DV-250 Proof of Service by Mail

I (the server) am 18 years of age or over and live in or am employed in
the county where the mailing took place. I mailed a copy of all
documents checked below to the person in :
Not be listed in items or or
of form DV-100, Request for Domestic
Violence Restraining Order.
2
4
I declare under penalty of perjury under the laws of the State of California that the information above is true and
correct.
DV-250, Page 1 of 1
Judicial Council of California, www.courts.ca.gov
Rev. January 1, 2012, Optional Form
Family Code, §§ 6324, 6340-6344
Proof of Service by Mail (CLETS)
(Domestic Violence Prevention)
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California , Cou nt y of
Case Number:
Fill in case number:
DV-250
Proof of Service by Mail
Name of Person Asking for Protection:
Name of Person to Be Restrained:
1
2
Notice to Server
The server must:
Be 18 years of age or over.
Mail a copy of all documents
checked in
to the person in .
3
5
1
4
Server’s Information
Name:
Address:
Zip:
State:City:
Telephone:
(If you are a registered process server):
Registration number:
County of registration:
6
7
DV-112, Waiver of Hearing on Denied Request for Temporary
Restraining Order
a.
FL-150, Income and Expense Declaration
c.
FL-155, Simplified Financial Statement
d.
DV-130, Restraining Order After Hearing (Order of Protection)
e.
f. Other
(specify):
Note: You cannot serve DV-100, DV-105, DV-109, or DV-110 by mail.
5
I placed copies of the documents checked above in a sealed envelope and mailed them as described below:
5
To this address:
Zip:
State:City:
Name of person served:
DV-120, Response to Request for Domestic Violence Restraining Order
b.
a.
b.
Mailed on (date):
c.
Mailed from:
d.
City:
State:
Date:
Type or print server’s name
Server to sign here
3
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