This form is a proof of service for the Court of Appeal. The person who filled out the form enclosed a copy of the document identified above in an envelope or envelopes and mailed it to the person served. The envelope was addressed as follows:
Person served:
Name:
Address:
(city and state):
The document was mailed from the person's residence or business. The person who filled out the form deposited the sealed envelope(s) with the U.S. Postal Service, with the postage fully prepaid.
