ATTORNEY OR PARTY WITHOUT ATTORNEY (NAME AND ADDRESS) TELEPHONE NO. FOR COURT USE ONLY ATTORNEY FOR (NAME): Insert name of court, judicial district or branch court, if any, and post office and street address. SUPERIOR COURT of CALIFORNIA, COUNTY of SANTA CLARA 191 NORTH FlRST STREET SAN JOSE, CA 95113 Title of Case: CASE NUMBER: VERIFICATION (446, 2015.5 C.C.P.) STATE OF CALIFORNIA COUNTY OF ) SS. ) I am the in the above entitled action; I have read the foregoing and know the contents thereof; and I certify that the same is true of my own knowledge, except as to those matters which are therein stated upon my information or belief, and as to those matters I believe it to be true. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on (date) at (place) Signature , California. PROOF OF SERVICE BY MAIL (1013a, 2015.5 C.C.P.) STATE OF CALIFORNIA COUNTY OF ) SS. I am a citizen of the United States and a resident of the county aforesaid; I am over the age of eighteen years and not a party of the within entitled action; my business address is: On 20 I served the within on the in said action, by placing a true copy thereof enclosed in a sealed envelope with postage thereon fully prepaid, in the United States mail at addressed as follows: I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on (date) at (place) Signature Rev. January 1, 1985 , California. VERIFICATION PROOF OF SERVICE BY MAIL 2000 (C) American LegalNet, Inc.