PO S-015 Notice and Acknowledgment of Receipt - Civil
For Court Use Only
CASE NUMBER:
NOTICE AND ACKNOWLEDGMENT OF RECEIPT—CIVIL
TO (insert name of party being served):
The summons and other documents identified below are being served pursuant to section 415.30 of the California Code of Civil
Procedure. Your failure to complete this form and return it within 20 days from the date of mailing shown below may subject you
(or the party on whose behalf you are being served) to liability for the payment of any expenses incurred in serving a summons
on you in any other manner permitted by law.
If you are being served on behalf of a corporation, an unincorporated association (including a partnership), or other entity, this
form must be signed by you in the name of such entity or by a person authorized to receive service of process on behalf of such
entity. In all other cases, this form must be signed by you personally or by a person authorized by you to acknowledge receipt of
summons. If you return this form to the sender, service of a summons is deemed complete on the day you sign the
acknowledgment of receipt below.
(SIGNATURE OF SENDER—MUST NOT BE A PARTY IN THIS CASE)
ACKNOWLEDGMENT OF RECEIPT
This acknowledges receipt of (to be comple ted by sender before mai ling):
1.
A copy of the summons and of the complaint.
2.
(To be complete d by re c ip ient):
(SIGNATURE OF PERSON ACKNOWLEDGING RECEIPT, WITH TITLE IF
ACKNOWLEDGMENT IS MADE ON BEHALF OF ANOTHER PERSON OR ENTITY)
Date this form is signed:
(TYPE OR PRINT YOUR NAME AND NAME OF ENTITY, IF ANY,
ON WHOSE BEHALF THIS FORM IS SIGNED)
Form Adopted for Mandatory Use
Judicial Council of California
POS-015 [Rev. January 1, 2005]
NOTICE AND ACKNOWLEDGMENT OF RECEIPT — CIVIL
POS-015
Code of Civil Procedure,
§§ 415.30, 417.10
www.courtinfo.ca.gov
Draft 1
DRAFT !
01/29/04
FOR COURT USE ONLY
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
FA
X NO. (Optional):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
TELEPHONE NO.:
E
-MAIL ADDRESS (Optional):
ATTORNEY FOR (Name):
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
PLAINTIFF/PETITIONER:
Date of mailing:
Other (specify):
DEFENDANT/RESPONDENT:
(TYPE OR PRINT NAME)
NOTICE
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