¥
`
`FAX NO. (Optional):
`
`SC-104
`
`
`
` FOR COURT USE ONLY
`
`
`
`| DEFENDANT(Name,street address and mailing address):
`PARTY x] PLAINTIFF
`KONG DON LEE
`CLAIMS.Fsheds.D
`— SMALL
`
`Kong Lee <donaldkdlee1@hotmail.com>
`
`
`
`267 36th Avenue
`
`
`
`San Mateo, CA 94403
`
`TELEPHONE NO.: 650-288-2180
`E-MAIL ADDRESS(Optionaj):
`
`
`
`SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN FRANCISCO
`STREET ADDRESS: 400 McAllister Street, Room 103
`
`
`MAILING ADDRESS: 400 McAllister Street, Room 103
`CITY AND ZIP CODE: San Francisco 94102
`
`BRANCH NAME: Civic Center Courthouse
`
`
`
`CASE NUMBER:
`
`
`
`PLAINTIFF (name each): KONG DON LEE
`
`
`CSM-21-864918
`
`
` DEFENDANT(name each): JUN MENG LI
`
`PROOFOF SERVICE
`(Small Claims)
`(Before youfill out this form, read Information of the Small Claims Plaintiff (form SC-150) for instructions. A separate proofof serviceis
`required for each party served.)
`
`1. At the time of service | was at least 18 years of age and not a party to this action.
`
`2.
`
`| served copies of the following:
`PLAINTIFF'S CLAIM AND ORDER TO GO GO SMALL CLAIMS COURT
`
`The court may issue a warrantfor failure to appearonly if the order for examination is personally served by a registered process server, sheriff,
`marshal, or person specifically appointed by the court - Code Civ. Proc. § 708.170.)
`
`3. a. Party served (specify name ofparty as shown on documents served):
`Jun Meng Li
`b. Person actually served:
`party namedin item 3a):
`
`(1)
`
`LX] partyin item 3a
`
`(2)
`
`[__] other(specify name andrelationship to the person servedto the
`
`4. Address where service was made: 300 PopeStreet, San Francisco, CA 94112
`
`| served the party (checkall that apply):
`a. x] by personalservice. | personally delivered the documentslisted in item 2 to the party or person authorized to receive
`service of processfor the party on (date): 12/06/2021 at (time): 3:07 PM
`
`b. Cc]
`
`at (time):
`by substituted service. On (date):
`or d with or in the presence of the personindicated in item 3b(2):
`
`I left the documentslisted in item 2a, b,
`,
`
`(1) CL]
`
`(business orpublic entity) a person at least 18 years of age apparently in charge of theoffice or usual place
`of business of the person to be served. | informed him or herof the general nature of the papers.
`
`(2) CL]
`
`(home) a competent memberof the household (at least 18 years of age) at the dwelling house or usual place
`of abode ofthe party. | informed him or her of the general nature of the papers.
`
`(3) CL]
`
`(physical address unknown)a personat least 18 years of age apparently in charge at the usual mailing
`addressof the personto be served, other than a United States Postal Service postoffice box. | informed him
`,
`or herof the general nature of the papers.
`(4) | | thereafter mailed (by first-class, postage prepaid) copies of the documents to the person to be servedat the
`place where the copies wereleft (Code Civ. Proc., § 415.20). | mailed the documents on (date):
`from (city):
`(5) | | attach a declaration of diligence stating actions takenfirst to attempt personal service.
`
`i
`SC-10.
`1s Rew sanuany
`
`1, 2009
`
`20"
`
`REF: REF-2245326
`
`PROOF OF SERVICE
`(Small Claims)
`
`Page 1 of 2
`Codeof Civil Procedure.
`§§ 116.340, 415.10, 418.20
`Tracking #: 0080201216
`
`IAAT
`
`

`

`%
`
`PLAINTIFF/PETITIONER: KONG DON LEE
`DEFENDANT/RESPONDENT:
`JUN MENGLI
`
`CASE NUMBER:
`
`CSM-21-864918
`
`OR
`5. b.
`
`(5) __]
`
`form SC-104A,Attachmentto Form SC-104: Proofof Mailing After Substituted Service (Small Claims),is attached.
`(If you did not mail copies of the documents in item 2, have the person who mailed them complete form SC-104A
`andattach.)
`
`6. Person who served papers
`
`Gustavo Moreira Machado Lino
`a. Name:
`P.O. BOX 1848, Pacifica, CA 94044
`b. Address:
`415-488-5759
`c. Telephone number:
`d. The fee for service was: $ 85.00
`e.
`lam:
`
`not a registered California process server.
`(1) L_]
`(2) | exemptfrom registration under Business and Professions Code section 22350(b).
`(3) x] registered California process server:
`(i) | owner C_] employee CX] independent contractor.
`(ii) EX] Registration No.: 2020-0001407
`(iti) cx) County:
`San Francisco
`
`ABCLegalServices, LLC
`For:
`Registration #: 6779
`County:
`Los Angeles
`
`®
`2
`
`7. cx]
`
`I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
`or
`
`8.
`
`[__]
`
`lama California sheriff or marshal and| certify that the foregoing is true and correct.
`
`Date:
`
`12/06/2021
`
`Gus quo Liye
`
`Gustavo Moreira Machado Lino
`(NAME OF PERSON WHO SERVED PAPERS/SHERIFF OR MARSHAL)
`
`(SIGNATURE)
`
`f
`
`
`SC-104 [Rev. January 1, 2009]
`PROOF OF SERVICE
`Page 2 of 2
`-
`(Small Claims)
`Tracking #: 0080201216
`
`REFREr-eztsig
`
`acc
`
`
`