaid. The envelope was addressed as follows: (1) Name of person served: (2) Address: (3) Date of mailing: (4) Place of mailing (city and state): I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: (Type or print name) (Signature) American LegalNet, Inc. www.FormsWorkFlow.com